does this need further investigation ? - Kidney Disease

Kidney Disease

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does this need further investigation ?

Whatnow1973 profile image
20 Replies

I’ve been going to the gp since 2022 with vague symptoms but one consist results has been low albumin & high ESR (very high). They’ve said that these alone are not indications of a specific condition. I also have high blood pressure & very high cholesterol.

last year I started to get severe hip pain. When it happened again earlier this year I had a test for RA which came back positive and I was referred to a rheumatologist. I don’t RA, however she very through & is convinced I have something! I first saw her in March. I saw her again yesterday & she picked up my albumin, which has been consistently low since Dec 2022. She got me to do anytime test and these are the results:

Creatinine level, urine 9480 umol/L

Protein level, urine

5.75 g/L

Protein creatinine ratio, urine

606.5 mg/mmol

I can see these online but haven’t discussed yet. I know no one expect my doctor can confirm but I’m worried, should I be? Or is Dr Google leading me on the wrong path?

Thanks

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Whatnow1973
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20 Replies
orangecity41 profile image
orangecity41NKF Ambassador

We cannot diagnose , but hope your Doctor is not leading you on wrong path. You can get a second opinion.

Whatnow1973 profile image
Whatnow1973 in reply toorangecity41

Thanks for your reply. Not looking for diagnosis, just asking if I should be seeking further assistance. My doctor isn’t leading me down any path as we haven’t discussed these results yet. What looking to know is are these normal ??

Partner20 profile image
Partner20 in reply toWhatnow1973

It is impossible for you to be able to judge these results without their accompanying ranges. If you have those you may have some idea of where the results sit, and the NHS info on each test may be of help.

Whatnow1973 profile image
Whatnow1973 in reply toPartner20

Unusually there is no ranges on the protein/creatinine ratio is says :

In non-diabetics consider clinically significant?proteinuria to be present if protein/creatinine?ratio (PCR) is 50mg/mmol or more.?Consider nephrotic range proteinuria if PCR is?300mg/mmol or more. As per NICE CKD guidelines.?A Protein creatinine ratio >29 mg/mmol in?pregnancy is considered abnormal.

so if I’m reading this right there is a potential issue. I was a bit dehydrated too though. It was first thing, I’d had a coffee and a small water.

Partner20 profile image
Partner20 in reply toWhatnow1973

Dehydration can definitely negatively affect all kidney function tests, so perhaps a repeat test would be a good idea. Creatinine can increase with both protein and exercise, so avoid both of these factors in further tests.Low albumin can indicate problems with protein retention, too, so maybe this needs investigating too.

Whatnow1973 profile image
Whatnow1973

Thank you. My GFR is fine, >90. Blood albumin low for 2 years.

Blackknight1989 profile image
Blackknight1989

my apologies for the time-wasted and my congrats on the stellar eGFR reading but apologies for the low blood albumin…do you know the condition it is an indicator of? If too personal a question no need to answer, just most here are some sort of CKD sufferers or at least have severely limited kidney function not many with your symptom no matter the condition causing said symptom…my best to you!

Whatnow1973 profile image
Whatnow1973 in reply toBlackknight1989

Please don’t apologise, I appreciate you taking time out of your day. Currently I have no idea what is causing the low albumin. My GP brushed it off as nothing for 2 years & it’s only now I’m under a consultant that she’s looking for reasons and kidney issue are of the areas she’s looking in. Best to you too.

Blackknight1989 profile image
Blackknight1989

Ah the Overworked GP, the most stressed, under-paid and significantly over-burdened with patients who aren’t really sick (just ask them they’ll tell you) should have been a specialist then they could have practiced real medicine.

Tough way to come to CKD if that’s indeed what the low albumin is indicative of….regardless she should be able to identify the cause and get you started with a plan of care….as you most likely know, if indicative of CKD/kidney disease there isn’t a treatment as understood for most diseases…a couple of promising ways to help slow progression etc but no blanket treatment to “cure”. Though if you take care of yourself you can control progression and effects…I’ve lived as a CKD 4 eGFR 16-20 for almost 30 years! Probably TMI….my best to you and I hope your issue isn’t didn’t something without the lifetime stigma that can cause! My best to you!

allene7 profile image
allene7

Hi ,First I want to say I'm not a doctor. Just suggestions and possibilities.

Low albumin can be a sign of liver or kidney disease. Or some other condition not sure what.

High levels could also be a sign of dehydration, not sure what you drink per day or how much.

Albumin is made by the liver it;s a protein. It enters the bloodstream and helps keep fluid from leaking out of the blood vessels.

I absolutely think it needs more investigation. Unless you are dehydrated and that would be an easy fix,

Good luck

Whatnow1973 profile image
Whatnow1973 in reply toallene7

Thank you for taking the time to reply. Hopefully I will hear something this week. I may well have been dehydrated for the urine test but my albumin has been low for every blood test I’ve had since Dec 2022.

I guess they will recheck. I’m the meantime I’m going to ensure I’m super hydrated!

Bet117 profile image
Bet117NKF Ambassador

Whatnow1973,

Low albumin can have many roots from kidney disease, to malnutrition; not getting enough protein, to liver issues, infection, or vitamin D deficiency, but each person is different.

Considering that you have high BP and a few other issues, it's to your benefit that your GFR is good.

I know that Dr. Google is a temptation, but he/ she doesn't see you in person and therefore just provides information, much of which may not be pertinent to you.

My thoughts, leave him/ her be a bit. At this point, it can't hurt to see a consultant and get their thoughts on the entire picture; they can always confer with your GP and rheumatologist if need be.

Stay positive and move forward as the key thing is that you address this.

Reach back and let us know what the outcome is.

Bet

Whatnow1973 profile image
Whatnow1973 in reply toBet117

Hi

Thanks for taking the time to reply.

I do have low vit d always. Usually end up having a loading dose once a year & supplement throughout. Although the rheumatologist told me the only way to lose albumin was via consistent diarrhoea or via urine.

I’m in the uk & I don’t have private health. Annoyingly I’ve always had but I took a job that doesn’t offer it which I never would’ve done if my gp hadn’t of said the test meant nothing! So I’ll have to wait and see if they’re going to refer me to anyone else.

I’ll keep you posted.

Take care and have a great week.

Bet117 profile image
Bet117NKF Ambassador

Hi back,

One day at a time with all of this.

You are doing the best that you can.

I have heard about the UK Health System via my close friend from Doncaster; the GP handles all until you reach a specific level, so hopefully you are seen by or can find a good one.

Even in the US, referral to a specific specialist is not simple, so I can empathize with you.

Remember that many things can be tied together in this case causing all of this.

Have you looked at your kidney and urine labs going back to 2022 to see if there is a trendline? Check them.

I'm glad that your Rheumatologist is at least covering bases that can hopefully get this identified and treated.

Don't you wish things were simple?

If you can see another GP and your insurance will cover it, consider doing so.

Hopefully you will have answers soon.

Reach out at any time and remember to think positive.

Whatnow1973 profile image
Whatnow1973

I heard from rheumatologist and she’s made an urgent referral to the renal team. She said my kidneys are inflamed?!

I can’t quite believe this. And I’ve had the issues for so long and no one has done anything about it.

Darlenia profile image
Darlenia in reply toWhatnow1973

It's great that you have a rheumatologist watching over you. They're often worth their weight in gold. Your situation interests me since I have a son with PsA, an autoimmune disorder, and his lab numbers are similar to yours here and there. His rheumatologist watches his joints and organ functions closely, he's particularly wary of inflammation, etc. You may or may not be in a similar boat, but I sense you're in good hands.

Blackknight1989 profile image
Blackknight1989 in reply toWhatnow1973

Based on the information you have provided there is no way she has any idea if your kidneys are inflamed?!? Unless she preformed a cat-scan or MRI imaging you’ve not mentioned…if all she had done is blood/urine test and not cat-scan and it would need to be imaging as detailed as a baby ultrasound, there is no way she could know…I’ve searched the internet for imaging studies or specific blood tests to determine that your kidneys are inflamed and I don’t find any…no way she could know, she might suspect but I’d not worry too much if you are concern because I can’t find any info that suggest she could know for sure they are inflamed…her experience and her exposure to kidney disfunction might lead her to suspect or be highly suspicious of inflammation but I can’t find a specific test blood or imaging that would give her the inclination to believe they are absolutely, 100% inflamed…my guess is that’s her normal go to for referral and she just uses the old “your kidney/kidneys are inflamed, beyond my experience thus referral!” Based on what you have disclosed she might suspect but doesn’t know for sure…that her go to reason for referral. So I wouldn’t be overly concerned as she doesn’t really know…

Whatnow1973 profile image
Whatnow1973 in reply toBlackknight1989

Blackknight1989 thanks for your reply. I think she’s basing this on my esr which is currently 136, plus my other results. But I agree she can’t know for sure. I had a CT in March, all good. She’s requested an ultrasound.

Whatnow1973 profile image
Whatnow1973

Hi, I’d thought I’d update all who replied and offered advice/support.

So the bad news is I do have nephrotic syndrome, the nephrologist thinks it’s autoimmune and has ordered loads of bloods. If it’s not he will do a biopsy but he has confirmed this diagnosis. The good news remains my kidneys haven’t get began to fail.

I’m lucky as I’ve been on BP meds for a while. However he said it was puzzling why my PCR was still so high on Lorastan.

I’ve been put a a very low salt diet, 2.5g per day and he’s also prescribing furosomide.

I know it could be works but it’s still quite mind blowing and feels life changing.

Badger2024 profile image
Badger2024 in reply toWhatnow1973

Sorry to hear that. It’s a shock when first diagnosed with any lifelong condition but you’ll be surprised by how you will be able to manage it quite effortlessly once you get your head around it. Baby steps. Important to get bloods done regularly and have a doctor who actually cares about your health. The British Heart Foundation recommends everyone shouldn’t have more than two grams of sodium per day. It’s outrageous how much salt the general population has daily. As it’s an acquired taste you’ll start preferring things lower salt. It just takes time. Take care

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