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kidney damage -> toxins in blood stream

Ok so I'm bumping up this thread, I just got bloods results from tests, GFR is at 65 (28M) (was 84 back in 2017).

I'm fairly muscular, but I stopped all training, ceased creatine supplementation, and reduced my protein intake to 80g a day, all of that over two weeks prior to the test,

so I think results came back fairly low, knowing all the above.

Motives for having bloods, were the symptoms I'm currently experiencing:

General fatigue
Itchy skin all over
Back pain on both sides
Metallic taste in mouth.

Do you think those symptoms above might fit this GFR number?

I'm set to have bloods re-done in a couple of weeks.

Thanks!

Those symptoms are all things associated with kidney issues; but your GFR does not reflect that. I would follow Jeff's advice and see your doc to do an overall assessment to better find out what, if anything is going on; as well as refer to a nephrologist to help find the reason for the decline in GFR. You also may want to recheck the GFR in a bit as things like dehydration can cause lower numbers than they really are.
 
This could be way off, but could something like reducing protein down to 80g while being a muscular person increase creatinine levels? I mean, they are a by-product of muscle breakdown and protein is required for a multitude of functions in the human body let alone maintaining muscle. Could 80g of protein for a longer than usual duration result in an increase in muscle breakdown which would contribute to creatinine elevation? This could hold no merit but it’s something I’ve always wondered.
 
Bump, anyone here got some new updates as to what lab tests are the most reliable for kidney function?
 
Kidney damage from high BP doesn't seem to be immediate, but cumulative over time (years), barring any acute hypertensive injury/emergency, where one episode might cause AKI, then possible enhanced suceptibility and further progression to kidney disease.

Any AAS user should read the following study IMO:


Pathophysiology of Hypertensive Renal Damage


Especially, high BP and influence on kidney health is a huge point of concern for people like me, who naturally have addictions and is powerfully drawn to AAS use and stim use (often concurrently)
 
Bump, anyone here got some new updates as to what lab tests are the most reliable for kidney function?
24 hour Renal clearance

According to my kidney doc
 
24 hour Renal clearance

According to my kidney doc
had bloods drawn last week because I had (have) symptoms from unknown nature for weeks now: feel lethargic, lower back pain, some degree of mental brain fog,itching in extremities.

Am hypertensive so am worried it's the kidneys: eGFR came back at 84 (down 15 points from gfr = 99 from last blood test back in february of this year, so from three months ago),

GP is not concerned, however I'll ask him for further more thorough blood analysis for kidneys and maybe 24-hour urine as well,

what do y'all think?
 
had bloods drawn last week because I had (have) symptoms from unknown nature for weeks now: feel lethargic, lower back pain, some degree of mental brain fog,itching in extremities.

Am hypertensive so am worried it's the kidneys: eGFR came back at 84 (down 15 points from gfr = 99 from last blood test back in february of this year, so from three months ago),

GP is not concerned, however I'll ask him for further more thorough blood analysis for kidneys and maybe 24-hour urine as well,

what do y'all think?
its easy to drop points - can be a ton really none issues - but ask them for what ever makes you feel comfortable - just let them know you are very upset about the drop its effecting your daily life - and 24 hour renal clearance would put your mind at ease

They would know based on bloods if your having issue - https://www.kidney.org/online-communities - these have tons of info

im at 67 egfr and was pretty upset for a year - until I had that renal clearance done - by a different doctor - and if your really really concern just become pro kidney maintenance - read up and do what you can do

At 67 egfr with my blood test before the renal - the doc told me i had a O.25 Chance to go on dialysis in 20 years - i was upset by that but I would imagine 84 - which was probally temp number to be honest - would come back at a zero - based on your age - im 54

Creatinine is shitty way to determine kidney function - even cystatin c for me was a shitty measurement - honestly think they have a little more work to do figuring out the best kidney function test..but according to my doctor...Renal is his

this was my doctors note to me just on bloods and my EGFR was low during this time - before the RENAL which was given right after
Then he released me
Your blood test for your kidney done showed your kidney function to be excellent. Your protein test in the urine was also excellent.
You can do the 24 hour test about 10 days prior to the appointment with me But the blood repeat kidney tests done showed excellent kidney function.
 
Creatinine Clearance seems to be the way to go IMHO. Along w other renal values as well ~ in addition to seeing the whole picture of someone; not just one or two lab values and in just one snap shot in time.

I bought into the Cystatin being the gold standard idea years ago. Not convinced it is anymore.
 
What all was out of range on blood work? Creatinine, sodium, what were they? Any swollen lymph nodes?
 
Creatinine Clearance seems to be the way to go IMHO. Along w other renal values as well ~ in addition to seeing the whole picture of someone; not just one or two lab values and in just one snap shot in time.

I bought into the Cystatin being the gold standard idea years ago. Not convinced it is anymore.
you mean serum creatinine clearance or urine creatinine clearance ?
 
What all was out of range on blood work? Creatinine, sodium, what were they? Any swollen lymph nodes?
well eGFR is based on serum creatinine so my gfr numbers reflected the amount of creatinine in my blood at this instant in time, no other abnormalities, exept sodium a little high (133mmol/l)
 
other simple tests to add are cystatin c, urinalysis, and microablumin creatinine ratio urinalysis.

A basic urinalysis is going to catch big things and it's cheap (like if you are leaking a lot of protein in your urine). The spot microalbumin : creatinine ratio urine test uses a ration so hydration won't have as much of an impact and it will catch tiny amounts of protein that often happen years before your creatinine even moves.

Look at creatinine over time (not a one time reading), plus the above tests and your bloods as a whole and that will give you a good indication.

There are good secondary markers such as uric acid as well. Again, not a primary indicator of kidney function but will help tell the story.
 
Kidney damage at the level where you have itchy skin, rashes, and fatigue usually happens near stage 4 CKD, or End stage renal failure

No antioxidant is fixing that or countering any effects of it. You have to realize the things you are calling toxins like potassium, and albumin serve functions in the body. It's only when they are critically elevated, and aren't excreted that they compromise other functions in the body (ex. hyperkalemia and cardiovascular issues).

The reason dialysis becomes the only viable solution after a certain point is because things like sudden cardiac death become a far greater risk in people.

You can try high dosing astragalus, but really work with a nephrologist and PCP on this issue as well if you have compromised kidney function.
problem with diagnosing kidney disease, and then classifying symptoms accodring to gfr values and stages, is that it leaves out the fact that GFR measures the glomerular filtration of creatinine (or Cystatin C) ONLY.

I think almost all the symptoms associated with CKD and kidney damage are rather caused by the reduced clearance of uremic toxins, which are mainly cleared through tubular secretion, NOT glomerular filtration.

For example, in CKD-associated pruritus the activation of PAR-2 has been recently purported to be one main factor behind the subjective symptoms that are often reported to be felt in CKD patients, to a varying degree:


Uremic solutes of indoxyl sulfate and p-cresol enhance protease-activated receptor-2 expression in vitro and in vivo in keratinocytes


Increased Levels of Total p-Cresylsulfate Are Associated with Pruritus in Patients with Chronic Kidney Disease


Turns out water-based uremic solutes such as p-cresylsulfate and indoxyl sulfate are excreted through renal tubular secretion, therefore have little to do with glomerular filtration, which filters most of the serum creatinine and cystatin C, and hence, the GFR value and subsequent CKD stage).

In generalized declined CKD, most often glomerular functions and tubular secretory abilities goes more or less together as far as their capacity for excreting the renal metabolites into the urine is progressively reduced (classified into CKD stages and corresponding symptoms).

But, what in the case where tubular secretion mainly is greatky diminished, such as as a result of acute tubular injuries going chronic (from nephrotoxic drugs), or tubulointerstitial fibrosis, but GFR remains high, because the glomeruli would have been relatively spared from the drug-induced tubular damage (common and main mechanism of drug-induced nephrotoxicity)?

Ofc I'm setting myself as a possible example (lol), but I've been allegedly suffering from a couple drug-induced nephrotoxic injuries (not related to aas or hypertension); as a result I have persisting symptoms such as generalized prutius (mild), unspecified lethargy/fatigue that I developped, metallic taste in mouth...,

despite GFR being consistently normal on tests (I've done creatinine and cystatin C) over the years, as well as consistently normal 24-hour urine, consistently normal albumin-to-creatinine ratio, and other flurries of tests repeatedly done,..., being normal as well,

I might still be suffering from pruritus, in the possible eventuality it's my tubular secretion functions that are more greatly reduced from the injuries, rather than overall glomerular function, therefore allowing some uremic toxins to remain unfiltered in the blood (tubular secretion into urine), thus allowing pruritus symptoms to be felt in me, despite all my other lab values being normal.

Only my anaecdotal hypothesis obviously, but could be a thing.
 
problem with diagnosing kidney disease, and then classifying symptoms accodring to gfr values and stages, is that it leaves out the fact that GFR measures the glomerular filtration of creatinine (or Cystatin C) ONLY.

I think almost all the symptoms associated with CKD and kidney damage are rather caused by the reduced clearance of uremic toxins, which are mainly cleared through tubular secretion, NOT glomerular filtration.

For example, in CKD-associated pruritus the activation of PAR-2 has been recently purported to be one main factor behind the subjective symptoms that are often reported to be felt in CKD patients, to a varying degree:


Uremic solutes of indoxyl sulfate and p-cresol enhance protease-activated receptor-2 expression in vitro and in vivo in keratinocytes


Increased Levels of Total p-Cresylsulfate Are Associated with Pruritus in Patients with Chronic Kidney Disease


Turns out water-based uremic solutes such as p-cresylsulfate and indoxyl sulfate are excreted through renal tubular secretion, therefore have little to do with glomerular filtration, which filters most of the serum creatinine and cystatin C, and hence, the GFR value and subsequent CKD stage).

In generalized declined CKD, most often glomerular functions and tubular secretory abilities goes more or less together as far as their capacity for excreting the renal metabolites into the urine is progressively reduced (classified into CKD stages and corresponding symptoms).

But, what in the case where tubular secretion mainly is greatky diminished, such as as a result of acute tubular injuries going chronic (from nephrotoxic drugs), or tubulointerstitial fibrosis, but GFR remains high, because the glomeruli would have been relatively spared from the drug-induced tubular damage (common and main mechanism of drug-induced nephrotoxicity)?

Ofc I'm setting myself as a possible example (lol), but I've been allegedly suffering from a couple drug-induced nephrotoxic injuries (not related to aas or hypertension); as a result I have persisting symptoms such as generalized prutius (mild), unspecified lethargy/fatigue that I developped, metallic taste in mouth...,

despite GFR being consistently normal on tests (I've done creatinine and cystatin C) over the years, as well as consistently normal 24-hour urine, consistently normal albumin-to-creatinine ratio, and other flurries of tests repeatedly done,..., being normal as well,

I might still be suffering from pruritus, in the possible eventuality it's my tubular secretion functions that are more greatly reduced from the injuries, rather than overall glomerular function, therefore allowing some uremic toxins to remain unfiltered in the blood (tubular secretion into urine), thus allowing pruritus symptoms to be felt in me, despite all my other lab values being normal.

Only my anaecdotal hypothesis obviously, but could be a thing.
any thoughts on this?
 
My GRF came back at 66 last year. Doc said because I have more muscle than the average person he did not see and issue. Getting yearly test done again in 3 weeks.
 
Kidney damage at the level where you have itchy skin, rashes, and fatigue usually happens near stage 4 CKD, or End stage renal failure

No antioxidant is fixing that or countering any effects of it. You have to realize the things you are calling toxins like potassium, and albumin serve functions in the body. It's only when they are critically elevated, and aren't excreted that they compromise other functions in the body (ex. hyperkalemia and cardiovascular issues).

The reason dialysis becomes the only viable solution after a certain point is because things like sudden cardiac death become a far greater risk in people.

You can try high dosing astragalus, but really work with a nephrologist and PCP on this issue as well if you have compromised kidney function.
I think there's some level of glomerular compensation for the damaged nephrons, hereby maintaining GFR at same levels and not showing the damage done; problem with kidney damage, is that it looks fine when it already isn't, and can be reversed and slowed down,

but as soon it's confirmed your GFR is on a definitive downward trend (from several tests over several months), along with the possible apparition of other abnormalities (proteinuria,...), it's already TOO late.

That's why progressive kidney damage is so difficult to assess and determine correctly, and why users are deluded they're not destroying their kidneys because "bloods look fine"...

IMO we still lack good measures to more accurately determine the extent of kidney damage and the evolution of kidney health and possible degradation in healthy/CKD individuals
 

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