CKD stage 4 but no proteinuria

[snapqueen]

I was diagnosed 8 years ago when my egfr dipped just below 60. It has been a steady, slow decline to where I am at now with an egfr of 27. My nephrologists, I've had 3, have characterized my decline as steady. I've followed all the dietary guidelines but only fleeting improvements. Now at 75 years of age I'm in stage 4. At the same time other than creatine of 1.95, most of my labs show no problems with protein, potassium, phosphorous, calcium, etc. Has anyone else reached stage 4 without any other indications? Thanks

[CKD3Khan]

I was diagnosed with stage 4 about 11 months ago, at age 66. Creatinine has been steady around 2.00 but was around 6.00 when I was diagnosed. eGFR has been as low as 29, has recovered a little to around 36. Except for cholesterol being somewhat high, all other levels are in the normal range, including sodium, potassium, Vitamin D, Magnesium and other results. No indications of proteinuria. There was concerns of hypoparathyroidism for a couple of rounds of labs, but recent labs have found levels to be in the normal range too.

[Nana16]

I was diagnosed in 2010, when my levels were around 48. I was 63 then. No proteinuria, all the lab levels are good except creatinine at 1.64 and BUN 33 on my labs this month. I am at stage 3b now, eGFR of 32. I've been bouncing around between 32 and 35 for the last 3 years or so. I have watched salt and potassium in my diet, in particular, and also eat much less meat than I did 14 years ago. Only eat poultry and fish, and occasionally a small amount of grass-fed beef. I do eat a half cup of lactose free yogurt every morning and have one small glass of fat free milk at bedtime. I also watch refined sugar, make almost all of my food from scratch because I have Celiac disease. I eat a simple diet, as many veggies as I can tolerate with also having IBS-D. I've had autoimmune hypothyroidism (Hashimoto's) for well over 20 years, and 4 years ago was diagnosed with compenstated congestive heart failure, which my cardiologist never told me about. I read it on a visit summary. When I asked him about it, he said he was keeping an eye on it and not to worry. I have silent ischemia as well, which he also didn't tell me, just gave me nitrostat and told me to use it if I have chest pain. Well, I don't feel the chest pain! It's silent ischemia, which means I don't feel the pain. By the time I recognize that I am having a problem, I'm in some place like the middle of the grocery store, and can't take the nitro. I've yet to take it, though I've had it for almost 4 years now. I am slowly becoming more exercise intolerant, despite trying to stay as active as possible. I also have severe osteoarthritis in my spine, can't take much for the pain because of my lowered kidney funtion. But I am 77, and all in all things could be worse.

[gojets in reply to Nana16]

your 77? You have nothing to worry about

Your kidneys will out live you

Only 1 on 100,000 stage 4 ever go to stage 5

CKD is the most over diagnosed disease

[Nana16 in reply to gojets]

I think my kidneys will probably last as long as I need them, but I'm still trying to take good care of them. I just watched my sister in law go sliding rapidly down to end stage kidney disease, and she died last summer at the age of 73. I'm pretty sure that most people, as they age, have reduced kidney function, and likely many of them are not told, as was the case for my sister in law. She knew nothing about it until she was already approaching end stage. Then there is my husband who is 78, diabetic, has had many cancer treatments and surgery, had a major heart attack but never knew it until years later, and also has a spinal cord injury. His eGFR is around 90.

[Sapphire187]

Yes, I have. I am 66 years old and am at stage 5. I have never had a problem with any of the labs you mentioned. However, I do have anemia, secondary hyperparathyroidism (due to CKD), and BUN in the 50’s. I wasn’t diagnosed with CKD until January 2022 when my eGFR was 44.

[drmind in reply to Sapphire187]

Are they treating your hyperparathyroidism? My neph treated mine a few years ago with daily vitamin D3 and calcitriol. The calcitriol was slowly tritrated over the next few months until the PTH level fell to normal. I believe the treatment formula depends also on your calcium level at the time.

[Sapphire187 in reply to drmind]

My PTH has been high for the last 1.5 years and my neph just started treating it 3 weeks ago when my PTH went over 600. She started me on calcitriol. My calcium has always been within the normal range. How long did you have to take it before you got back in the normal range?

[drmind in reply to Sapphire187]

I think I took it for about a year and a half before it was on the normal range I was started on it daily, then after several months I took it every other day, then it was only on MWF, and eventually it was stopped. But, I also had to take Vitamin D3 daily which I still take. I can't find the level my PTH has gone, but I think it was higher than yours. It was also high for about a year or more because my primary did not know how to treat it. It was around this time when I started to see a very good neph and he immediately treated it. Unfortunately, he moved away and I haven't been able to find anyone as good as he was. Anyway. Its good thst you getting the PTH treated. I was told that eventually if left untreated, the body begins to take calcium it needs from your bones. BTW my calcium was always normal, too, so I'm not sure what's going on with these high PTH s

[Momwatcher in reply to drmind]

at the risk of sounding very stupid may I ask what is PTH?

[PeaB4YouGo in reply to Momwatcher]

PTH is the lab result that tells us how well our Parathyroid is doing.

[barbara55109]

I am 62 and stage 4 for 4 or 5 years. My ckd is from long term dehydration from losing my colon at 30. I have no protein in my urine and I need salt and pottasium. My phosphorus was a little high and is normal since I take a binder when I have diet coke. Sadly few restaurantrestaurants have caffeine or phosphorus free diet pop. I do have to take calcitoeal,(spelling ) but my parathyroid numbers are good with the medication. We aren't cookie cutters. Our ckd comes from different sources. Ane once over 65 age related decline kicks in. Some dr advocate for a scoring system to account for age related decline since it isn't really ckd. I've posseveral journal articles here about age related decline.

[jawonion in reply to barbara55109]

Hi. I went to my first visit today Dec 2 with kidney doc. Lot of questions. She saw my last labs, but I don't think she saw the ones from Oct 2024. Only the ones from Aug 24... she ordered ultrasound which she says will show more than the MRI I had last week. Ordered lots of blood work and urinalysis. I sometimes have not too good memory so I have to write everything down. She did say I can take a Benadryl for itching and sleeping as needed. To add more protein to my diet since I'm a vegan..drink 64 ounces of water and take B12 vitamin. As for potassium and protein she said not to worry about it at this point and basically not to listen to Dietician. Eat more protein. Eat bananas if I like. I saw her notes after I left and she is saying possibly CKD stage 2? but how can that be if my Creatine as of Oct was 1.12 and eGFR was 55? I guess the new labs will reveal more. And I have a history of renal cancer in family. Mother died from it. Daughter has only one kidney bc cancer took the other at young age. On a scale of 1-10...I will give the kidney doc a 6, not sure if I was really feeling her energy. Blood pressure normal. But she did say will monitor weight. That's the story. Have a good day all.

[barbara55109 in reply to jawonion]

There are different CKD charts that turn scores into stages. Your Dr. may be using one that has 55 at stage 2. Also, there are some charts that factor in age differently. At 75 it is likely that you are experiencing at least some age related kidney decline. I know of no chart that shows an eGFR of 55 as stage 4. Stage 4 is usually an eGFR of below 29. An eGFR of 55 is only slightly below "normal" for someone much younger. It was only in the last few years that labs even started sharing scores below 60.

[jawonion in reply to barbara55109]

Hi barbara 55109. She did mention something about different scores, like I said, my memory is not the best. Im 63 , not 75. So I guess she has to take that in consideration as well. Still not clear if she was looking at latest labs bc she showed my my blood work from 2022- Aug 24 and egfr had dropped 11 points. Guess i'm just fortunate and feeling ok. I have to wait until Jan 1 when new insurance kicks in to have blood work and ultrasound done. I see her again in Jan 2025 as well.

[barbara55109 in reply to jawonion]

Sorry, I thought you were the original poster who is 75.

[jawonion in reply to barbara55109]

😀 no worries. btw..that one did send link about registered nutrionist.

[barbara55109 in reply to jawonion]

Did he send a link to his "college" which also gives diplomas in aromatherapy, massage, vegan cooking, herbs, and so on. They are "voluntarily regulated" - they give themselves a registration. It is not the same as being a licensed doctor, nurse, dietician or other medical professional. Licensed medical professionals in the US are licensed by a government agency and required to graduate from an accredited institution and meet requirements, including continuing education requirements. Not the same thing at all. His diploma required 30 weekends or 60 weekdays and 28 clinic days. Somehow in that very short period of time he has become an expert in diabetes, obesity, weight loss, health eating, sports nutrition and CKD. He paid 165 pounds to get "registered." My endocrinologist must have been a fool to spend 4 years in undergraduate school and 4 years of medical school in an accredited institution, three years of residency, three years of a fellowship. He had to pass several exams to become a licensed MD and board certified in endocrinology. Even with my endo's 24 years of full-time experience Oliver thinks he knows more after his 88 days diploma. Oh yeah, my Dr is a published author and researcher and Oliver presents lit reviews from decades old Google posts.

[jawonion in reply to barbara55109]

YO! YOU HAD ME ROTFL!! 🤣🤣🤣 Best laugh I have had in days! I sure need my spirits lifted! thanks, barbara55109😂. Yeah, I guess our docs are just dumb as rocks to go through all the schooling and accreditation they do, when all they have to do is spend 60 days perhaps online learning their craft! that was too funny! You should take up comedy! I was reading up more today re: CKD and all that jazz. Kinda had me down. Thanks. Be well!

[barbara55109 in reply to jawonion]

Another big difference. My endo doesn't feel the need to post photos of his naked abs to lure patients in. instagram.com/p/C_vM-Rptmhn/ instagram.com/p/C-NWsE3NNti/ instagram.com/p/C8Z1zPZNwC4/

[jawonion in reply to barbara55109]

WHAT DA!! LMFAO!! he can't be serious can he?? 🤣🤣🤣🤣🤣 and to have other famous ppl name next to his? BIZARRO . nope, can't imagine the kidney doc I saw yesterday ever posting anything remotely insane like that! You got real jokes!! I needed these laughs! Ppl never ease to amaze me!!

[jawonion in reply to barbara55109]

NO! I didn't get a link, and wouldn't have bothered with it at all! Thanks for wising me up!

[vinadhun2]

I am in almost similar situation. I am 77 and all my parameters are normal for kidney function except creatinine around 2.0. No protein in urine. No diabetes, no thyroid problems, cholesterol is normal, BP is normal. Everything else is normal. GFR around 33.

My nephrologist tells that creatinine goes up due to age. Just monitor.

I did blood test for first time in my life in 2019 and at that time creatinine was around 1.85. Since then it has been fluctuation between 1.7 and 2.0

[paulsamson458]

First time on here. I am male 83 yrs old. CKD diagnosed about 13 yrs ago with egfr of 60. Steady decline until I am at egfr of 22 now. Abnormal labs are creatinine 2.73, BUN 36, glucose 106. Hemoglobin, hematocrit and RBC slightly low, Take meds for BP, cholesterol, GERD and depression. Nephrologist started me on Jardiance 5 mths ago. Have lost about 9 lbs with no effect on egfr. I get the impression that this is no big deal with him. Tells me that I have no dietary restrictions and not to lose any more weight. Am 5'6" and 149. No proteinuria. Kind of discouraged because tired all the time. But everyone says that I really don't look 83. Hate when I hear this because I really don't feel that great.

[Sapphire187 in reply to paulsamson458]

Sounds like you may have anemia due to the CKD. I’ve had anemia due to CKD since I was stage 3b and am now stage 5. This happens when the kidneys don’t make enough of the hormone erythropoietin, which signals the bone marrow to make more red blood cells. You might want to ask your doctor about it.

[vinadhun2 in reply to Sapphire187]

what is level of hemoglobin

[snapqueen]

Thanks everyone for sharing. At least I know I am not alone. I had gestational diabetes over 50 years ago so I have been classified as prediabetic for a long time. I credit that issue with keeping me on the straight and narrow diet wise so that my glucose hardly ever goes over 100. My previous nephrologist pretty much wrote me off as age related CKD and did nothing. My current nephrologist ordered a kidney biopsy but the technician did not get a sample of my kidney tissue, only fat. Now since my egfr is 27, he wants to postpone another one hoping my labs will improve. I also recently had a TIA or ministroke. They would like to do a CT scan with dyes but that is also a problem if your egfr is below 30. I guess CKD is a many faceted disease and there is a lot the doctors don't know.