Possible early Kidney Disease?

[Moye75]

My husband has secondary, treatment resistant, hypertension and I was looking into possible health conditions that may be causing the high blood pressure and came across polycystic kidney disease. His recent blood test/urine test showed a egfr of 69, creatinine over the high normal range and protein in his urine but his gp hasn’t flagged anything up of concern. Does this indicate he has a kidney problem? Or can all of these together still be normal?

[orangecity41 NKF Ambassador]

Here is a link to National Kidney Foundation on information about eGFR that might help in discussion with your husbands GP Doctor

kidney.org/kidney-topics/es...

[Bingo88]

Good morning Moye75. I don't think his doctor will be concerned about his Egfr number because that's still pretty good. I have protein leakage from my kidneys and my Egfr is a lot worse so I am under a consultant. There is a Facebook group which is very helpful and run by Andrea. Chronic kidney disease uk. You can ask questions there as well as get on foods to eat to help keep his kidneys functioning as well as possible. Brian

[Moye75 in reply to Bingo88]

Just to be clear, he hasn’t been diagnosed with any kidney issues, just high blood pressure. I read online that if the egfr is below 90, that can be normal but if you have protein in your urine,together with the egfr being under 90, that’s a sign the kidneys are struggling, including the high creatinine levels. He’s 50, slim and fit otherwise. I’m just concerned the doctor is dismissing possible early signs of a kidney problem as they are looking at each level independently and not together?

[userotc]

Rather than self-diagnosing eg polycystic kidney disease, I suggest getting a diagnosis from a medic that understands the condition. Then report back on here for support. Good luck.

[Moye75 in reply to userotc]

I’m not self diagnosing, I’m asking if having protein in urine, an egfr of 69 and a creatinine above the high normal level is indicative of a kidney issue. My husband’s gp hasn’t mentioned any of his results being a concern.

[userotc in reply to Moye75]

Sadly GPs generally dont even mention kidney disease at stage 3 (which your husband is not at). Whilst its been said its because diagnosis is unclear, personally I believe its because medics generally cant do much/anything until later stages. But I believe it's wrong because the patient may be able to do something. For example, my mum was never told even at stage 3 but has managed it for many years via Nutritional Therapy.

PS I only referred to self-diagnosis because polycystic kidney disease is only one of many types.

[Moye75 in reply to userotc]

Thank you. I got my husband to go back to his gp after doing a shop bought kidney urine test which again showed protein in his urine (it was previously dismissed as probably being dehydration). She was so annoyed and then redid his cbc and egfr but didn’t reorder anytime test? I have no faith in doctors these days and unfortunately feel like I have to check these things myself. I just wanted to know from somebody who understands this a bit more than me if having protein in your urine together with an egfr of 69 and high creatinine is something to look into or if I’m worrying unnecessarily. My husband thinks I’m being concerned over nothing and his gp seems unconcerned. I just don’t want to leave something and then find out it was an issue and we could have started to implement changes earlier to avoid it getting worse.

[userotc in reply to Moye75]

I dont think you are worrying unnecessarily and you are sadly spot-on with your view on doctors nowadays. Following poor personal experiences with primary & secondary care, we now personally rely on Nutritional Therapy instead.

We sometimes use medical authorities for diagnosis (which I suggested for your husband's case) and NT for treatment and disease prevention or management. In mum's case, besides managing the ckd, she was also able to wean off BP medication too and is 115/75.

Does the protein test you've done indicate a level? Because my mum's is <1g, her nephrologist is unconcerned.

[Moye75 in reply to userotc]

I’m not sure that his urine test showed the level of protein? I have his serum albumin level but that’s part of his blood test. That was 51 g/L with the range being 35 to50…I’ll have to check with him. All I can do is encourage him to bring this up with his gp. I just want to be relieved from the worry if it’s nothing. His dad died we think of an aneurism which I read can be related to PKD and I know it can be hereditary….Who knows…

[userotc in reply to Moye75]

Albumin in his urine is more appropriate than in serum for assessing urinary protein. Mum's serum level is even lower than your husband's at 39g/L and stable whilst her urine figure increased to many times over-range. Albumin is a small protein so its leakage is an early indicator of damage so youll see uACR (urinary albumin/creatinine ratio) quoted as a key marker of kidney disease. In February, I linked a blog on here which includes mum's battle with uACR at that time and potential, nutrition solutions.

The key thing is to get as many relevant serum and urine data as possible done. You or he may need to insist that medics do this though, as Im sure youve realised.

[Moye75 in reply to userotc]

Thank you

[lowraind in reply to userotc]

I totally agree with you. If patients were informed earlier they could learn more and do things that would help maintain kidney health, especially regarding medications, blood pressure, diet and hydration.

[userotc in reply to lowraind]

I totally agree with all but one of the things you've listed.Re medications, my recent research indicates few options with very limited trials' data for those reported to directly help CKD eg SGLT2s, ACE, ARB.

This seems consistent with my mum's nephro's views in not considering any due to efficacy uncertainty and side effects.

Consequently we remain wedded to NT!

[lowraind in reply to userotc]

My reference to medications was to those taken previously which contributed to CKD, such as acetamenophen.

[userotc in reply to lowraind]

👍👍

[drmind]

I hear your concern,but to consider if one has kidney disease, at least three lab tests over a period of time is usual. In addition, much to our chagrin most of us weren't diagnosed by our gps until we had GFRs in the 30s or CKD 3 or 4. Referrals to neurologists aren't usually made until these numbers are reached. Have you had a chance to discuss your concerns with your husband's gp? Or is his gp not giving your concern any merit at this time? Whether or not his hypertension could be a result of kidney disease based on recent lab results is an important diagnosis which has to be made by a physician. You and your husband should expect your concerns about this issue to be addressed by your gp. What most of us have learned is that we have to advocate for ourselves and get answers from our doctors and not be dismissed.. You have raised legitimate questions about your husband's health. So encourage your husband to get answers and he may have to change doctors to do so. I wish you the best and applaud you for trying to help your husband learn more about his health. Keep in touch and let us know how things turn out.

[Moye75 in reply to drmind]

Thank you

[PKDpostTRANSPLANT]

I have polycystic kidney disease and a kidney transplant. Yes those things can be caused by PKD but that doesn't mean they are caused by it. They can also be caused by other issues. I think it is very reasonable and important for you to look into the issue though and I am surprised by the pushback you are getting. Is it possible for you to get a second opinion from another doctor? High blood pressure that is not well controlled can damage the kidneys so maybe the blood pressure is the issue rather than the kidneys causing the blood pressure, but I think it is reasonable for you to want to rule out the possibility of kidney disease first, but there are many types of kidney disease.

Polycystic kidney disease does cause hypertension as one of the first symptoms (but a renal ultrasound would easily confirm or rule out this possibility). Then proteinuria and a decrease in egfr continue as the disease progresses. You are right that polycystic kidney disease can cause brain aneurysms, but it is a small percentage of those with polycystic kidney disease. If you are able to get a referral to a nephrologist (I know many people have trouble getting in to see one) that would be your best bet. They can work with him to rule out kidney disease. However, regardless of if he has kidney disease or not, his blood pressure needs to be controlled to prevent further damage. If he is not already on one, I suggest a low sodium diet to help bring down his blood pressure while you work to get answers.

[Moye75 in reply to PKDpostTRANSPLANT]

Thank you.

[PKDpostTRANSPLANT]

You are welcome. I hope it helps. Drmind made a great point above that you should first confirm that the egfr is actually low by checking it a few more times.

[Moye75]

It has been checked a few times and has decreased. Thank you to everyone, at least I have some information now.

[Justicelover]

it might be the kidney causing the high blood pressure, but you should start looking into some natural stuff to bring down the high blood pressure and then something natural to clean his body as well the kidneys, try to do it now that he’s still peeing to avoid all the secondary problems, and use a lot of nutrition so it doesn’t decline his health, if this continues they’re going to say he needs dialysis and that complicates everything, search for a lot to bring down creatinine levels and the protein in urine, I’ve read that sometimes the kidneys are dehydrated, I don’t trust on dialysis clinics either, with my boyfriend his creatinine levels we’re going down faster when he was at the hospital than at the clinic, if you need to do dialysis I do recommend to do the one at home since is less invasive than the one at the clinic.

[Moye75 in reply to Justicelover]

Thank you

[Beachgirl32]

ye

Ah my blood pressure was high in stage 3 from polycystic kidney disease usually it is an inherited disease but not all the time does any family me wrs have it yep see nephrologist to determine where kidney disease is coming from good luck to you both

[Moye75 in reply to Beachgirl32]

Thank you