Chicago tribune, section 5, Wednesday Nov. 17 has an eye opening article about CKD CONFUSION. Very interesting article which says ( in short) that the new research indicates that a commonly used bench mark for defining CKD - a FGR of less than 60 often results In older adults receiving a diagnosis and treatment for a condition that will never cause symptoms or hasten their death. It further suggest that diagnostic guidelines should be refined.
It talks about resistance to change the system because of financial implication and so maintain the status quo.
An interesting article. A ray of hope.
Your comments are welcomed.
Sam
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htpi1543
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I think too that it need to be refined but in the other direction. NKF's definition is more granular but somehow it seems to be common among GP to rule out CKD based exclusively on GFR and lack of protein in urine.
That arbitrary threshold likely work most but not all the time and I think it is a dangerous oversimplification. That's what should stop IMO and leave formula or arbitrary number to workgroup.
I agree. In my case other factors entered into diagnosis than just eGFR. I was diagnosed at age 76 with eGFR of 54 and put on CKD diet. I do have a Doctor who thinks because I had eGFR of 60, that, I do not have CKD. He must have read the Chicago Tribune article
Wouldn't you rather be dx earlier than later? And what treatment? The only treatment I'm getting is a diuretics' and BP meds. The BP meds are not new though. Knowing early, you can plan and hopefully slow the decline.
What I found is there are not many treatments for CKD with the exception, like you say, of managing BP and controlling diabetes. I had PKD. Although there are a few drugs to slow progression, I was too late to the game. Thankfully, I had a double nephrectomy and transplant 14 months ago.
This info and the debate has been ongoing for years. Old folks (late 70's and older) need not worry about mildly depressed eGFR. Young folks do. And yes, financial incentives to maintain the status quo are extremely powerful. To read the article on press reader, google "Chicago Tribune kidney confusion".
On balance, I agree mainly with jodaer. Particularly since many on this forum have complained they were only "diagnosed" late. This includes my mum. Had she been informed her kidneys were struggling years (rather than my dad discovering!), we could have done something to maybe prevent the subsequent damage caused.
Many years later that is still just diet & wellbeing. The medics just comment "continue with what you're doing"!
I think under 60 is not a death sentence & there are many things that can be done to prevent decline. Symptoms have to be addressed including cofactors like heart disease & anemia as these might interact & if treated prevent further complications like stroke & heart attack - so when we preserve kidney function we look at what effect kidneys have on other organs including blood & heart & what effect anemia has on the kidneys. It’s one interdependent system. Complex but manageable with common sense & regular monitoring, with a whole food plant based diet & reasonable exercise.
I encourage people to read the article. It is clear many commenters have not read the article. I frequently see posts here about people in their 70s-90s who have a eGFR in the 50s and are very afraid CKD will kill them. While on the personal level I understand their fear, I really want to shout, "Don't worry. You are already above life expectancy. CKD isn't going to get you before something else does." But that doesn't sound very compassionate though does it. I am reminded how my mother's Dr. stopped doing mammograms and colonoscopies in her late 70s. I got very upset. He gently asked me if I though my mom, with her other health conditions and worsening dementia, would survive the surgery and chemo that a breast or colon cancer diagnosis would lead to. I said no. He explained that's why he stopped doing painful, invasive tests on generally unhealthy seniors. Our profit driven medical system leads to life at all costs tests and treatments. Patients really need more information - accurate information - so they can make wise choices about their own situation.
Hi Barbara. I agree with you and the article. Our society tends to fight against the obvious - that our bodies will wear out over time and expire. My dear father passed away at age 75 from from painful bladder cancer. But not before the surgeons fixed a heart valve and a relatively pain free slipped disk a few months before. Looking back, I have to shake my head. Why? I can only think that it was a lack of candor and a profit motive. It's well known that organs only last so long - maybe 100 years if things go really well. One can't have life without experiencing the other sooner or later. It's the cycle of life. I remember speaking to a friend (a nurse) who was arranging a party for her mother - her mom wanted to celebrate a big milestone, her 100th birthday. My friend wryly said it was interesting to see her mom's labs - her gfr was only in the single numbers and added that her mom's battery in her pacemaker was also running low. A few months later, her mom peacefully passed away in her sleep, choosing not to replace the battery. So, yes, medical interventions are great when quality of life is improved, but recognizing that we are finite is important too. I love your statement: "Patients really need more information - accurate information - so they can make wise choices about their own situation". Yes, oh yes! Please, let that happen - in lab reports, in conversations, in everything. As rational human beings, we can handle it when it is honestly delivered and reality plays a role.
It's blocked from copy and paste, but you can read by hovering over right side and selecting the arrow. The article flows from left to right, not up and down.
You lucky thing - I rue the day I injected smartphones into my veins. Having previously rued the day I injected mobile phones (Nokia) into my veins you'd have thought I'd have learned. I was a very late adopter in both cases but succumbed to the lure.
Fool me once...
Yeah reading on a phone. It works on my PC too when I click on Darlenia's link above. It just reads side to side when I scroll rather than vertically as on the phone
I tried the side to side, that's when I get the block box. Oh well.
I'm not savvy with modern gadgets. I would like a SmartPhone but it's out of my budget now. I get a great deal on internet in the States, only $10 per month normally and since the pandemic started it's been free and will be free until 6 months after the CDC ends the pandemic. I also have a house phone, land line, which is only $10 per month. I have a cell phone for emergencies that I pay $18 per month for. I rarely use it unless I get a flat tire or something like that, or need to make a long distance call.
I see people with SmartPhones texting instead of talking to people at their table at lunch. It must be more addictive than a computer LOL
Try: jasn.asnjournals.org/conten... (This was suggested by somebody else on this forum responding to the scared 69 year old man who was just diagnosed)
Yes, this is good news. Hoping my levels stay in their current range. Doctor told me "You have Stage 3A Kidney Disease, don't worry "Just live your Life"
As a person who used to enjoy a LOT of fast food, potato chips and the like what I'd like to see is a more preventive approach...i.e. starting the education as to how lifestyle choices affect a person years later. Of course I probably would not have listened in my 20's and 30's but could possibly not have developed CKD in my 50's. Since I have Graves Disease (hyperthyroidism) and a very, very fast metabolism I could eat as much as anything I wanted to. I was athletic at least but didn't gain weight despite my diet choices. Because of this not one single doctor considered me to possibly having kidney issues. Every time I went to the doctor my BP was elevated at what they say is prehypertension levels. I thought it was white coat syndrome and ignored it for years. I had a thyroid storm after a particularly stressful time and had to see a cardiologist. He put me on BP meds and now it's under control. That was in 2014. I didn't find out about my kidney damage until 2017. Now at 58 years old my eGFR is 17 and I'm on the transplant list.
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