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Possible kidney issues, GFR 35

MikeS

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Just got yearly bloods done. GFR was 35. Normal low is >60. Was 45 last yr...73 in 2018.
Started meds for hypertension 2017 Lisinipril; NSAID diclofenac .
Creatinine was 20 but I had just worked out, taken 75g protein and 10g creatine, so thats not an accurate reading.
Hoping that plan to switch protocol on many things will raise the number.

Need to switch from ACE inhibitor to Calcium channel blocker Amlodipine. ACE inhibitors can potentially drop GFR by 1/3.
Drop the NSAID diclofinec.
The part I dont care for is reduced protein from 250g ED. Probably should go to 100g, but going to try 125-150g.
Have to make up the calorie deficit with other marcos, dont want to reduct calorie intake.
Drop the Creatine. Drop the slin.

Pretty much my plan and Dr agreed totally. He initially wanted to drop the NSAID only.

Hoping to get to the low to mid 50s.
Then tinker with maybe adding more protein.
Otherwise Im in Stage 3 Chronic Kidney Disease. At 60yo 10-15yrs life expectancy.
Will follow this program, the in 6wsks, check blood and Albumim to Creatinine ratio with urine test.
Wish me luck. Any suggestions welcome!
 

thethinker48

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Did the doc mention doing a Cystatin C test?

Doing that, and dropping the ace inhib to retest to get your actual value. You can add astragalus after that and see the bump in your blood test.

How is your BP on the meds?

You know what you're doing by the sounds of it
 

IronLion2

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I personally think doc may be fear monger a little with your last few lines but I'm glad you're taking this seriously.
 

nothuman

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megadose astragalus the second you read this. Just 2g raises my GFR by 20. You could really go much much higher than that (6g+) without much side effect risk.

Also, I hope you have a good BP monitor at home and make sure it's roughly 115/75

Good luck. You got this :)
 

Knight9

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Vitamin Shoppe Astragalus. 300caps. 20 bucks.
Take 4-6caps AM and 4-6caps PM.
 

qbkilla

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Was this a 24 hour urine test to get your true gfr? Or a blood test that gave you a creatinine level that correlates to your egfr?

You said your creatiine is 20, do you mean 2.0?

Any history of protein in urine?
 

MikeS

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Guys thanks so much for the advice on astragalus. Will pick some up tomorrow! Going to look into it as well of course. My mistake my creatinine was 2.0... BP on lisinopril was 105 / 70. Taken today. So the meds work very well for me, I was borderline without. It was a blood test not urine. So the creatinine was blood. I will have to take the ACR urine test just to see how I am excreting albumin and creatinine. Thanks again guys any other advice is great. I feel like I've covered every angle, along with some good suggestions here
 

qbkilla

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The creatinine is definitely high. Stopping creatine (a supplement that is hard on kodneys) and lowering protein should help along with better hydration. Were you hydrated? The good news is they are only estimating your gfr using creatinine, they dont know your true gfr because they didnt do a 24 hour urine test.

Did they take a urine sample? Was protein present?
 

nothuman

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I'd see a good functional medicine doctor for this one too. They will actually try to help you reverse this if it's possible.
 

upeccmi

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I go to a renal doctor, my egfr was as low as 40(12/2019). NSAID is bad for kidneys, so is creatine, do not take them any more. Get a Cystatin C test. My gfr went up to 55 with this test, my egfr through bloods was up to 46(6/2020). I have been taking 9g astragalus per day. I am 53 yo.
 

qbkilla

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I go to a renal doctor, my egfr was as low as 40(12/2019). NSAID is bad for kidneys, so is creatine, do not take them any more. Get a Cystatin C test. My gfr went up to 55 with this test, my egfr through bloods was up to 46(6/2020). I have been taking 9g astragalus per day. I am 53 yo.

In your case your GFR or egFR went up? GFR meaning you got a true value from a 24 hour urine test, egfr meaning they estimated your GFR based on creatinine.

Also, about how much does 9g of astragalus per day run?
 

upeccmi

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I take 10 vitamin shoppe tabs and I also take "bulk nutrition" powder form. Cost is not an issue as opposed to dialysis, which my mother was on for years prior to her death.
I did a few 24 hours, they were not much off from the egfr. I do have protein in my urine so there is issues.
I do have to say, I did not workout for some time (due to COVID) prior to this last test. Creatinine dropped from 1.86 to 1.67
 

gotgame

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You know that creatine can mess with the labs results so you shouldnt have been taking that.


Lets see what the repeat is in 6 weeks. As was mentioned earlier is suggest a renal ultrasound to go along with your labs. This isnt a one time abnormal reading its trending down and is concerning.

Did you also say you were taking insulin? Wait really? Or was that a mistype and you meant the lisinopril?
 

qbkilla

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I once had a doctor tell me drop supplements (creatine and protein) and retest creatinine, it came back fine after I dropped all that. She said both were bad for kidneys and her crossfit athletes typically retested fine after dropping that crap.

Is protieinurea or elevated creatinine usually a worse sign for kidney health? I've had good creatinine numbers but proteinuria constantly
 

muscle96ss

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Just got yearly bloods done. GFR was 35. Normal low is >60. Was 45 last yr...73 in 2018.
Started meds for hypertension 2017 Lisinipril; NSAID diclofenac .
Creatinine was 20 but I had just worked out, taken 75g protein and 10g creatine, so thats not an accurate reading.
Hoping that plan to switch protocol on many things will raise the number.

Need to switch from ACE inhibitor to Calcium channel blocker Amlodipine. ACE inhibitors can potentially drop GFR by 1/3.
Drop the NSAID diclofinec.
The part I dont care for is reduced protein from 250g ED. Probably should go to 100g, but going to try 125-150g.
Have to make up the calorie deficit with other marcos, dont want to reduct calorie intake.
Drop the Creatine. Drop the slin.

Pretty much my plan and Dr agreed totally. He initially wanted to drop the NSAID only.

Hoping to get to the low to mid 50s.
Then tinker with maybe adding more protein.
Otherwise Im in Stage 3 Chronic Kidney Disease. At 60yo 10-15yrs life expectancy.
Will follow this program, the in 6wsks, check blood and Albumim to Creatinine ratio with urine test.
Wish me luck. Any suggestions welcome!

Get an ultrasound and biopsy. 73 to 35 in 2 years is not normal. If you have your immune system attacking your kidneys, which is what happened to me; you need to be able to catch it ASAP before it eats it up any more!
 

gotgame

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I once had a doctor tell me drop supplements (creatine and protein) and retest creatinine, it came back fine after I dropped all that. She said both were bad for kidneys and her crossfit athletes typically retested fine after dropping that crap.

Is protieinurea or elevated creatinine usually a worse sign for kidney health? I've had good creatinine numbers but proteinuria constantly

Depends but for bodybuilders its worse to have protein in your urine. The glomerulus should be able to filter nearly all proteins and if your getting it in ur urine its breaking down that mesh network. Creatinine on the other hand is just used because its a decent indirect marker. We are classically taught to think of inulin as the gold standard ( i dunno if that is true anymore) but we use creatinine as its made by our bodies in a general consistent concentration and gets freely filtered by our glomerulus and it is considered to not be readily secreted or absorbed..but truthfully it is secreted to a small degree.

Using the classical MDRD calcualtion the assumptions are made that creatinine is stable....buuuut bodybuilders do things like take creatine thus artificially throwing off the equation thus making some drs who dont know better thing your kidneys are crapping out. Its also true of steroids that increase creatine stores in our muscles and having higher muscle mass. but its a good indirect marker for the general pop.

In general AAS can be pretty tough on your kidneys...both through direct androgenic induced glomerulosclerosis, blood pressure issues and mess up your RAS a bit.
 

gotgame

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Get an ultrasound and biopsy. 73 to 35 in 2 years is not normal. If you have your immune system attacking your kidneys, which is what happened to me; you need to be able to catch it ASAP before it eats it up any more!


Exactly. and while I had just posted that AAS can ofcourse cause direct renal issues i HATE when drs just jump to that conclusion. Ohhh you take steroids...that must be what is causing every one of your issues in life. There are ofcourse other things that need to be on the differential and multiple autoimmune conditions are treatable.

The OP needs to get real lab work that isnt being skewed. Id suggest an renal ultrasound to go with that. Depending on those findings posible a biopsy after.

Renal damage and failure is not something anyone wants to deal with... look up the dialysis stats and vascular complications. Dont be that guy if you can prevent it and treat something early.
 

MyNameIsJeff

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Find a kidney specialist who will want to do the following:

1) 24h urine collection+ blood work to calculate creatinine clearance and to check for proteinuria.
2) Ultrasound of the kidneys and Doppler ultrasound to check for Renal Artery Stenosis

Until then, drop the nephrotoxic NSAID and (potentially in those with CKD) creatine. Reduce protein intake. I would keep the ACE inhibitor in there until 1) and 2) have been performed. Unless there is one of the few contraindications, ACE inhibitors or ARBs are recommended medications to delay disease progression in CKD, chiefly through their ability to reduce proteinuria. See https://kidneyfoundation.cachefly.net/professionals/KDOQI/guidelines_bp/guide_11.htm

I would not start using Astragalus until you have been properly diagnosed. You don't want to take any drugs that might mask the underlying issue by boosting eGFR without any corresponding changes in histology.
 

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