Sudden drop eGFR

[lakeheadguy]

Last lab eGFR 49 Nov16, 58 on 28 Oct, 51 Jul 51, 56 Apr 21

Blood creatinine high

Urine creatinine 1.8 on 28 Oct, 2.2 on 26 Jul, 1.9 on 31 Mar, 3.5 26 Feb,

10.0 20 Jun 2017

Creatinine in urine is getting lower while blood creatinine is rising.

Changed to low protein diet 3 months ago, 50-70 mg / daily,

walk daily for exercise

What else can I do?

[Skeptix]

What's you body weight and what's you urea/BUN (include range applicable, I.e. are you out if range on urea)

[lakeheadguy in reply to Skeptix]

Body weight 180 lbs, urea 6.5 mmol/L range 2.7-8.4

[RoxanneKidney]

Eat plant protein instead of animal protein which is high in creatinine.

[Skeptix]

Thanks.

Your urea is in range so the most obvious (to me) benefit of low protein diet doesn't apply to you (less protein in = less urea waste = urea comes into range. But you're not out of range)

That said, the science indicating the preserving effect of a low / very low protein diet doesn't say by what means that occurs. It's just "low/very low protein diets are beneficial" and that's that.

Moreovee, the beneficial effects of a very low (supplemented with keto acid analogues) exceed the benefits of a plain low protein diet, in the literature. These diets are applicable from stage 3a / non diabetic.

So you could consider that. At 180Ibs a very low doetsry protein diet of 0.43g/kg would give you a daily budget of 35grs. Quite a deal less than your 50-70gr (=60gr). You'd supplement the other 0.17g/kg with keto acid analogues to get to 0.6gr/kg total.

You'd have to go plant based: meat (and hi protein plant) just doesn't work with low/very low protein diets as its too protein rich. You'd blow your daily protein budget in a flash and not be able to get nutrients/calories on board. I've to eat cardboard bread, for example. It's about 1.2gr protein per slice compared to the nearly 6gr per slice of shop bought brown, wholegrain bread. I can't blow 12gr of a 28gr daily protein budget on a couple of slices of nice toast with my breakfast!

You consider that route yet? You'd ideally need an up to speed renal dietician to help guide guide check your ongoing bloods and they are hard to get, unless you pay.

[lakeheadguy in reply to Skeptix]

In Canada need referral for renal dietician. Would like to research plan based protein diets. Any good websites?

[Skeptix in reply to lakeheadguy]

About the best place to start is Lee Hull's book, Stopping Kidney Disease. It covers a multitude of factors involved in disease progression and how it is that diet can address many of them. It's a great first-base to go to and there's tonnes of recent papers listed if you want to dig further.

Once you have the principles the food kind of works itself out: you find receipes that work, cut down the processed side of things, etc. Me? I mass produce meals and free them to cut down the effort and keep myself on track

I haven't used it much but plant based kidneys is a Facebook group focusing on such diets

Given the guidelines are mainstream and recent, you should be able to get a referral. The only issue is that the RD isn't likely to be abreast of the guidelines from an implementation point of view. Mine is aware of the guidelines but is almost operating out of her brief by taking me on - the guidelines not being official policy yet.

You could get an online RD and use them sparingly (just let them check your bloods and guide). But that woul mean doing more spadework yourself in terms of understanding how diet can be used to steer your bloods where you need them to be.

I've booked good progress with little RD intervention.

[itzmich]

I would go to a renal dietian for help. The protein amount seems high to me its probably more like half. Are you consuming red meat or is it plant based protein. Speak to your doctor about this because each person and numbers are so different. It a lot to navigate.

[WildIris]

My creatine and eGFR have bounced a lot in my last 4 labs, range of 35 for eGFR. Hydration at the time of the test may be more important if you have CKD related water retention problems or take diuretics (time them so you're not tapped out at the time of the test). Creatinine levels do seem to respond to factors other than kidney function, I guess its just the most stable and convenient blood test, and your levels do show a downward trend. I agree with the others about plant protein seeming easier on kidneys. My eGFR responded well to the vegan/very low protein/keto-acid supplement diet, like Skeptix, and various other kidney specific diet changes like low salt, no dairy, add nuts and soy and fruit and veggies.