Urine ACR

[Tony_Mimicted]

I just got my mother's acr results

ACR - 95 mg/mmol (normal is 2) or 840 mg/dl (normal is below 30)

We will be seeing the nephrologist tomorrow

Mum's already on a ace at 20mg close to max dose

[Skeptix]

Has your mam been diagnosed with CKD? I wasn't under the impression that ACE max does was 20mg - I was told it was 10mg. But in any case, worth finding out what more can be done as spilling protein damages kidneys further.

Keep in touch after you've been to the nephr to see what they say

Best

[Tony_Mimicted in reply to Skeptix]

Just came back a few hours ago, there's nothing to be done. All that can be done is to control the blood pressure and that was all. Can't say I wasn't disappointed even though I knew this would happen. Her eGFR this time was 68 and this is enough for me to be satisfied as its manageable but her protein spillage is so high 3 times the worst amount. Right now I'm trying to plan on what to do as I believe she might be on dialysis within 3 years with the amount of proteins being spilled. I wanted to say I pray..., I hope... then I realized those are not possible like the many here who can diet and prolong their time. My lifelong dream was about to happen within these two years and now its gone, just like that

[userotc in reply to Tony_Mimicted]

Tony. Isnt there good news in that eGFR isnt worsening (3mths ago around 60 according to previous post, now 68)? As I understand it, eGFR is the key criterion for dialysis although tbf there are other factors eg "uncontrollable fluid overload" nice.org.uk/guidance/ng107/...

It's good that they are monitoring renal function as that is a potential side effect of ACE medication cks.nice.org.uk/topics/hear... .......along with protein spillage, as Skeptix mentioned.

As you know from our private messages, we are focused on diet & wellbeing to help my mum with our current focus on lower carbs (as well as lowish protein) to lower spillage. In our pms, you indicated your mum's diet is healthy but could you/she do more?

[Tony_Mimicted in reply to userotc]

Hi, sorry for the late reply, just been trying to avoid everything for a while. Honestly, what could be done we've already tried. There still is a lot of protein leakage and I can notice under my mum's eyes that they're already swelling a bit. I know diet can help reduce the leakage but the number of proteins is so damn high, its at a number that a diet might not have a effect on its progression

[Skeptix in reply to Tony_Mimicted]

68 is a fair amount of function - there's wiggle room there. userotc has raised diet which can influence protein spillage. There's also a drug class called SLGT2 which work alongside ACE in the area of reducing protein spillage (by lowering bloodpressure in the kidneys themselves.

Is your mum up for digging down and doing what it takes to slow/halt this disease. If so there's little chance of dialysis in 3 years!!

[Tony_Mimicted in reply to Skeptix]

Hi, sorry for replying late. My mother is only hypertensive for about 5 years now and isn't diabetic. She also has been significantly reducing her protein intake

[Sophiebun11]

Hi,

At least her eGFR is at a good level. Is she on a plant-based diet? That is recommended as a CKD diet and lowering or cutting out meat from her diet will lower protein in her system.

Ask about a referral to a Renal dietician if she hasn't seen one yet.

Did the Dr. say dialysis in 3 years, or is that a concern of yours? I'm stage 4 and don't plan on being on dialysis in 3 years. My eGFRs in high 20s last time it was checked, I go again this month.

Good luck.

[Skeptix in reply to Sophiebun11]

Good hunting yourself so, this month. Sailing in about the same eGFR boat as you..

[Tony_Mimicted in reply to Sophiebun11]

Hi Sophie, honestly its just my own personal worries. My mother has been cutting out meat from her diet and has been taking vegetables only for awhile now but the number of spillage is still really high. The doctor has said that probably because of hypertension the damaged parts of the kidneys are already fibrosed and that the spillage can't be stopped.

[GoodHealthIsAJourney]

Is your mum's blood pressure well controlled with the 20mg ACE? Blood pressure is a big contributor to protein in the urine. Some people require more than on type of BP med.

[Skeptix in reply to GoodHealthIsAJourney]

Indeed. It seems (and I speak as a mechanical engineer) like a good idea, generally, to take your foot off your kidneys.

Whether it's doing less protein, salt, BP .. or more meds .. or both.

In their favor, meds are easy. So consider them as well as being careful regarding them.

[Tony_Mimicted in reply to GoodHealthIsAJourney]

Hi, sorry for replying late. When we measured at home for the last 2 weeks the blood pressure is around 110 which is ideal for me, but when we went to the doctor and had it measured it was 150, doctor said it was just stress.

[Blackknight1989]

Wow I’m surprised as there are many more options to help control protein levels in urine. Saying the ACE is all the treatment available and sending you home is lack of knowledge, ignorance or laziness. With that level of protein the damage to nephrons is inevitable and a continued worsening of eGFR and other CKD markers is hastened. The new approval of SGLT2 medications such as Farxiga and Jardiance can help. Finding the cause for the protein issue is paramount and certainly a referral to a renal dietitian to recommend a hyper-low protein diet are all things to help with the issue. I’d seek another doctors opinion if that’s an option.

[Tony_Mimicted in reply to Blackknight1989]

Unfortunately, my nephrologist has also consulted with his superior who also is an advocate in plant based diet. Things like diet would work if the spillage is within minimal to moderate imagine a tap that's closed but water still seeps through, my mother's kidneys are like tap wide open. As for SGLT2, my mother is not diabetic and I'm not sure if it will work

[GoldenBailey]

Tony, I see your post is six months ago, but hope you get my message. I also hope you and your mom are doing well. I know everyone is different, but I hope this gives you some hope. I was first diagnosed with ACR of 1100+ (should be 30 or under) about 15 years ago. I seem to have gone into remission, which is possible. I never came under 300, but wasn't in the outrageous range. For the past year or 18 months, it's running close to 3000 now. My egfr hasn't ever dropped below 17. I'm now 73 years old and while I know the protein affects my prognosis, I've had a lot of good years. Good luck and prayers in your journey.