CKD 3b

[jeffmensch]

My doctor tells me that ckd 3b is irreversible. I had greatly improved my diet, my water intake, and my exercise, BUT my creatine and egfr stay the same, WHY and HOW is this possible?

[Bassetmommer NKF Ambassador]

Because your doctor is correct. Unlike other organs, the kidneys do not regenerate so once damaged, they usually remain damaged. There are cases where there can be improvements, but not often the course. And sadly, once damaged, they usually progress. The thing that is controllable to some extent is the speed of the decline. Think of a filter system that operated at 100 percent.... works great. The something comes along and damages the filter, and now you are working at 40 percent. What happens usually is that the filter will eventually fail as it can not keep up with the demand to filter at less capacity. If you help the weaken filter with less load, the decline will slow down. So with CKD, eating the proper foods that have less protein or easily to process proteins helps the kidney stay viable longer. Water helps, watching salt, the right medications, watching sugar intake and taking care of diabetes if you have that all can slow the decline. But..... eventually, the kidneys will fail. So keep up the good habits and help slow down the progression. Sounds like you are doing a great job of it.

I have stayed off dialysis for over five years and I was at stage 4 back then.

[jeffmensch in reply to Bassetmommer]

if your creatine is 1.85 and egfr at 40, how long do kidneys have in years? - I do not have diabetes

[Bassetmommer NKF Ambassador in reply to jeffmensch]

Oh Honey, if I could predict that I would be rich..... no one has that crystal ball. And it all depends on so much of the individual. I was originally diagnosed in 2009 and the damage was caused before that. NO one did anything about it until I went to stage 4 and that has been over five years and I am still not on dialysis. So actually it has been 15 years since I was originally diagnosed, and I have a slew of other comorbidities and I am old. Age is another factor. Kidneys decline naturally with age. So someone in their 60s having a GFR of 70 might be their normal. There are a lot of people who NEVER get past stage 3 once it is caught. Many slow the progression down to many, many years. Stay the course you are on and I bet you stay for a long time. Just keep checking with lab work at least every 6 months or more. Keep your BP normal. 130-120/70 or less... eat right, exercise and live well.

[jeffmensch in reply to Bassetmommer]

If I am your honey, tell me about you

[LisaSnow in reply to jeffmensch]

Lol!

[TDPowers in reply to Bassetmommer]

Bassetmommer what is your GFR and have you decided what kind of dialysis you’re going to do. My GFR goes from 13 to 10 Im trying to decide what dialysis treatment to do Im asking you because you post a lot and always give good information . Thank you

[Bassetmommer NKF Ambassador in reply to TDPowers]

Thank you for the compliment and asking. MY GFR runs between 15 and 13. Yes, I am in the process of doing home hemodialysis. I have a patent advocate who I am working directly with. We have done the preliminary interview and he feels that I am a viable candidate. Once closer, I will have a home inspection and review. I am having the first of two surgeries at the end of this month for an AV fistula. One surgery to connect the vein and artery and the second surgery to lift it up to the skin. Then when things get too bad for me, I will start dialysis training which is quite long and thorough. I am doing all the prep so that the fistula heals up and I am not hit with crashing into dialysis and needing a chest catheter. I did not want to do PD because I am a larger person with diabetes and the solutions, which are glucose based, can cause weight gain and issues. AND I cannot going swimming with a PD catheter in the current channel where I currently work out. I am hoping to continue with that. There is no wrong choice. PD is great and easier to do at home, but it is constant and can be tricky at first. Home hemo is also tricky, very tricky but allows for my schedule to do it when I want and for less each time. In center hemo is great because you do not have to worry as much as you have nurses there but it is a time commitment and where I live, they are booked up. Ask quesions and check with your family because they all need to support you.

[TDPowers in reply to Bassetmommer]

I wish you the best and thank you so much for all of your great information

[barbara55109 in reply to Bassetmommer]

Hopefully you won't need a second surgery. I have tiny veins and had to get an upper arm fistula. They were sure they would have to do two operations. BUT they didn't. My fistula is accessible and healthy. Two years and I still haven't had to use it. Drs were so sure I'd be on dialysis by now. My egfr has hovered around 25. Since dehydration caused my CKD, mega doses of anti diarrheals has really made a difference. Getting more liquid to make it to my kidneys has made a world of difference. I have an ileostomy and for 30 years most of what I drank went into my ostomy bag instead of into my kidneys. Hopefully you won't need two operations.

[Bassetmommer NKF Ambassador in reply to barbara55109]

Oh that's great about the two surgeries. I would rather have it done and be done. I too am having an upper arm fistula. You sound like a real Warrior. Thanks for sharing.

[barbara55109 in reply to Bassetmommer]

This is a great explanation!

[orangecity41 NKF Ambassador]

Here is a link that explains eGFR and shows relation to age.

kidney.org/atoz/content/gfr

[Miss-guineapig]

Jeff, I am 3a and was quite shocked with the diagnosis, as my kidneys were the last think I thought was wrong. But I have changed my diet, starting to exercise more but need to do much better. It is all manageable so make changes , keep positive and do your best. Some people make enough changes that their body will cope well and although kidneys won’t improve people can remain at stage 3 and feel well. Keep in touch with your Dr re BP and blood sugar, in Scotland we get an annual blood test ., don’t know where you’re from but I am sure there will be a review protocol too. Wishing you well x

[userotc]

By following a Nutritional Therapy protocol, my mum has almost doubled her eGFR in the past few years following a nephrectomy. Her nephro didnt help and told us it would never improve from 36 ml/min - it's now ~60!!.

She's not been told her CKD stage has changed, we consider it manageable if not reversible.

Id suggest a qualified NT specialising in renal rather than a medical doctor. He/she should adopt a personalised approach which may address why youre finding no improvement.

[Hidden]

There are many things that can affect GFR such as diet and drugs. I tracked my wife's GFR over time and made a chart. She was as low as 39 (stage 3b) and is now at 77 (stage 2). You can see it varied quite a bit over the 3.5 year period. She pretty much eats a regular diet and does not follow a renal diet.

EGFR Chart

[HisLittleOne]

Through much prayer and intermittent fasting and resveratrol supplementation I was able to improve my kidney function significantly (at age 74 my nephrologist said he no longer classifies me as CKD). He said my improvement is remarkable and encourages me to continue doing the things I’ve been doing. He said that intermittent fasting and losing weight has a great benefit to kidney function.

Just FYI and encouragement ☺️

[bumblebee_tuna]

jeffmensch You are asking for help but leaving a lot of details out. You say that you are not diabetic. So what is the source of kidney disease? Have you done an ultrasound? A biopsy? What is your age? Do you have protein in your urine?

Generally, doctors are less concerned with a specific eGFR number, but instead more concern with the rate of the decline. If your number is stable you should be pretty happy. Making it go up with a magic diet is not something you should chase imo.

[jeffmensch in reply to bumblebee_tuna]

high blood pressure caused hypertension which caused kidney issues; im 56, no ultrasound, biopsy necessary according to nephrologist; almbumium is normal which is good

[bumblebee_tuna in reply to jeffmensch]

With no albumin and hypertension under control (with an ACE or an ARB I assume), it is expected that the rate of decline will be slow. You are not likely to reverse it -I lived with a CKD diagnosis over 30 years and not once did my eGFR go up. Are you on Farxiga? If not, something to ask your doctor about.

Edit: I think what you are worried about (understandably), is whether your kidneys will outlive you or would you need to go on a kidney replacement therapy (dialysis/transplanting). No one can tell you what will happen, not even your doctor - they can only monitor you and react to the changes. Sometimes, once we go on our second half of our life -journey the decline accelerates. Sometime it doesn't. The biggest indicator is albumin in your urine - you don't have that which is great!

[mondoll in reply to bumblebee_tuna]

may i kindly know why you asked him why he is on Farxiga? Because i observed since i took Farxiga, my creatinine went up from 90 to 121 over the last 7 months😞

[bumblebee_tuna in reply to mondoll]

Farxiga is renal protective, when you start taking it there is usually an initial drop in eGFR (higher creatinine) and then eGFR is stabilized. It is now been shown to also help CKD patients that don't have Diabetes.

[jeffmensch]

only on olmesartan for blood pressure

[ThatTimeAgain]

After reading these comments I’m starting to worry, I’m 34 and just found out my egfr is 55…..I’m a good healthy weight, don’t smoke or drink, no heart probs or diabetes and no idea at all for the quick decline (I was in the mid 70s just 3-4 weeks ago). I had a miscarriage in march and was almost 9 weeks but surely that wouldn’t affect my kidneys? Iv been asked back for a repeat blood test so am currently awaiting that, what should I expect next? P.s sorry for hijacking the post! And thankyou for any responses

[WildIris in reply to ThatTimeAgain]

A miscarriage can throw your system out of whack, especially if you took tylenol or advil or bled much. I know its hard not to worry. eGFR is based on creatinine, a protein, so eating a lot of protein, or being dehydrated or other things can affect it (though its stable for most people). Drink plenty of water and see how the next test comes out. 55 is hopefully a temporary dip.

[ThatTimeAgain in reply to WildIris]

yes I was in the hospital and had bled through most of the pregnancy but it was in march, everything else for me is generally alright (I have quite bad endometriosis and very large fibroids which need to be removed by open surgery) but I do hope you are right and it’s only a temporary dip. Thankyou ever so much for responding

[ThatTimeAgain]

My creatinine was highlighted in red too as that was high, I do not take ibuprofen or any meds like that due to asthma (just thought I would pop that info in too)

[Blackknight1989]

Because organs and more specifically the specialized cells that make these organs that we cannot make or duplicate (yet) to replace when they fail (like kidney or other organs except liver as those do regenerate). Further the two values you mentioned are generally major functions of the kidney. EVEN if these numbers improve that doesn’t mean your organs improve. For example (in most cases) even if the lab work used to measure the organ function do improve that does not mean the organ cells damaged (in most cases) have somehow regenerated or recovered only that the remaining cells of whatever organ is showing improvement are not as stressed. While your labs can show improvement that doesn’t mean the kidneys have spontaneously made new kidney cells and as such your actual damage to that organ has improved. Instead it means only that you aren’t “stressing” the remaining cells and their function had improved. Unfortunately (minus the liver as liver cells can regenerate if you leave enough healthy cells) most organs cannot or do not regenerate and as such any improvement in lab values mean only that the remaining cells aren’t being stressed as much prior to cleaning up diet and adding exercise and generally do not mean you any organs are making new cells to actually replace damage done.

[tas1kubra]

hi jeff

I understand your disappointment, but also there is a bit confusion about the input-output connection of nutrition and ckd results, which also affected me for a while.

Whenever main reason of your ckd is nutrition based, such as diabetes or obesities, then changing your diet affects the result. Because eating is the actual cause, and when you moderate the main cause, the pressure on your kidneys will be less.

On the other hand, for other cases such as me, I have ckd with an unknown cause. It can as well be genetic. So changing my diet or restricting some food will not make the result better for me. Because simply the damage is done. At my first weeks, I was trying to play everything I put in my mouth and see some correlation with my creatinine. After couple of weeks though, I realized thats not where I should be looking. Also my doctor doesnt give me a diet for this level, I have gfr around 35. I hope it helps.