Good news and bad news

i had my blood work done yesterday for my two-months recheck with endo.

bad news first:

my GFR (glomerular filtration rate) was 31. in July when i was diagnosed it was 35, then 33 in late november, and now 31. I am two points away from Stage 4 CKD (Chronic Kidney Disease). I don’t know how to stop that number from dropping so fast.

From the National Kidney Foundation:

1) Why glomerular filtration rate (GFR) as a measurement of kidney function?

GFR is usually accepted as the best overall index of kidney function in health and disease. Normal GFR varies according to age, sex, and body size; in young adults it is approximately 120-130ml/min/1.73 m2 and declines with age. A decrease in GFR precedes the onset of kidney failure; therefore a persistently reduced GFR is a specific indication of CKD. Below 60 ml/min/1.73 m2, the prevalence of complications of CKD increases, as does the risk of cardiovascular disease.

Table 3: Stages of chronic kidney disease and clinical action plans
Stage Description GFR Clinical Action Plan
1 Kidney damage with normal or increase GFR ≥90 Diagnosis and treatment, slow progression, CVD risk reduction
2 Kidney damage with mild decrease GFR 60-89 Estimating progression
3 Moderate decrease GFR 30-59 Evaluating and treating complications
4 Severe increase GFR 15-29 Preperation for kidney replacement therapy
5 Kidney Failure <15 Kidney replacement therapy (if uremia present and patient desirable)


National Kidney Foundation. KDOQI Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification and Stratification



now for the good news:
my A1C was 6.1! basically staying the same, even with the change from NovolinN/NovolinR to Lantus/Novolog.

Amiga:
I am sorry to hear the bad news… I am not familiar enough with GFR. Do you mind shedding some light on what that whole numbering thing means and what happens when people drop below 30?

The good news, on the flipside, ROCK!! Congrats on such a gorgeous A1C.

i edited my blog post to answer your question. As you can see why i’m very concerned with that #. I am 2 points away from Stage 4. Preparation for Kidney Replacement. Which means Dialysis. and that is fear.

Landileigh,

I am sorry to hear this news. What is your plan, what is your doctor suggesting for you?

i’ll find out monday, when i have my appt. i’ve done everything they have asked so far. i’ve dropped 35lbs. i’m on hypertension meds, i’m doing very well with my diabetes. watching the salt, walking… i mean, WHAT ELSE COULD I DO???

I will keep you in my thoughts, keep us updated.

I love you and am proud of you for doing all you can for yourself. You are amazing and you will come through this!

You gotta believe!

I have had kidney issues too, but nothing compared to what you are going through.

Did your doctor say anything about protein consumption? I cut down on the amount of protein I ate at one meal, and the amount of protein I ate in general. My creatinine and BUN levels stabilized. I’m guessing that protein was one of the first things that your doctor addressed; so I’m not sure if this could help you in any way, but it’s all I can think of.

I’ll be wishing all the best for you.

-Bill

Landileigh
I am so sorry about your kidneys. I have a GFR of 20. When I was first diagnosed with type 2 back in September of 2007 I was at a GFR of 30. The doctors tried pills and then Byetta and I lost another 10%. Then they put me on insulin and I somewhat stabilized. My doctors talk about dialysis everytime I go to see them. The thing that makes me feel a little more secure is that I have blood work drawn every two weeks. And I have an agreement that if “I” feel like something is off, I can call the office and go get more blood drawn to check what I think is wrong even if it has only been a few days since I was checked. We have picked up on things in an early stage this way. And I just feel better knowing that they listen when i say there is something going on. Also, I have been collecting information on home dialysis. I don’t want dialysis, but if there is no choice, I want to do it for myself. Your diet is definiitely very important. The protein is an issue, but so is potassium. This means no orange juice, bananas. potatoes, strawberries and watch the bread and spinach. BUT if your doctor wants you on these types of restrictions, he will tell you so. Check with him or her or them.
In the meantime, enjoy every minute of every day. Laugh and Love and Hug and Dance and Sing and Talk and do all the things that make you happy. I smile and mark every month on my calendar that I have made it without dialysis. With other problems I am not a candidate for transplant surgery. But by the grace of God, all my loving family and friends and all the loving and caring people on here we WILL get through this. And I will be smiling with you with every triumphant step forward that you make.
Congratulations on your great A1C and obviously great blood sugar control. I am sorry with all my heart for what you have been going through. We are all with you.

FOLLOW-UP:
My endocrinologist was very happy with my A1c. He stated that my blood pressure is up, this is why my kidneys are working a bit harder. He switched out my Verapamil for a new medicine, this will allow one of my BP meds to be upped if needed. I have been on Verapamil for so long, he thinks it is not doing what it should be doing. So I have to go in for a BP check in 2 weeks, and hopefully we’ll be able to get that down and then stabilize the kidneys.

Sounds hopeful. :slight_smile:

My heart goes out to you! You must be a strong amazing woman Landileigh. Glad to be considered in your list of friends. Take Care and God bless! Pam

Well I can feel for you. While I have not had the test done quite yet, I’ve got some major issues I need to work on. My A1C came back at 10.9; my Alb/Creat ration was 1007.95 mg/g and my microalbumin concentration was 887 mg/L. Obviously I am well on the way to Stage 2 or 3 by now and trying to find out what to do to slow the progression. So keep doing what you do and hopefully you’ll impart some sage advice to us in need.

It's been a few years, could you let us know an update?