Possible kidney issues, GFR 35

[tokon]

This was on 40 mgs of telesmartan and 4 grams of astragalus. My cystatin C results also put my egfr at 130. My EGFR based on my serum creatinine fluctuates anywhere from 61-70 based on me being "on" or "off" and hydration and overall size. I'm fairly big compared to an average person. 5'11 220 lbs lean maybe 12% or so.

So cystatin-C and serum creatine tests result in widely different eGfr? Which is a better indicator of "real" kidney function?

 

[DOGGCRAPP]

So cystatin-C and serum creatine tests result in widely different eGfr? Which is a better indicator of "real" kidney function?

Creatinine over time and cystatin-c are both good indicators but that doesn’t mean gfr should be overlooked...especially over many blood tests over time (if cystatin isn’t done which is the usual as it’s rarer unless asked for on bloodwork). Creatinine again over time that is elevated is a large indicator that you are heading down a bad path...

 

[DOGGCRAPP]

when you lowered your creatinine did you also loose a little bit of muscle size and volume? Did you also come off harder anabolics? I find astragalus or not, reducing doses and compounds in conjunction with losing a little muscle size and volume reduces my creatinine anyways.

A far better measure of kidney health is a 24 hour urine test with a creatinine clearence to get a TRUE GFR + Cystatin C test. All this creatinine nonsense is for not when we are dealing with massive bodybuilders.

Again huge spikes aside, generally higherish creatinine for guys like us does not mean much.

I absolutely disagree I have not seen a bodybuilder yet that had repeated creatinine over 2 who it was a blip...every single one was going down a bad path with more testing...

 

[tokon]

Creatinine over time and cystatin-c are both good indicators but that doesn’t mean gfr should be overlooked...especially over many blood tests over time (if cystatin isn’t done which is the usual as it’s rarer unless asked for on bloodwork). Creatinine again over time that is elevated is a large indicator that you are heading down a bad path...

Thanks Dante.

To my knowledge (although I would need to look back at test results) I have never had cystatin done but my creatine has been consistently elevated over time, hence my concern. On the results I have to hand, the lab my dr uses applies the ckd-epi equation to calculate egfr which gives different readings to the equation you provided a link to previously.

 

[DOGGCRAPP]

Thanks Dante.

To my knowledge (although I would need to look back at test results) I have never had cystatin done but my creatine has been consistently elevated over time, hence my concern. On the results I have to hand, the lab my dr uses applies the ckd-epi equation to calculate egfr which gives different readings to the equation you provided a link to previously.

as a bodybuilder I feel you should be looking at the cockgraft gault equation...

 

[tokon]

as a bodybuilder I feel you should be looking at the cockgraft gault equation...

Yes, I understand that, and this results in a higher egfr, however my creatine has still been elevated above the lab ref range values over time. One dr i seen, after asking what training I did etc., was not too concerned whilst others generally are.

 

[DOGGCRAPP]

Yes, I understand that, and this results in a higher egfr, however my creatine has still been elevated above the lab ref range values over time. One dr i seen, after asking what training I did etc., was not too concerned whilst others generally are.

I agree that’s cause for concern (I am hoping your taking 48 hours off at least previous to bloodwork from hard training and your creat to bun ratio is below 20)

 

[tokon]

I agree that’s cause for concern (I am hoping your taking 48 hours off at least previous to bloodwork from hard training and your creat to bun ratio is below 20)

re: 48 hrs off - for a long time (until a dr pointed it out to me), I didn't, as I was not aware of the importance of these factors. I usually give the blood first thing in the morning so again, for a long time, was not aware of the importance of hydration on results!

at least on the more recent test results i have, I cannot find a creat:bun ratio result. I will have a look at older results data.

Thanks for the input, very much appreciated.

 

[DOGGCRAPP]

re: 48 hrs off - for a long time (until a dr pointed it out to me), I didn't, as I was not aware of the importance of these factors. I usually give the blood first thing in the morning so again, for a long time, was not aware of the importance of hydration on results!

at least on the more recent test results i have, I cannot find a creat:bun ratio result. I will have a look at older results data.

Thanks for the input, very much appreciated.

You can calculate the creat/bun ratio and if it’s plus 20 your terribly dehydrated which will skewer results. I’ve seen guys go in with a c/b ratio up near 30 before who had subpar kidney readings and I had them go back in fully hydrated and the creat/bun ratio was 16 This time and much much better results with both kidney values and hematocrit

 

[tokon]

You can calculate the creat/bun ratio and if it’s plus 20 your terribly dehydrated which will skewer results. I’ve seen guys go in with a c/b ratio up near 30 before who had subpar kidney readings and I had them go back in fully hydrated and the creat/bun ratio was 16 This time and much much better results with both kidney values and hematocrit

Ok, thanks. The only thing is, on these test results I am looking at, it appears values for both urea level and creatinine are "serum" rather than plasma (is it different?) so I am not sure if the ratio calculations i have referenced are applicable?!

 

[warlock]

You can calculate the creat/bun ratio and if it’s plus 20 your terribly dehydrated which will skewer results. I’ve seen guys go in with a c/b ratio up near 30 before who had subpar kidney readings and I had them go back in fully hydrated and the creat/bun ratio was 16 This time and much much better results with both kidney values and hematocrit

Dante, is a creatinine/bun ratio of over 20 always indicative of dehydration? If this ratio is over 20, does that always mean you're dehydrated?

 

[JETHRO TULL]

Thank you DC, your advice on the astragalus was valuable... Have been taking 3g a day and going to keep on that regiment!

Mike, I am really glad! That is great news.

 

[DOGGCRAPP]

Dante, is a creatinine/bun ratio of over 20 always indicative of dehydration? If this ratio is over 20, does that always mean you're dehydrated?

Its not a set in stone thing...it can mean more drastic things like congestive heart failure/heart failure or kidney problems but thats worst case scenario and in the majority of cases are dehydration. Bun (urea nitrogen) goes up and down while creatinine remains somewhat stable. So when the ratio is over 20:1 that usually and I say "usually" means dehydration (because the majority of people again arent in CHF or in a dire situation) but simply seriously dehydrated. IN the last two years Ive seen 24-33 C/B i people...thats serious dehydration. One of those guys has passed due to heart problems. But again thats rare...the majority of the time its dehydration.

 

[tokon]

Creatinine over time and cystatin-c are both good indicators but that doesn’t mean gfr should be overlooked...especially over many blood tests over time (if cystatin isn’t done which is the usual as it’s rarer unless asked for on bloodwork). Creatinine again over time that is elevated is a large indicator that you are heading down a bad path...

Dante - I think I have misunderstood "creatine over time"! Were you referring to the "pee in a bottle" 24-hour test, or elevated creatinine levels in a series of blood tests over a period of months/years? Although, thinking about it, neither results are "good"! Thanks.

 

[Stewie]

Dante, is a creatinine/bun ratio of over 20 always indicative of dehydration? If this ratio is over 20, does that always mean you're dehydrated?

If you look at your Albumin and it's >5g/dL this is a good indicator of dehydration.

4.7-.9g/dL is pretty good indication you're not sufficiently hydrated.

 

[Killer.7]

I will check out vitacost astragalus. Hoping some Canadian brahs chime in here with good astragalus recommendations.

I absolutely disagree I have not seen a bodybuilder yet that had repeated creatinine over 2 who it was a blip...every single one was going down a bad path with more testing...

Of course. That's not what I was trying to say though. I said huge spikes in serum creatinine aside, a slightly or even moderately elevated serum creatine ALONE is not a good indicator of kidney health. For a more accurate reading I encourage guys to do a 24 hour urine collection whereby the lab can then do a creatinine clearence and find your TRUE GFR. NOT an EGFR. In addition to other tests like cystatin C, and ACR.

 

[qbkilla]

Dante - I think I have misunderstood "creatine over time"! Were you referring to the "pee in a bottle" 24-hour test, or elevated creatinine levels in a series of blood tests over a period of months/years? Although, thinking about it, neither results are "good"! Thanks.

Not to speak for him but I'd assume he means both. If creatine is trending upward over time into the upper and out of range this is not good. The 24 hour urine test will then give a gfr or a definite answer (not a guess from bloods) if gfr is in fact low meaning poor kidney function.

 

[Flex500]

So cystatin-C and serum creatine tests result in widely different eGfr? Which is a better indicator of "real" kidney function?

There are egfr calculators where you can input cyst c and creatinine. That is likely the most accurate as far as egfr goes.

 

[tokon]

There are egfr calculators where you can input cyst c and creatinine. That is likely the most accurate as far as egfr goes.

Thanks for the input. Looking through my test results over a number of years i cannot see any cystatin-c values. Obviously next panel I need to request this.
Thanks again.

 

[Flex500]

Ok, thanks. The only thing is, on these test results I am looking at, it appears values for both urea level and creatinine are "serum" rather than plasma (is it different?) so I am not sure if the ratio calculations i have referenced are applicable?!

I work in the medical field (although in orthopedics) and have an advanced degree so I know some of this but I didn't feel "settled" until I found a great doctor and we looked at my entire health picture. Remember, your heart and kidneys are tightly intertwined and there are plenty of tests that should be able to give

Thanks for the input. Looking through my test results over a number of years i cannot see any cystatin-c values. Obviously next panel I need to request this.
Thanks again.

oh yeah they will rarely if ever schedule it. Even if you saw a nephrologist they may not schedule it in the first round of bloods. When I went I did more effing bloodwork than you can ever imagine and they didn't do cystatin c. It's grown in popularity the last 2-4 years though.