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Suggest Treatment For Stage 3 Chronic Kidney Disease
Question: I am 66 and thought I was in very good health. walk 3 miles a day. 5'4'' 130 pounds. non smoker. just been told i have stage 3 CKD. Looking at old medical records, I have had it for at least 5 years and no one mentioned it to me. I have no symptoms.
I had ultra sound and found out my kidneys are half the size they should be.
What will happen down the road?
I had ultra sound and found out my kidneys are half the size they should be.
What will happen down the road?
Brief Answer:
need more info
Detailed Answer:
Hello
Thanks for the query
It is unfortunate that this was not noticed till now. But please don't worry, in order to help you I need to know more about you so that I can give a customised recommendation
1. Were you in the habit of taking painkillers ?
2. what is your creatinine , hemoglobin, calcium, phosphorus and uric acid ?
3. do you have swelling of the leg ?
4. please list the medications you are on currently
Please get back to me , I am awaiting your reply
Regards
need more info
Detailed Answer:
Hello
Thanks for the query
It is unfortunate that this was not noticed till now. But please don't worry, in order to help you I need to know more about you so that I can give a customised recommendation
1. Were you in the habit of taking painkillers ?
2. what is your creatinine , hemoglobin, calcium, phosphorus and uric acid ?
3. do you have swelling of the leg ?
4. please list the medications you are on currently
Please get back to me , I am awaiting your reply
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have taken pain pills from time to time in my life. I also took predesone for sinus infections.
The creatiine level on 4/8/15 was 1.13 and gfr was 51. On 3/24/15 it was 1.2 and 47.
10/23/14 was 1.04/57. 10.28/13 was 1.2 and 47. March 2, 2011 was 1.1 and 50.
Hemoglobin on 4/8/15 was 14.5
Calcium 9.3
alkaline Phosphatase, S was 79
I do no shave anything called uric acid test.
I do not have swelling in the legs.
I was on Crestor and quit. My vitamins are B3, B6, B12, C, D, E, Qu10 That is it.
My potassium is 5
total protein is 6.4
forgot to mention on 5/20/14 my creation was .08 and GFR was 72.21
The creatiine level on 4/8/15 was 1.13 and gfr was 51. On 3/24/15 it was 1.2 and 47.
10/23/14 was 1.04/57. 10.28/13 was 1.2 and 47. March 2, 2011 was 1.1 and 50.
Hemoglobin on 4/8/15 was 14.5
Calcium 9.3
alkaline Phosphatase, S was 79
I do no shave anything called uric acid test.
I do not have swelling in the legs.
I was on Crestor and quit. My vitamins are B3, B6, B12, C, D, E, Qu10 That is it.
My potassium is 5
total protein is 6.4
forgot to mention on 5/20/14 my creation was .08 and GFR was 72.21
Brief Answer:
Follow up
Detailed Answer:
Hello
Thanks for the query
I am extremely sorry for the short delay in my reply. There was a family emergency.
Here are my suggestions to you
1. Your serum creatinine is normal and you do not have chronic kidney disease
2. The gfr you are calculating is not accurate, you are probably using the formula which is only used for drug dosage
3. For more accurate reading I recommend Dtpa Reno gram or insulin test
4. Howver proteinuria would mark the start of chronic kidney disease so please get a 24 hour urine protein done
Few tips for a healthy kidney
1. Drink plenty of water . About 3 litres a day
2. Keep yourself well hydrated at all times
3. avoid analgesics especially NSAIDs group
4. Follow a low salt diet
5. exercise daily for atleast 30 min a day
I am once again sorry for the inevitable delay in my reply. I usually try and answer within 12 hours
I am sure you will have doubts, I will be happy to clarify.
Regards
Follow up
Detailed Answer:
Hello
Thanks for the query
I am extremely sorry for the short delay in my reply. There was a family emergency.
Here are my suggestions to you
1. Your serum creatinine is normal and you do not have chronic kidney disease
2. The gfr you are calculating is not accurate, you are probably using the formula which is only used for drug dosage
3. For more accurate reading I recommend Dtpa Reno gram or insulin test
4. Howver proteinuria would mark the start of chronic kidney disease so please get a 24 hour urine protein done
Few tips for a healthy kidney
1. Drink plenty of water . About 3 litres a day
2. Keep yourself well hydrated at all times
3. avoid analgesics especially NSAIDs group
4. Follow a low salt diet
5. exercise daily for atleast 30 min a day
I am once again sorry for the inevitable delay in my reply. I usually try and answer within 12 hours
I am sure you will have doubts, I will be happy to clarify.
Regards
Above answer was peer-reviewed by :
Dr. Yogesh D
Please clarify. Yes, I am totally confused. I forgot to mention my kidneys are half the size they should be. I do not remember any illness or injury that brought about this. Could I have been born with small kidneys? An ultra sound picked this up a few weeks ago.
What is going on if I do not have chronic kidney disease?
I have taken pain pills from time to time in my life. I also took predesone for sinus infections.
The creatiine level on 4/8/15 was 1.13 and gfr was 51. On 3/24/15 it was 1.2 and 47.
10/23/14 was 1.04/57. 10.28/13 was 1.2 and 47. March 2, 2011 was 1.1 and 50.
Hemoglobin on 4/8/15 was 14.5
Calcium 9.3
alkaline Phosphatase, S was 79
I do no shave anything called uric acid test.
I do not have swelling in the legs.
I was on Crestor and quit. My vitamins are B3, B6, B12, C, D, E, Qu10 That is it.
My potassium is 5
total protein is 6.4
Hi, please read all the above. Everything on the internet says if I have GFR OF 59 or less I have CKD.
The tests that the doctor has now ordered are CBC, Ferritin, Iron, Phosphorus, UA Dipstick and Microscopic, CRITER, Urine Microalbumin/Creatinine Ratio, and PTH
What is going on if I do not have chronic kidney disease?
I have taken pain pills from time to time in my life. I also took predesone for sinus infections.
The creatiine level on 4/8/15 was 1.13 and gfr was 51. On 3/24/15 it was 1.2 and 47.
10/23/14 was 1.04/57. 10.28/13 was 1.2 and 47. March 2, 2011 was 1.1 and 50.
Hemoglobin on 4/8/15 was 14.5
Calcium 9.3
alkaline Phosphatase, S was 79
I do no shave anything called uric acid test.
I do not have swelling in the legs.
I was on Crestor and quit. My vitamins are B3, B6, B12, C, D, E, Qu10 That is it.
My potassium is 5
total protein is 6.4
Hi, please read all the above. Everything on the internet says if I have GFR OF 59 or less I have CKD.
The tests that the doctor has now ordered are CBC, Ferritin, Iron, Phosphorus, UA Dipstick and Microscopic, CRITER, Urine Microalbumin/Creatinine Ratio, and PTH
Brief Answer:
Chronicity
Detailed Answer:
Hello
Thanks for getting back
Small sized kidneys is usually because of hypertension, chronic glomerular nephritis or reflux nephropathy. However size of the kidneys does per say determine chronicity. Patients can be normal with small sized kidneys.
Let me help clarify your confusion point by point
1. Cortico medullary differentiation determines chronicity more than the size. Many individuals have smaller than normal kidneys
2. If cmd is lost or partially lost then I recommend you to undergo a Dtpa scan
3. I also suggest you to quantify your protein loss , that can mark start of chronic kidney disease
4. make sure hypertension is well controlled
I hope I was able to clear your doubts, please get back to me if you have any further doubts
Regards
Chronicity
Detailed Answer:
Hello
Thanks for getting back
Small sized kidneys is usually because of hypertension, chronic glomerular nephritis or reflux nephropathy. However size of the kidneys does per say determine chronicity. Patients can be normal with small sized kidneys.
Let me help clarify your confusion point by point
1. Cortico medullary differentiation determines chronicity more than the size. Many individuals have smaller than normal kidneys
2. If cmd is lost or partially lost then I recommend you to undergo a Dtpa scan
3. I also suggest you to quantify your protein loss , that can mark start of chronic kidney disease
4. make sure hypertension is well controlled
I hope I was able to clear your doubts, please get back to me if you have any further doubts
Regards
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I do not have hypertension. I have had hypotension. How do I quality my protein loss. Help again, what is a cortico medullary differentiation in lay terms.
Are any o the tests I am scheduled for include what you are recommending.
What do you think I have--i lay terms.
Are any o the tests I am scheduled for include what you are recommending.
What do you think I have--i lay terms.
Brief Answer:
Follow up
Detailed Answer:
Hello
Most patients who develop stage 2-3 chronic kidney disease have hypertension so that fact that you don't have hypertension goes against having ckd
The kidney is divided into cortex and medulla which usually visible on ultra sound . In chronic kidney disease this differentiation ( cortex and medulla) is not visible anymore. The radiologists write 'cmd' lost in such patients.
Quantification of protein is done by collecting urine voided one full day in a can and giving it to the lab for measuring how much protein is lost in a day. It should be less than 300mg/ day
I suggest you to undergo Dtpa in the next visit
Regards
Follow up
Detailed Answer:
Hello
Most patients who develop stage 2-3 chronic kidney disease have hypertension so that fact that you don't have hypertension goes against having ckd
The kidney is divided into cortex and medulla which usually visible on ultra sound . In chronic kidney disease this differentiation ( cortex and medulla) is not visible anymore. The radiologists write 'cmd' lost in such patients.
Quantification of protein is done by collecting urine voided one full day in a can and giving it to the lab for measuring how much protein is lost in a day. It should be less than 300mg/ day
I suggest you to undergo Dtpa in the next visit
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My blood test dated April, 2015 showed no blood or protein in urine. The work "Leuk" showed trace.
What does this mean?
If my kidneys have always been small, does that mean my eGFR has always been low.
I have two other messages thru the day above but I just obtained my ultrasound report:
IVC and visualized abdominal are normal
The right kidney is 7.6 cm. There is mild right-sided hydroneprosis. The left kidney is 9.3 cm without hydronephroisis
Bladd er is without filling defect.
So with that info, what in the world is going on?
You have been so helpful.
Thank you. Please give me all info you can think of.
What does this mean?
If my kidneys have always been small, does that mean my eGFR has always been low.
I have two other messages thru the day above but I just obtained my ultrasound report:
IVC and visualized abdominal are normal
The right kidney is 7.6 cm. There is mild right-sided hydroneprosis. The left kidney is 9.3 cm without hydronephroisis
Bladd er is without filling defect.
So with that info, what in the world is going on?
You have been so helpful.
Thank you. Please give me all info you can think of.
Brief Answer:
Reflux nephropathy
Detailed Answer:
Hello
Thanks for the details
You have unilateral small kidneys, your left kidney is normal in size.
Most often single sided small kidney is because of reflux of urine back into the kidneys. One other reason could be renal artery stenosis however these patients have hypertension.
I recommend you to get
1. Dtpa scan done
2. Micturating cystoyrethrography to rule out reflux
3. Reflux nephropathy will require surgical correction by a urologist
Patients with single kidneys can have a normal life and usually don't have any complications however it is very important to follow the preventive steps which I had jotted down in the earlier post
I know you are anxious, please get the tests I have asked you to get. You can get back to me anytime for any doubts you may have
Regards
Reflux nephropathy
Detailed Answer:
Hello
Thanks for the details
You have unilateral small kidneys, your left kidney is normal in size.
Most often single sided small kidney is because of reflux of urine back into the kidneys. One other reason could be renal artery stenosis however these patients have hypertension.
I recommend you to get
1. Dtpa scan done
2. Micturating cystoyrethrography to rule out reflux
3. Reflux nephropathy will require surgical correction by a urologist
Patients with single kidneys can have a normal life and usually don't have any complications however it is very important to follow the preventive steps which I had jotted down in the earlier post
I know you are anxious, please get the tests I have asked you to get. You can get back to me anytime for any doubts you may have
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I will have all the above done. My question is since I have a small kidney and my e gfr over a period of 6 years has been between 57-47, will this not have to be treated just like kidney disease stage as far as what I don't eat. I know I should avoid salt, what about potassium and phosporus?
Thank you,
Thank you,
Brief Answer:
Follow up
Detailed Answer:
Hello
Thanks for getting back
You have asked a very important question. Potassiun and phosphorus restriction is individualised. I usually do not restrict phosphorus and potassium until the creat becomes 1.5 mg/dl if their phosphorus and potassium is well within normal limits. However I recommend that you avoid red meat at the moment. You can have normal diet, check your potassium and phosphorus at each doctor visit
Regards
Follow up
Detailed Answer:
Hello
Thanks for getting back
You have asked a very important question. Potassiun and phosphorus restriction is individualised. I usually do not restrict phosphorus and potassium until the creat becomes 1.5 mg/dl if their phosphorus and potassium is well within normal limits. However I recommend that you avoid red meat at the moment. You can have normal diet, check your potassium and phosphorus at each doctor visit
Regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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