Some time ago, just over 2 years now I had to go into hospital for just a day with a breathing problem and whilst there I had several blood tests.
I was told one of them, the kidney function test was abnormal and I might be referred to see a renal consultant. That actually didn't happen.
I have regular annual general routine blood tests through my GP and have asked on numerous occasions why I was told I had kidney problems but always get told "everything is ok".
Recently I had an unrelated hospital appointment and the consultant I saw sent a letter to my GP and I received a copy of it too. He started off by mentioning my past medical history and stated "this patient has chronic kidney disease" so I am obviously a little bewildered.
The last Creatinine and Electrolytes test results in December 2023 I am putting below. Under the "Result" tab, it states, Abnormal, but expected 😐 so I am even more confused. Any replies would be appreciated.
Serum sodium level 141 mmoI/L. Serum Potassium level 4.1 mmoI/L. Serum chloride level 106 mmoI/L. Serum creatinine level 86 umoI/L. eGFR using creatiniine (CKD-EPI) per 1.73 square metres 57 mL/min/1.73*2 (>60.0) which then states "below low reference limit". Serum urea level 7.1 mmoI/L
Can anyone clarify what is going on here with these results? Whether it is relevant or not I do not know but I have had the most awful skin itching for some time affecting mainly my face, neck and head on a mainly daily basis. When I mentioned this to a GP some time ago, I was prescribed antihistamine tablets but they really do not have any effect. Thank you for taking the time to read my post.
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eaggirl1856
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I'm not a regular contributor here, nor am I medically qualified to give you an informed opinion. However, from my own experience I can make a comment or two which may or may not help you make sense of it. I'm in UK, aged 84, am at stage 3b CKD. I have regular bloods taken for non CKD issues. I have a strong impression of two things, first being that GPs prefer to deal with one condition at a time and second, they routinely don't bother raising early stage CKD with more mature patients. For example, I only happened to see a reference to CKD in my blood test results on my surgery's online account, nobody had raised it with me. Looking back through the tests I found that it had featured for at least two years previously. When I queried it with my GP he said "not to worry, he was satisfied with my weight and life style so it was a case of "keeping an eye on it". In fact from my own research there did seem to be a strong link with the hypertension that I was being separately medicated for. Another 'impression' I have gained is that GPs don't rush to refer CKD patients 'up the line' to specialist NHS consultants until the condition is further advanced, stage 4? My advice to you is to do your own research and really push for answers when talking to your GP.
I agree with this totally! I'm stage 3 , found out three years ago after a well women clinic visit when I was 60 . My Drs gave me no information about the condition and seemed totally unconcerned about it , after researching it myself, I agree they don't rush to do anything untill your stage 4 . Like you when I questioned them about CKD they said I had a healthy lifestyle,I've no other health issues and just keep doing what I'm doing and monitor it 🤷♀️ . My GP doesn't even send for me for blood test although they admit they should, I ring and arrange them myself.
Aged 64 my GP said, "your kidney reading is a little higher than it should be, but do not worry I will keep an eye on it". Did she hell? It was 45. After over a dreadful year in her care and her ignoring every symptom I consulted her on, I was egfr 15. She then gave me 3 more bloods tests-so 4 in all before she eventually stopped the Glucophage SR and referred me to a Nephrologist. 15 months.
Yup. I agree. If my gp had told me sooner I would not have been in this situation. She had to have seen the gfr numbers going down. I also found out I have ckd after a hospital stay
Welcome. You have asked good questions here, and while I am not the best of us to answer, I shall try. Others will respond to you shortly, I am sure.
You are in the USA right? Oregon here. Definite differences in how tests results are calculated.
Unfortunately, it is maddeningly getting to be nearly commonplace for doctors not to mention early or even moderate CKD Chronic Kidney Disease to their patients. Perhaps they think we’ll run screaming from the exam room? Alas, we are made of sterner stuff!
I can only assume your doctors have noticed a drop in your eGFR score. This takes your creatinine and your other metabolic tests and comes up with a number, anything under 60 in America, that stages your degree of kidney impairment.
Now it appears your eGFR score is 57. Does that make sense from your lab sheet? If so, it is indeed below the general 60 cutoff indicating CKD, although it doesn’t tell us why, and that is why you should be speaking with a nephrologist, urologist, or a trusted medical professional. Call your doctor, get a referral. In America they’ll see you, but outside it’s iffy as they like your kidney function to be lower.
So, ‘generally speaking,’ your kidneys may POSSIBLY be functioning at 57 when normal can be anywhere from 60 to 100, 120 even. What does it mean? It means something may be wrong. But, it could also mean you had an infection in the urinary system, and that caused your number to lower.
Since it was noted more than once, in your chart, it may very well be true. But keep in mind the eGFR fluctuates. It is not 57 every day. It goes down when the body is ill, say the flu; and it raises when you’re well hydrated and stable health-wise. On average, which means its highly individual.
I can also see your uric acid level is a bit higher than it probably should be, so ask about that as well. I am unsure about your potassium and creat levels as I have old information as my issues began thirty years ago. Your sodium, your salt, levels are fine. Id be interested to know if your WBC was normal…creat looks normal from what I read just now, and these are clues your doctor will be looking at to make the diagnosis.
These tests were taken at one time—just a day. As you take them more often (possibly) to investigate, you’ll learn to spot patterns. You will see how it all fluctuates and what is fine, and what may signal changes to look into more.
Until your appt, read. Davita is a great resource on the web. NKF Natl Kidney Foundation. NIH Natl Institutes of Health. Read about chronic kidney disease, it’s causes, and get in to talk to a medical professional soon.
I’m sorry this happened to you. Get a new doctor. Empower yourself with information, ask questions as you need to, and know you aren’t alone. They did it to me, too. Now I always get copies of all test results. Now I ask questions, even if they don’t like it. 👍
thank you so much for the info you have given. I am in the UK. I am going to dig out previous blood test results (usually 12 monthly) to compare the figures as I always print them out for reference. I do have occasional UTI problems but not close/near to the date of the last blood test. Someone posted a reply to tell me of a good Facebook page, Chronic kidney disease uk so I will take a look on there later. I really appreciate your lovely reply. Thank you so much
Good morning eaggirl1856. There's a very good Facebook group run by Andrea and they will help you with advice on your results and also the itching problems you are having. Itching was mentioned last night in the group and some said Antihistamines didn't work. But used something else. The group is Chronic kidney disease uk. Hope this helps you. Brian
I have access to all my lab results and doctor's summaries via an online' My-chart'. I can message the doctor's staff from there also, all patients are set up with this. Full disclosure, I am a retired intensive care nurse, but my point is to be your own advocate. Ask about your results, ask about treatment plans.
Thank you for your reply. I have asked several times at my GP surgery and all they tell me is there is nothing to be concerned about and they will keep tabs on the numbers from my blood tests in the future. I was especially puzzled with the mention on my last blood test in December 2023 stating "Abnormal, but expected". Why expected but I got nowhere with answers
Sounds like you do have early, mild kidney disease. You're doctors aren't worried about, that's good. Still, your kidneys are more vulnerable than those of other people, and you should take some steps: Avoid acetaminophen, (Tylenol its called here), don't eat too much meat, especially red meat- protein stresses kidneys more than other foods, but, of course, you do need protein. A lot of people on this forum are vegan. Drink plenty of water. Look up kidney diet, or Mediterranean diet, and which drugs may be harmful for kidneys. Don't worry!
thank you. I do not know why the consultant I saw with an unrelated health problem stated in his letter to my GP/me that I had chronic kidney disease! I am actually being seen at this same clinic (gastrointestinal) tomorrow afternoon so I will mention it. I rarely eat meat nowadays but don't really want to go down the vegan route. I drink plenty of water every day. I will look up kidney/mediterranean diets in the coming days.
i disagree about the acetaminophen, that is ok with kidney disease. It is ibuprophen you should avoid. yes, limit the protein. I have an app on my phone that helps me keep track. It's called 'Kidney Diet'.
I am going to look up the "kidney diet" app later. You mentioned ibuprofen but that is something I never take and haven't done for many years following a stomach bleed.
Tylenol, paracetamol for you, is fine. I don’t take it as it doesn’t help, and it’s bad for the liver. Ibuprofen is a kidney killer so its good you don’t take it!
However, it isn’t just ibuprofen, it’s any NSAID Non-Steroidal Anti-Inflammatory Drug. This includes all the arthritis meds, which are tons. Just using them once can cause kidney disease in some, so I wanted you to be aware. 👍
Thanks again for posting. I do have osteoarthritis in both knees and take paracetamol or codeine for the pain. I realise I cannot take any NSAID's. The right knee is the worst and I was due to have replacement surgery but decided against it simply because I had a major shoulder operation last September and living on my own now I found it incredibly hard to manage. Even over 7 months on I still have much discomfort. I knew it would be even harder with a knee op so decided to decline at the moment
I hear shoulder rehab takes longer. Ouchies. Empathy with the knees. I tore my ACL and need reconstruction of the ligament and tendons and a roto rooter, but other stuff makes me high risk so I live with the pain. It seems they’ve perfected the knee replacements, but of course, it’s gotta be hard those first couple months. 4% lidocaine patches, non prescription, have been helpful to me
How old are you? A eGFR of 57 in a younger person vs and older person is very different. We all lose kidney function as we age. It is a warning sign for someone who is 30 and completely normal in someone in their seventies.
I'm not sure what online sources you are reading. 57 is barely in the CKD diagnosis range and you are already at life expectancy in the US. It can be difficult to hear, but it's true. Do you have any underlying conditions that might impact your kidney functioning. High blood pressure? Diabetes? Lifelong dehydration? Any genetic conditions that are tied to CKD? Has your eGFR dropped suddenly and last longer than 3 consecutive, spaced out tests? If not, then your Dr. is probably giving you an accurate diagnosis.
The doctor hasn’t diagnosed her. He/she refuses to tell her much of anything. While 57 at 76 years old may be okay, it isn’t normal if it slips even lower, which we don’t know yet if it’s done. She is checking her past tests.
It isn’t normal to be stonewalled at your gp when you are asking why some anomolies have been noted in your chart. Nor is it the best way to keep your kidneys in good health. Information, I’m sure you’d agree, is always worth pursuing, even if it turns out you’re okay. Not everyone ends up okay.
Charts automatically flag everyone with an eGFR below 60 as "abnormal." This is why many doctors and researchers have called for the creation of an age related eGFR to more accurately diagnosis CKD in the elderly. She asked her Dr. and he said it was normal for a 76 year old to have an eGFR of 57. This is completely inline with all the articles I've read on this subject, particularly if there is no underlying conditions tied to CKD. I encourage you to read the medical articles I posted if you are interested in this topic.
No, I get that. I was at 60 for many, many years, and I never once was told it was abnormal in any way. I wasn't ever told having one kidney left meant I was CKD automatically. I never knew to watch certain things I eat, why I peed so much, etc. etc. One can say I was 'normal' but I had one kidney. Now that the eGFR is around 45, I'm no longer normal? Yeah, new guidelines and more extensive communications between patients and doctors necessary!
Regarding our friend here, when you say She asked her Dr. and he said it was normal for a 76 year old to have an eGFR of 57. I am under the impression this isn't the case: there was no real conversation about her numbers. It was pointed out by two other professionals, through her records, not in person per se, and not by her GP. The point is moot and she's getting help so YAY.
My mother's tests showed 35-45 for eleven years, and her GP never told her. Not once. This is commonplace and while a 60+ may not be so abnormal, 45- is. Now I am trying to teach her kidney health and frankly, it would have been much easier eleven years ago for her to understand! Ah well. I am glad there is talk of restructuring this
thank you CatOnACloud (love that). You are completely correct, my doctor has NOT said anything about my results. Not quite sure where barbara55109 thought that was the case.
I have been out today a lot & then on to help an elderly lady so I still haven't got round to digging out my past results. Dentist tomorrow morning so when I get home that will be one of my jobs, after a dog walk, of course!
You wrote, "I have asked several times at my GP surgery and all they tell me is there is nothing to be concerned about and they will keep tabs on the numbers from my blood tests in the future." That's where I got the idea your Dr said your labs were fine. You told us!
I was curious about the eGFR levels so I googled and it showed this....I do not have high blood pressure or diabetes. Only issues I have at the moment are gastrointestinal (hiatus hernia) and previously almost 3 years ago bowel cancer. I must dig out the previous test results I printed just to see what they show from previous years...
Yes, but that eGFR isn't unusual for seniors. There's a lot of disagreement among professionals as to what is considered "normal" for older folks. (See link below.) That's probably the reason for the statement on your lab report of "Abnormal, but expected". I suspect they'll fine-tune the CKD diagnosis for those of us in that category as time goes on. I sense you have a nice future ahead of you.
"The study findings suggest that the current CKD definition that does not consider age-related eGFR decline may inflate the burden of CKD by classifying many elderly people with normal kidney aging as having a disease." "65 years or older and had eGFR of 45 to 59 mL/min/1.73 m2 with normal/mild albuminuria. In this latter group, the risks of kidney failure and death were of similar magnitudes to those of controls without CKD." Accounting for Age in the Definition of Chronic Kidney Disease jamanetwork.com/journals/ja...
I used to do ultramarathons and was concerned how they affected my liver (also took NSAIDS) so my PCP agreed to run blood tests after the races for me. I tracked the results in a spreadsheet. The races did not affect my blood tests but they did show I had kidney issues. She agreed and referred me to a nephrologist. The first one just said since I was small and in shape, no worries. The second one I went to a year later when my function kept dropping was better, ran a lot of tests and scheduled a biopsy. It's been 5 years and I'm now on dialysis. Tried diet, exercise, etc and nothing helped so here I am at 60 waiting to go back active on the transplant list.
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