Test Results Are In and There’s Improvement

[Grateful2021]

Hi All,

Yesterday, I had my first urinalysis and a renal panel done. This was the last step to take before being referred to a nephrologist. Well, it’s not likely I will be referred now because my creatinine went from 1.13 a year ago to 1.05 yesterday. My GFR went from 52 to 56. (Calculated using the GFR calculator 59). I have no HBP or Diabetes, but I do have Hashimoto’s.

I am thrilled to say the least. Thanks to the advice here about plant based diet and lowering sodium, phosphorus, and potassium. Of course, I’m not out of the woods yet, but at least I’m on the right track. Since I’ll be on Medicare Advantage Plan soon, I was trying to assemble my care team in advance making sure the same doctors would accept my new insurance.

If I won’t be referred to a Nephrologist, how often should I have lab work done? I’m hoping that my GP will keep an eye on my results at regular intervals. Which tests should be done and how often?

Thanks for your help!

[Bassetmommer NKF Ambassador]

Congratulations. The doctor would decide how often but since you still have CKD, it's probably best every 4-6 months or more just to make sure things are steady.

[Grateful2021 in reply to Bassetmommer]

Thank you. I just needed to hear that I’m doing the right thing.

[Michael__S]

I have a similar GFR and I have bloodwork scheduled 4 times a year, 2 of them are merely more than checking my GFR while the other 2 are more in depth. I can't tell you whether it's appropriate for you but it feel adequate to me given my situation.

[Grateful2021 in reply to Michael__S]

Thank you!

[Marvin8]

Blood work should be done every 3-6 months, although most nephs would tell you yearly. Even if insurance doesn't cover it, the CMP panel is relatively cheap if requested through one of the online test sites. The online doctor will give approval for you to go to a local lab, usually Quest or LabCorp. I'll also be going on Medicare next year, but I'll be on regular Medicare, not Medicare Advantage. Additionally, my eGFR went from 52 to 56 a month ago.

[Grateful2021 in reply to Marvin8]

Thank you for your reply. I’m choosing Medicare Advantage so that I don’t have to go through the referral process (I hope). It’s been a nightmare for me.

[jodaer in reply to Grateful2021]

Check on that referral process before you sign up. I'm on original Medicare and there is no referral required. I can see whoever whenever I want, Some of the Advantage plans require referrals and doctors are paid more to not refer.

[Grateful2021 in reply to jodaer]

Yes. Agreed. That’s why I’ve been building my care team before going on Medicare. Fortunately, my husband has explored all options ahead of me.

[TaffyTwoshoes27 in reply to Grateful2021]

My Humana Medicare Advantage plan (HMO) (a/k/a "Plan C") requires me to get referrals from my PCP to specialists, or at least some specialists. I have no idea how much a supplemental Part D program cost, but it is included with an advantage plan. I find that it is worth it.

[orangecity41 NKF Ambassador in reply to jodaer]

I too am on original Medicare with supplement. I have looked at Advantage Plans but do not meet my future needs. Some require high deductibles for some procedures.

[Darlenia in reply to Grateful2021]

Simply remember that Medicare is federal and recognized throughout the country. Medicare Advantage Plans are generally state or local based. This can become important when looking outside your network for highly specialized cancer treatments, organ transplants, etc.

[Grateful2021 in reply to Darlenia]

Thank you. I have more work to do.

[horsie63 in reply to Darlenia]

Not only that some states like Oklahoma are kicking people off that had signed up due to Covid.

[Darlenia in reply to horsie63]

That's very concerning! With Medicare advantage plans, Medicare turns a very large pot of money over to those insurance companies under that umbrella to use in the patient's health needs over the year. And these companies generally aren't supposed to exclude or throw clients off their plan for pre-existing conditions. Seemingly, there's a big problem brewing in Oklahoma and elsewhere. I suspect Medicare may stop shuffling money their way down the road.

[horsie63 in reply to Darlenia]

Oklahoma has one of the worst records when it comes to health care. It's ranked #48 in healthcare and #42 in education. I'm lucky enough I work for a tribe and have my insurance paid for.

[Darlenia in reply to horsie63]

You're fortunate, indeed very fortunate. Everyone should have access to good healthcare in this nation.

[horsie63 in reply to Darlenia]

Definitely unfortunately it's nothing but a money racket and god help you if you are poor and uninsured. There's so much about the health care industry that makes me angry...lobbyists for the pharma and insurance companies get rich of off people's suffering and Congress does nothing.

[Darlenia in reply to horsie63]

Yes. And we can't forget the hospitals, many owned by private equity firms, placing outrageous prices on everything to drive huge profits. The people are seemingly powerless. It is what it is.

[Marvin8 in reply to Grateful2021]

Original Medicare Parts A and B don't require referrals to see specialists while many Medicare Advantage plans do. Medicare "Advantage" was simply a carve-out for the insurance companies to insert themselves into the money trough. And don't forget that every penny that goes to the insurance company through Medicare Advantage is a penny less in health benefits for you. I would never get Medicare Advantage.

[chicablue in reply to Grateful2021]

regular Medicare does not have the referral process!

[Grateful2021 in reply to chicablue]

Thank you. I’ll check that out.

[jodaer in reply to chicablue]

You can also see any doctor you want.

[chicablue in reply to jodaer]

Yes! And after someone suggested I try one of those advantage plans, I checked with my doctors and none of them accepted it!

[Grateful2021]

Sodium, Potassium, Chloride, Glucose, BUN, Creatinine, GFR, Calcium, Albumin, CO2(bicarbonate), and Phosphorus.

[TaffyTwoshoes27 in reply to Grateful2021]

Sounds like a CBC test.

[lowraind]

My preference is every 3 to 4 months. My neph diagnosed hyperparathyroidism, then said my next appointment in six months. She also took me off Calcium and Vit. D. I disagreed and told my personal physician what had happened and that I was not comfortable with the way the neph handled it. She referred me for an appointment with an endocrinologist, who I finally saw, after 4 months. What a difference! He had a lot of blood work done (8-10 vials), did a bone density test, has me doing a 24 hour collection (I have had only one since 2017), and has me coming back in three weeks. I see my personal physician every 3-4 months, and when I ask, she refers me for a blood test.

[Grateful2021 in reply to lowraind]

Thank you. You have given me some hope. I have a referral for an Endocrinologist/Rheumatologist in September. I’m looking forward to it.

[nonna70]

I have had a similar experience.

[sparkie88]

Renal panel, Urine analysis and with microspic analysis every 6 months this is US standards in Nephro Dr care or at least renal panel or complete metabolic panel every 6 months i am still monitored even with significant improvements from 39 to 60 currently by internal med Nephro Dr no change in diet however reduced in amount of food involuntary and fasting parts of the day most days. You should watch out for Vitamin B12 deficiency it will make CKD worse especially when you at at the early stages it cause anemia which suggest end stage progression and heart disease likely increased rate of dementia and neuropathy even without diabetes. Still work with your primary care Dr get an ECG check for heart issues and make sure to do things that makes your heart healthy that is the goal for every CKD patient in every stage and keep stress at bay don't worry so much about your kidneys and neglect the most important organ. Take care

[Grateful2021 in reply to sparkie88]

Than you. Good advice.

[orangecity41 NKF Ambassador in reply to sparkie88]

Thanks for info. I have low B12 and anemia. Now taking B12 prescribed by Doctor.

[jodaer]

You can request but they don't always have openings.

[jodaer]

Medicare advantage plans are not always what they claim. Also, what fits for one might not fit for another. If you need help check out SHIP in your state. They will help you find the right fit for you.

[Grateful2021]

It is the soonest they can get me in.

[Grateful2021]

Thank you. I’ll check out Part G.

[Sophiebun11]

Good news, and good that your Dr. was considering sending you to a Neph with an eGFR in your 50s still. Most don't get sent until we are in Stage 4 with eGFR at 30 or below.

Keep up the good work. Stay on a plant based diet, or start one. And drink lots of water.

Congrats, it's wonderful to hear good news.

[Ruthy35]

In the UK I gave been under virtual clinic for at least 5/6 years. This means I get sent blood test forms and urine forms every 6months and the results are read and I get a letter from the doctor etc with results. The last one I had done see my post was a full blood count with everything on it from my GP surgery. I noted from the emailed results that my egfr and creatine levels were high based on this I contacted the renal department at the hospital and I have a blood test booked next week. I'm currently checking my blood pressure as told this could be a sign that my filtration rate is slowing down again