eGFR is falling

[TopazForests]

I had my 90 visit with my PCP and the bloodwork dropped from 32 to 31. I have been on Farixga and we had hoped to see an increase not a decrease. I am working on weight loss (down 8 pounds) for a future hip replacement where the doctor wants me at or below 250 pounds. My PCP seems to think this was caused by a combination of inflamatories for my severe arthritis and metformin and of course HBP and diabetes. I am working with a dietician on changing my diet (hubby is a major potato fan and for years I've been joining him in eating them.)

She said that at or below 30, you can no longer take the Farixga. She isn't sure if it will be helpful at 31 and I will see a nephrologist in Sept.

What can I expect from a nephrologist over my PCP? Are most nephrologists good at managing multiple medical problems? I have severe arthritis in every joint in my body, this started in college and has slowly progressed to include more joints. I currently have 3 joint replacement and am waiting for that hip one. I also have adrenal insurfficienty, fibromalgia, and a couple of minor things plus of course HPH and diabetes. After a couple bad experiences with specialists trying to give me extremely bad medical advice about CKD, when I was there to be treated for the condition they specialize in, which makes me nervous.

[kellyscats1]

It soulds like you already have some good answers inside your head. Morbid obesity is a killer.. makes arthritis terrible...kills your joint etc... anti-infamatories are rotten on kidneys .. and eating A potato is not bad.. it is how many and how often..Perhaps getting to a more normal weight will help everything..but i think you already know that and are hoping for a simplier or medical solution..yup losing weight is tough,, but your life depends on it so i do wish you luck,

[TopazForests in reply to kellyscats1]

I know losing weight is difficult, I've been trying to lose to a "normal" weight most of my life. Things got really bad when I was in a high stress job for 12 years and used food to "soothe" the stress. A little over a year ago, I got serious about weight loss and was on Keto until my CKD was discovered. I lost about 76 pounds in 6 months. I'm still losing but more slowly now and in the past 6 months have lost about 18 more pounds. I also have an appointment with a weight loss specialist in a couple of weeks to see what I can do to increase the amount of weight I am losing so I can have the hip surgery sooner.

I've had a bad experience with the orthopedic surgeon who told me to go back on Keto and eat as much protein as I wanted and it wouldn't bother my CKD. I now have a new orthopedic who said to talk to my PCP about weight loss and she is sending me to a specialist. There were two other specialists recently who ignored all other medical conditions, including one who insisted that I must take a medication that I have had an anaphylatic reaction to in the past. This makes me nervous about new specialists.

As a physician friend of mine once said, even the person who graduated last in the medical school class is still called doctor. After years of excellent specialists who are retiring, I seem to be finding new ones that are solely focused on their speciality and ignoring all other medical things going on. Darn people who decide that retirement is a good thing. LOL (Hubby is retired and I am on disability but call myself retired.)

[kellyscats1 in reply to TopazForests]

Yes.. it is hard to find docs who see the big picture. As a nurse for over 40 years the change in heath care is quite sad and as a result it behoves us to be our own advocates. I run everything by my kidney doc before anyone else. Weight loss is hard.. crazy fad diets make me cringe. there is no secret to weight loss .. calories in.. caloriwa burned...Common sense safe plans like weight watchers...where you can keep protein down and still lose weight ..abeit it is not as dramatic..

Replacing knees and hips on those with morbid obesity is not a good practice but once you d lose the weight all will fall into place,,

Nothing is more dancerous to the body than morbid obesity.. fat tissue does not heal. it does not have a blood supply... anesthisia risks.. and on and on..sound like you are on the way to getting better..Kudos... and phrmacists are a wonderful resource...

[jodaer]

Hi, Topaz, you have a lot going on. I can only speak of my own experience, but I've found my old neph was good at helping manage HBP and Diabetes. I've recently relocated but my new one seems OK with that too. I think with an eGFR of 30 you need to be seeing one. Most insurance companies will pay a doctor to "oversee:" the different specialists and what they are doing. Another person to make friends with is your pharmacist. They know drugs better than any doctor as far as what the side effects and which don't interact well with each other. Good luck

[TopazForests in reply to jodaer]

I am lucky to have a great PCP who will oversee all the medical conditions that are being treated by specialists. I'm even luckier to have my "own" pharmacist in my sister who answers all questions and researches if necessary.

[RoxanneKidney]

Farixga is known to tank your GFR. This can last a long while but will come up again. I suggest that you read some studies. As far as the 30 cut-off goes...that is the number BEFORE the meds, not after the meds. So for example, if the meds are given to someone with a GFR of 42 and it tanks to below 30, that is common. Read the research.

[TopazForests in reply to RoxanneKidney]

Interesting, I will have to find and read the research.