What's required for a diagnosis of CKD?

[GoodHealthIsAJourney]

Four months ago, I went to the doctor for the first time in about 15 years. Had routine labs done (all normal, eGFR 93), except I had microalbuminuria. I immediately made an appointment with a nephrologist. I’m sure he’s not used to seeing people with my numbers, so he wasn’t terribly concerned, but wants to see me back in 8 months for a follow up. Neither my PCP or nephrologist have diagnosed me with CKD (and I was too nervous at the time to ask), but everything I read says I have it. When you have microalbuminuria, is that an automatic CKD diagnosis, or do you need to base it on 3 tests over a period of time?

[orangecity41 NKF Ambassador]

Here is a link from National Kidney Foundation on eGFR and calculation. This might help in understanding eGFR. kidney.org/atoz/content/gfr. Microalbuminuria is something to discuss with your Doctor as maybe other causes.

[userotc in reply to orangecity41]

Mum is steadily moving in the right direction as far as the y-axis (eGFR) of the graph you linked is concerned. But not as far as urine albumin is concerned with her urine ACR fast increasing up to latest ~9mg/mmol/l and urine microalbumin likewise to 43 ug/ml.

If that continues, could the eGFR be affected? Her nephro appears unconcerned but we are.

[orangecity41 NKF Ambassador in reply to userotc]

I am sorry unable to answer that.

[userotc in reply to orangecity41]

No worries. I don't think her nephro knows either but he wouldn't be as honest as you!

[Bet117 NKF Ambassador in reply to userotc]

I agree with Orange City as we are not physicians, just here to support, discuss and share experiences.

Your Nephrologist or GP are the experts and is the best resource.

I would ask in Mum's specific case.

[userotc in reply to Bet117]

As I indicated, her nephro appears unconcerned after discussing it with him on at least 2 separate occasions. So, as the "expert", I guess there's no need for concern!

[Marvin8]

Unless you're very young, your eGFR indicates you're probably normal and that your efforts would probably be better spent inquiring why the albuminuria rather than worrying about ckd. As orangecity said, there may be several causes.

[Okiksaints1955]

CKD, to be diagnosed properly, is a handful of tests over a period of time. It is not one type of test in a single snashot or time. The results are baseline on current condition (also tests over a period of time).

Your Nephrologist is the expert and is the best resource at your present stage.

Incomplete information or data leads to improper diagnosis and is dangerous.

Good luck, take care and be well.

[Bet117 NKF Ambassador in reply to Okiksaints1955]

Agreed! Well put, Okiksaints! Thank you!

[Tolmezzo]

The only point of concern is that albuminuria "could be" early sign of kidney damage. Even when blood test are still ok. If you are not diabetic, or having hypertension, or other genetic issues I would stay more than relaxed but get tested every 6 month.

[Bet117 NKF Ambassador]

Hi Good Health Is A Journey,

Honestly, many factors could influence albuminuria.

I would speak to your doctor as to what his/ her thoughts are in your case and negotiate a monitor of your labs and go from there.

Below is an article on albuminuria from the NKF , but remember that each person is different.

kidney.org/atoz/content/alb...

Stay Positive!

B...

[RoxanneKidney]

I have a protein thing going on too. Yes, pretty much automatic if it happens 3 consectutive times. Was this a 24 hr. urine sample?

[GoodHealthIsAJourney in reply to RoxanneKidney]

No - it was a single test. Two since then have been negative. Getting another next month. I believe it was my blood pressure, which is now well under control. How about you?

[RoxanneKidney]

Like you, I never had any other issues either. I am on bp med even though my own bp is low...now it is REALLY LOW. But did bring my total protein down from 560 to 115 in 24 hrs urine sample. Im on lisinopril.

[GoodHealthIsAJourney in reply to RoxanneKidney]

I'm on lisinopril and hydrochlorothiazide. My first albumin/creatinine ratio was 211, and my last test was 8.5. Yes, I've changed my diet drastically (I used to consume huge amounts of protein), but I think the real change was my bp. I'd like to get a 24hr test too!

[RoxanneKidney]

Mine albumin/creatinine ratio was 460. that sucked. When they redid the 24 hr urine, they did not redo the ACR, but the creatiniine in the blood came down too. I had been lifting weights for approx 6 months, at least 4 days a week and running on a treadmill for 30 min those days too. But the protein had been an issue before, they just never did anything about it. Then my dyostolic pressure started to come up a couple years ago when I was taking care of my mom who had terminal cancer, so I just figured it was stress. Anyway, still pissed that no one sat me down years ago and told me what that GFR number actually meant. SMH. I sure would have stopped running marathons and lifting heavy. SMH. Anyway. Now my job is requireing the COVID shot. I'm thinking of quiting have you had the shot?

[GoodHealthIsAJourney in reply to RoxanneKidney]

I keep learning over and over that we have to be own health advocates! Fortunately, I've been requesting my lab reports for years, so I could always compare numbers and look for trends. But honestly, that's what we're paying an obscene amount of money to our health care professionals for! Rant over.

I spent a lot of time and reading on both sides before finally deciding to get the vaccine. But I understand it's a personal decision, and I don't judge anyone for making the decision that is right for them. So many people on both sides are angry with anyone who doesn't agree with them. Life is too short for me to waste time on that. I had a set of blood tests before the vaccine, and another set about 3 months after. Thankfully, it hasn't impacted my bloodwork. I hope you can make the right decision for you! ❤️

[RoxanneKidney]

I had a Cystatin C blood test recently that is supposed to be a more reliable marker than creatinine. Esp regarding GFRs over 60.