decrease GFR

[Savreen1]

hi,

Recently done labs but not happy with result. It’s decreasing from 19 to 17 in last 3 month. My nephrologist preparing me for dialysis but I really want to improve.

[Bassetmommer NKF Ambassador]

Sorry about the decrease. There is a ton of information out there on renal diets and they do make a difference. Basically, it is no processed foods, very limited red meat, low salt and lots of veggies and healthy fats like olive oil.

Things to work on now so you are not surprised or overwhelmed....(wish I had done this) Go see a dialysis center. Go and see an in-center training site and talk with them. Plan on getting the fistula done if you are doing home or incenter hemodialysis. Get the fistula done as far in advance as you can to get it to heal and mature. And most important, talk to other patients about their choices and why. Find out about how much equipment and supplies you will get with PD or HHD. Make space. Make your choice and then WAIT! Do not let your Neph push you into dialysis until your GFR is lower or you start to feel symptoms such as edema and extreme tiredness. Get labs done every 3 months so you are not surprised with a drop. Just to let you know I waited until my GFR was 7. I felt fine and had no symptoms, but I started before I crashed into dialysis. Because I have still a lot residual kidney function, I only do two hours 3 times a week. That is a very low prescription but for me, it is working.

I slipped through the pre-dialysis training. I never toured the facility. The day I thought I was going for a tour and introduction I was slapped in a chair and poked. Not the way to go.

And why did I go with home hemo??? Because it does allow freedom of when you do treatments. For example, if I have a meeting, I can push either the time or day off. I wanted the freedom to do that. I also like to swim and cannot do that in the type of pool I go to (current channel) with PD. I also did not want a tube hanging out of my belly. Also, I have no issues with sticking myself. I also do all my own lab draws and any shots I need. However, I was not aware of the time and commitment there is with the equipment and maintenance. We actually had a room built to house all the supplies. There is a ton.

[Savreen1 in reply to Bassetmommer]

Thanks for sharing your story. But I have 4 years old daughter. So I’m very scared with dialysis life. I really want to improve.

[ShyeLoverDoctor]

Get on the transplant list now, if your laws are the same as they are in the us you can listed once your function is below 20. If you think you might want or might qualify for transplant .No one wants dialysis however it is life support. Eventually if you continue to lose function you will need it or you will otherwise die. As far as I know nothing can be done to improve kidney function at a certain point. You can try to preserve function best you can.

[Savreen1 in reply to ShyeLoverDoctor]

Thanks for reply but in Australia I can’t listed until start dialysis. So I want to preserve my function. It was increased 2 years ago when during pregnancy my kidney function left only 13% then it’s increased 31% but suddenly start decreasing now.

[ShyeLoverDoctor in reply to Savreen1]

Got it, no early listing. On one hand, the body is going to do what it does. However, if a medical professional with years of training and experience says it’s time to prepare, then it’s time. Decide which treatment modality you want. Most people feel better on PD, but you need room for.a large amount of supplies and a sterile room. You can’t be lifting a young child with a catheter, you’ll get a hernia. PD catheter takes 1 month to heal, a fistula takes 3 months. You may not use it right away. Nephrologists love a patient with a fistula ready to go. What you do not want is to crash suddenly into dialysis and need a chest catheter which carries the risk of serious infection. Make the decision, then start asking people to “help spread the word” you will need a living donor. Never ask anyone directly they get defensive and sometimes hostile - I learned this the hard way. Only 1 in 5 donors tested ends up being eligible, you have to be very healthy.

I am not a doctor, however with a rapid decline it sounds like you are about to enter End Stage Renal Disease and will require dialysis or a transplant or you will die. They used to put people on dialysis at GFR 15 but found that wasn’t necessarily beneficial to patients and many doctors do it at 10. My doctor made me wait until 6, I felt horrible and in the end I was angry he put it off for so long because I suffered a poor quality of life for too long.

I truly wish you the best.

[canadaeh in reply to Savreen1]

you can improve your kidney function! im in canada, improved from 8 to stady 23. my kidney failure is from injury not disease.

so what are your comor... other influencing diseases? my antidepressenant was casing redused kidney function, so look everywhere! eat well, and be cautious of your hot summer coming up. hugs to thee 4 year old, thats what makes life precioous

[Baron1]

Good Afternoon,

You should request from your General Practitioner or Nephrologist a "Renal Ultrasound" or CT Scan of the renal (Kidneys) to see what condition they are in.

The structure and microtubles are implicated in failing eGFR in some occasions. The thickness or thinness of the lining will also give you valuable information to assist in seeking the best treatment. Blood tests for eGFR is one of many tools you need to ascertain what is occurring and what can be done with supporting kidney function.

Best Wishes

[Rani224]

Hi Savreen - same happened to my dad and we got it back up to 19 in just a couple of weeks. I am hoping before his next blood test it will improve more (next blood test is beginning of October so not far). Here are dad's details below, hopefully you can take some help from it:

Dad has been diabetic type 2 for many years which has caused his ckd + high bp.

Bp is under control now

Diabetes is reversed through diet + walking

Ckd stage4 - stable atm according to Dr

Proteinuria 2+

Meds He is on -

dapagliflozin

Doxazozin

Linagliptin once a day for blood sugar (but they may take him off it as he is pre diabetic now)

Astorvastatin for cholesterol couple times a week (his cholesterol is ok but dr says it is beneficial)

Bicarbonate x3 times a day (closely monitored by dr)

Supplements he takes (ALL CHECKED WITH HIS NEPH. BEFORE TAKING - DO NOT TAKE ANYTHING WITHOUT CHECKING WITH DR)

Alfacalcidol (vitamin D dr prescribed)

Iron daily (dr prescribed)

Calcium daily (dr prescribed)

Omega 3 daily

Vitamin D supplement

Vit B complex couple times a week

Coq10 daily

Diet + walking

He walks daily after dinner & has lost 5kg (less weight = less work for your kidneys)

•NO SALT + NO SUGAR

•NO RED MEAT

• LOW POTASSIUM- NO TOMATOS / BOIL OR SOAK POTATOES + OTHER VEG BEFORE USING ETC

•LOW DAIRY (Although not cut out completely as he needs calcium) - no hard cheeses like cheddar etc - better options are mozarella / Brie/ soft cream cheese- read labels - low salt is better.

• Cows milk we have limited but not cut out. He mostly has soy or Almond milk. As his calcium is low we keep cows milk every other day. But if your calcium is ok then I would say stick to non dairy. I have read every label in the supermarket and the only supermarket non dairy milks without rubbish in the ingredients are alpro low sugar OAT milk, the unsweetened venmodo brand from lidl and plenish milks (but these don't taste great).

• READ LABELS - check salt content and anything that has 'phos or phosphate' or 'potassium' in the ingredients should be AVOIDED.

● SWITCHED TEA/COFFEE TO GREEN TEA OR CAMOMILE. OCCASIONAL CUP OF HIBISCUS TEA (helps with bp but be careful as it is potassium rich).

• Mainly veg diet with chicken breast or White fish once or twice a week. I have done A LOT of reading and if you have proteinuria and are in stage 4 - no matter what dr says I would absolutely limit your animal protein intake - if you can cut it out altogether.

● EGGS - try to stick to just the egg whites.

• Takes celery+Rocket juice every morning with acacia fibre + lemon.

• LOTS OF blueberries + berries in general

• APPLES + FIBRE are good!

• Drink no sugar cranberry juice + lemon water when you can. Stay hydrated!

• he is on a 2L daily liquid restriction but neph has said if it is a hot day or you are doing more physically than normal or for example we went on holiday to Sri Lanka - then can drink little more water... stay hydrated.

His creatinine and potassium did go up but the dr started him on bicarbonate which has helped and brought his egfr back to 19. I believe the above changes + the bicarbonate helped. I am hoping in Oct there is more improvement even if by just 1 point.

• keep an eye on your creatinine no. - dad's is still higher that I would like but it is coming down slowly.

It's a hard slog but keep at it - dad was diagnosed in March only, it will take time to see changes but I really believe lifestyle changes can help keep him away from dialysis - dr wants to discuss preemptive transplant with him but that was before the number went back to 19.

Don't panic- we have a neighbour who has ckd and she says her numbers do fluctuate - do your best to stay healthy and stay away from potassium / salt / sugar if you are diabetic / and red meats or high potassium/phos dairy. Eat lots of fibre.

[Savreen1 in reply to Rani224]

Thanks Rani for sharing your story. I’m vegetarian so no any meat or eggs for me. I think I have to work out on my eating portion and loose weight too. Thanks for giving me hope.

[TableTennisMama]

Just wanted to add a quick comment about your numbers. My experience shows that you could’ve gotten those same numbers from one blood draw. That’s how much a lab result can vary with the same blood sample. I know this because it happened to me.

I had two doctors that wanted blood drawn and both were asking for a GFR result. I cautioned the lab to not duplicate that test as my insurance would not pay for two at the same time. Well they messed up and duplicated the test. One result was 32 or 33, and the second result, (mind you on the same exact blood sample!) was I believe 37. My nephrologist explained that this was just normal variance and that’s why they look at your numbers over long periods of time. So the message is don’t get too terribly upset by these variances and have the patience to track it over time.

Best of luck to you.

[canadaeh in reply to TableTennisMama]

are you big? small? now that we have dropped the racial variable, i am questioning the gender one. i am taller, and would have concidered my self of superior muscle mass to most females, but that i not taken into account. my egfr, if i were male, would be jus fine....

sio remember, it is e GFR... estimated

[TableTennisMama]

I am 5 foot four, (though I used to be 5 foot 6 1/2) and my weight is 125#, down 30 pounds since going mostly plant-based. I have been physically active most of my life. I probably would say I have a bit more muscle than the average 69 year old woman.