Sudden GFR dip after adrenalectomy

[4rthDoctorFanGirl]

Hi all! I'm new here.I am basically writing this because I was diagnosed with Hyperaldosteronism early this year.I found a great endo...did a ton of tests and a vein sampling procedure (ugh) and finally had my surgery a month ago to remove my left adrenal gland.All went very well and my blood panels were perfect.Finally...my potassium is no longer scary low and I got off my BP meds...which was pretty exciting.A few days ago a had a follow-up metabolic panel and everything was normal.But my GFR, which is normally 80-90...has dropped to 56.For reference, I am a 64 yr old female.I've heard it happens a lot when people get their adrenal gland issues fixed, but then an underlying kidney issue shows up,very common then a big GFR dip.I have an appointment next week with my GP and I'm trying not to panic.I IMMEDIATELY started eating a strict CKD diet and drinking more water...working out more.I'm confident I can maintain this thing at this point but my big fear is that the GFR isn't through dropping yet! Mind you this is only one lab work done so far.Anyone else experience this or hear about it?

Thanks!

[RhenDutchess123]

Surgery and Anesthesia are hard on your kidneys and it can take awhile for your GFR to return to normal function...Your Doctor will most likely take Labs a few times because it takes 3 times to dx a drop in permanent function...Good for you on following a diet and exercising and remember to keep well hydrated to help flush the effects of your Anesthesia out

[4rthDoctorFanGirl in reply to RhenDutchess123]

Thanks for the reply! I also had a really horrible vein sampling procedure just a few weeks before the surgery that left me bruised and sore for a LONG time.In both procedures of course they used that contrasting stuff.I hear it's murder on your kidneys and can't help but wonder if that's part of it.

[jodaer]

I haven't had the experience you had but want to tell you keep up the good work and you probably won't have much to worry about, re dialysis/transplant. There are many people who have lower eGFRs and are doing just fine.

[4rthDoctorFanGirl in reply to jodaer]

Thank you for the encouraging reply! As I said my biggest fear is that the GFR isn't through dropping yet as my body gets settled in with it's new changes.Time will tell...I'm being very proactive until I see my GP next Wednsday.

[jodaer]

it might drop some more but eventually it will stop and then you will know where you are at. It might even come up a bit.

[4rthDoctorFanGirl in reply to jodaer]

I can only hope so! Trying to stay positive but very nervous.This came out of left field,literally! Like when I left the hospital it seemed all my health issues were behind but...that's what is so ironic about it.I've read a bit online and apparently it's a thing with my kind of adrenalectomies.Something about your adrenal gland producing that extra aldosterone for a long time masks an underlying kidney issue.Having high BP can beat your kidneys up and no one knows until the tumour/gland are removed.Fortunately my BP was always well controlled but...we'll see!

[Hawk12]

I, too have hyperaldosteronism. Unfortunately, mine is due to bilateral hyperplasia and is not amenable to surgery.

Hyperaldosteronism artificially increases GFR due to causing hyperfiltration in the kidney, and therefore lowers creatinine. Removing the adenoma, or in my case blocking aldosterone with an aldosterone blocker, will cause your GFR to drop, but not to that extent.

I suspect that the 56 is due to a combination of factors as suggested byRhenDutchess123. I will be very surprised if your GFR doesn’t return to at least the 70s. Anything over 60 is considered pretty normal for a 63 year old.

[4rthDoctorFanGirl in reply to Hawk12]

Thanks for the reply.Did you have a dip in your GFR when you started your medication? I've heard that is common as well with meds.It's frustrating and scary because since I was diagnosed with Conn's in the spring I've had to take K supplements and eat everything with K in sight just to maintain the low end of normal labs.I'm afraid that in doing so I have helped inadvertantly damage my kidneys more all this time.I ate very clean and healthy but the exact opposite of low protein,phosporous etc.Of course monitered sodium religiously though.Metabolic panel came back with creatinine in normal range.My BP which was always well controlled is really good with NO meds.Actually everything was...except GFR. My body has been through a lot in a short time with the vein sampling procedure and recent surgery.

Now eating strictly as if I have CKDa..drinking lots of water(always have) and working out.Talking to GP Wedn.

How are you doing since you got meds and Hypoaldosteronism under control? Everything good?

[Hawk12 in reply to 4rthDoctorFanGirl]

I had a kidney transplant. Renal failure due to hypertension/ diabetes? However, both were under good control. Diagnosis of hyperaldosteronism made after kidney transplant.

Unfortunately, my transplanted kidney was damaged by tacrolimus, used to prevent rejection. My GFR is in the low 30’s and did drop a little on meds, but now stable and, hopefully, blocking aldosterone will protect my kidney from further damage. I really think that your GRF will be fine! Best wishes!