HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For Stage 3 Kidney Disease

Posted on Mon, 29 Jun 2015

Question: I was just told I have stage 3 kidney disase and I am scared to death!!! I don't want to go into kidney failure or die. I don't have high bp, don't smoke or drink, not diabetic. So they are not even sure why this is going on. I want to do whatever I can to stop this and it is still possible for me to live a long life yet?

Answered by Dr. Rakesh Madhyastha (49 minutes later)

Brief Answer:
do not worry

Detailed Answer:
Hello

Thanks for the query

I would first want you to calm down. I have seen patients with stage 3 kidney disease have lived their full life without any problems. I will tell you how to go about it. However I need to know a few more details in order to help you

1. what is your serum creatinine and bun?
2. what complaints did you go to the doctor with ?
3. was any urine routine and ultra sound done ? please furnish the reports
4. is there any family history of kidney disease ?
5 what is your weight and height ?
6 are you on any herbal medicines? any frequent painkiller use?
7. mention all the drugs you are currently on

Please get back to me , I am awaiting your reply

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (1 hour later)

BUN 6 - 24 mg/dl 10
Creatinine 0.6 - 1.3 mg/dl 1.3
Sodium 135 - 145 mmol/L 139
Potassium 3.7 - 5.1 mmol/L 4.2
Chloride 96 - 110 mmol/L 106
CO2,Total 22.0 - 32.0 mmol/L 27.0
Anion Gap <=20 mmol/L 10
Calcium 8.5 - 10.5 mg/dl 9.1
Albumin 3.5 - 5.0 gm/dl 4.0
Phosphorus 2.5 - 4.9 mg/dl 3.2
GFR MDRD Af Amer >=60 mL/min/1.73 m2 57
GFR MDRD Non Af Amer >=60 mL/min/1.73 m2 47
Color, UA Yellow Yellow
Appearance Clear Clear
Glucose, UA Negative Negative
Bilirubin, UA Negative Negative
Ketones, UA Negative Negative
Specific Gravity, UA <=1.030 1.017
Blood, UA Negative Negative
pH, UA 4.5 - 8.0 5.5
Protein, UA Negative Negative
Urobilinogen, UA 0.2 - 1.0 EU/dl 0.2
Nitrite, UA Negative Negative
Leukocyte Esterase Negative Negative
WBC, UA <=5 0-2
RBC, UA Absent 2-5
Squam Epithelial cells, UA <=5 0-2
I did an ultra sound all came back fine, no family history of kidney problems
no pain killers no herbal med
5ft 4 230lbs so I know weight is a problem

occasionally previlsic for stomach mild ashma but hardly need it advair, allegra for seasonal allergies I had my gall bladder out around 10 years ago

Follow up: Dr. Rakesh Madhyastha (31 minutes later)

I am looking forward to any information that will be helpful and will hopefully make me feel more at ease . Thank you for you help

Answered by Dr. Rakesh Madhyastha (5 hours later)

Brief Answer:
Not chronic kidney disease

Detailed Answer:
Hello

Thanks for getting back

After going through your reports I have come to the conclusion that you are 'not' suffering from chronic kidney disease. serum creatinine can go up in many occasions like dehydration, post exercise, after a bout of fever or infection
Here is what you should do

1. repeat your creat and bun with good hydration. Do not exercise for a week before the test
2. if the serum creatinine is still on the higher side please get a 24 hour urine protein done
3. Perisatant renal failure in the absence of any apparent cause calls for a renal biopsy, it is essential that you get a renal biopsy done as soon as possible if the raised creat is persistent to know why it is high.

To call someone chronic kidney disease of any stage it is essential to have renal dysfunction for atleast 3 months otherwise it is still acute kidney injury

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (3 hours later)

I not sure this is good or bad news As you can tell from my weight I don't exercise, so that cannot be part of it. I don't drink enough though. These have been my number for the last three years. 12/30/13 GFR 57 1/2/15 GFR 52
6/2/15 GFR 47 6/4/15 GFR 47 I did have a bladder infection about 10 days before the 6/2/15 test was done. But it was all cleared up by the time I took the test. If it is not chronic Kidney disase, what other causes are there???? Cancer?? What kinds of things will a bioposy show. If it is damage to the kidney, can this be fixed? My way lower back has been sore for the last 3 days, it is very low tho, like right above my butt. Is that from Kidney?

Answered by Dr. Rakesh Madhyastha (12 hours later)

Brief Answer:
Not cancer

Detailed Answer:
Hello

Thanks for getting back. I am sorry for the short delay in my reply, I was on call at my hospital.

I must point this out at the outset that GFR is not a very good modality for measuring ones renal function as it depends on many things like body weight, gender, etc. What we usually do is to monitor creatinine closely.
I recommend you to lose weight to achieve a BMI of 18-22, this itself will bring down the stress on your kidneys to a large extent.

Biopsy will show why there is a renal dysfunction. For example IgA nephropathy, Minimal change nephropathy, sclerosis, level of chronicity etc

Some damages to the kidney can be fixed, it strictly depends on what the biopsy shows. Acute injury can be fixed. Whats more important is that progression of the kidney disease can be retarded based on the biopsy report.

Lower back ache is not because of the kidney. Kidney pain is usually in the lumbar region.

I am sure you are having many doubts, please get back to me I will clarify them.

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rakesh Madhyastha (16 hours later)

Thank you for your reply. What is nephropathy and can it be fixed or controlled?? IF so how?? I have heard I should be drinking lots of water and on a special diet for the kidney?? I seem to be tired a bit more and less energy, and thanks for the answer on the back pain. Lower back pain is probably a muscle then and the upper area more from the kidneys?? It does not hurt all the time, more of an ache. They are doing a sleep test on me to see about my blood pressure. My bp reading was 148/88 this morning. Yes, I have lost 8 lbs the last 3 weeks, but know I need to lose a lot more. I assume the achy upper back is from the kidney not working as well as it should. I was told there is a bp medicine that helps control that and one that also helps with the kidney working better???

Answered by Dr. Rakesh Madhyastha (10 hours later)

Brief Answer:
Nephropathy

Detailed Answer:
Hello

Thanks for getting back, since there are many questions I shall answer them one by one so that I do not miss any

1. Any dysfunction of the kidney is known as nephropathy
2. It can be fixed if it is an acute injury and controlled in case of chronic disease
3. Fixing and control is based on biopsy report
4. You can drink adequate water ( no need to be overzealous in drinking fluids). Avoid NSAIDs group of pain killers
5. Kidney not working well does not lead to any form of pain unless it is urinary tract infection affecting the kidneys
6. BP medicines helping the kidneys is known as ACE/ARB. I usually start Telmesartan once a day.
7. Your blood pressure is on the higher side, losing weight will help

I hope I Was of help, please feel free to get back to me. It is a busy day today, so i might take about 12 hours to get back to you

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (8 hours later)

Thank you, I just finished a sleep apnea test to check if that has to do with the higher BP too and I do know the weight does too. I go into to see primary Doctor tomorrow about the results on that test and will check with him about the BP medicine. I will have to contact the kidney Doctor I think about seeing about a Biopsy. What does that involve, is there pain and any kind of recovery and how long until test results are known??? Sounds like you are busy today and I hope all goes well.

Answered by Dr. Rakesh Madhyastha (10 hours later)

Brief Answer:
Renal biopsy

Detailed Answer:
Hello

Renal biopsy is a small procedure. In our set up we do it under local anesthetia and there wont be any pain during or after the procedure, just a small prick.
The recovery is immediate however we ask the patients not to engage in physical activity or strenuous exercises for a week. Little blood can be seen in urine, it is normal and it settles down within a day for 2.
In my hospital the pathologist take 2 days for the results, other hospitals take just a day. It depends on how busy the unit is.

We had two kidney transplantation back to back so it got a little busy.

I am happy you are meeting your kidney doctor, speak to him in length and find out what he feels about the decline in GFR.

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