I need some advice please after AKI (due to... - Kidney Disease

Kidney Disease

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I need some advice please after AKI (due to BP meds) a few months ago

nellie237 profile image
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Hi, I'm in the UK and being monitored by my GP, who I think is well intentioned but not particularly well informed. At the moment my eGFR has risen to 73, and I am being regularly tested for:-

Serum Sodium, Serum Potassium, Serum Urea, Creatinine, and FBC & Ferritin.

My question is Are there any other tests that I should be asking for, because I'm pretty sure my GP won't be aware?

Thank you

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nellie237
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The usual tests run in the USA for a determination of CKD are eGFR, serumCreatinine, B.U.N. (Blood Urea Nitrogen), and ACR (Albumin Creatinine Ratio). The tests are repeated for a couple or three times over a two-three month period of time. An extensive medical history is also taken. There are other tests as well but those are the primary ones.

nellie237 profile image
nellie237 in reply to

Thank you,

I think our equivalent of B.U.N. must be Serum Urea. I need to ask for the ACR. My GP has my history as I've been with the same practice for about 30yrs.

It's more the peripheral testing that I'm interested in learning about. If I knew what they were I'd be able to research and work out which tests might be relevant to me given my history.

Skeptix profile image
Skeptix in reply to nellie237

It probably depends on what approach your taking and how in depth you want to be. I'm going through Lee Hull's book again (very low protein diet and hitting any factor related to kidney health), noting things that could be tested.

Half way through the book and here's the list which attend to the factors being considered.

Serum urea

Serum creatinine

BP / Pulse pressure

Calcium

Magnesium

Potassium

Phospherous

Vitamin D

Total CO2 plasma

Serum bicarbonate

Serum Fetuin A

Serum Albumim

Proteinuria

IL18alpha vs IL18BPbeta

C-reactive protein

Ph

nellie237 profile image
nellie237 in reply to Skeptix

That is very useful, thank you Skeptix 😊

Skeptix profile image
Skeptix

Useful only to a point: you have to really immerse yourself to understand what each or these.things signifies and whether there is something to be done about them. I'm only starting the immersion!

I came across another paper on bone health and CKD and parathyroid hormone (intact) was an indicator of where things are/are headed bone wise. The list could be endless!

It is likely/ the hope though, that e.g. diet would sort out many of these factors at the same time rather than having to intervene on a metric by metric basis.

It's nothing if not interesting!

nellie237 profile image
nellie237 in reply to Skeptix

There is no doubt that we need to do our research, and we are all unique, and I find it interesting too. I have an underactive thyroid for years, for which I took my meds every day and basically ignored. Coeliac dx 6 months ago, followed by AKI 3 months ago. I also had a heart attack in 2012, and obviously high bp. Bizarrely, I look quite fit and healthy.

Bone health has been quite high on my 'list' since the coeliac dx. I'm taking 2,000iu Vit D, with 25mcg K2-MK7, and a lot of epsom salts in my bath. I might have to see if I can stomach sardines on gluten free toast........really not appetising 🤪 but maybe a small price to pay. I had a DEXA scan, which showed Osteopenia

I've come across quite a lot of info on low levels of the active thyroid hormone T3 (triiodothyronine) being common in ckd, which I've probably noted because I'm hypothyroid, but it is a very important hormone.

"T3 helps maintain muscle control, brain function and development, heart and digestive functions. It also plays a role in the body's metabolic rate and the maintenance of bone health."

The biggest hit to my system from the AKI has been Iron depletion. I was low but not anaemic at Coeliac diagnosis, spent 3 months religiously taking Iron tablets on an already sore gut to get to excellent levels. Six weeks after AKI I was anaemic and back on the Iron tablets.

I suspected that my kidneys stopped producing erythropoietin during the AKI, and asked my GP if we could test in the hope that levels would now be high/normal. His response was "EPO is synthetic". I'm guessing that he'd read about competing cyclists using EPO (they must be nuts). He realised his mistake, but was unable to order the test; he was able to order a reticulocyte count which came back at 66% through range which I was happy to know. I'm really hoping that I can stop the high Iron supplements soon.

Skeptix profile image
Skeptix

Bloody Hell.. and I thought I had trouble. Is there hope for this AKI repairing itself or are you lumbered with it.

What I wouldn't give for a sardine BTW. I bought 70 quids worth of cod n' chips yesterday for the wider clan and couldn't help ripping a chunk off. An 'umbrella sardine on toast. Ah lovely that'd be...

nellie237 profile image
nellie237

Yes it is repairing and my eGFR at last test was up to 73 (testing again this week), but statistics say that I am very likely to go downhill within the next year or so, hence my research and monitoring now.

Ah, cod n' chips would be nice. I dream of baker's bread.

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