Some advice for friend who's eGFR is going down?

[WifeofDiaylsisPatient]

Hello All,

A good friend of mine just had some blood work done.  Her eGFR was greater than 60 a year ago, now it is at 49%.  She is 59 years old.   Her creatine was 1.2, her BUN was normal.  She has high blood pressure but it has been controlled by medication since 2005.  I would say her eating habits are not all that great and she is about 40 lbs overweight.  She says she drinks a lot of milk.  The doctor told her to cut down on her milk and hydrate more with water, and to drink more water.  Her calcium was also slightly high.  Since my husband is on dialysis, I fear for her having to do this some day knowing what a pain in the butt dialysis is!  I have told her that she should see a nephrologist to find out if there is any underlying cause for this and maybe more specialized blood work needs to be done.  I also told her to thoroughly go over all her medication (she may be on a few other pills) and to make sure none of them are hard on her kidneys.  Since so many of you have different reasons as to why you went on dialysis, maybe you can briefly share what might be a reason for her eGFR to decrease so much in one year, and offer any advice.  Thank you for your time!

[jeannea]

I cannot give you a reason. There are a lot of reasons for kidney failure. She probably would benefit from consulting a nephrologist. Sometimes the decline can be slowed, sometimes not.

[obsidianom]

You are doing the lab value panic. STOP!! 
First off, Egf is notoriously off  in many patients. It is +/- 30% and in 1out of 5 patients it is WAY off. So that alone is something to remeber. A dop from 60 to 49 is well within the 30% tolerance.   Also GFR is UNDERESTIMATED in obese people
Second , a creatin ine of 1.2 shows some kidney damage but not yet severe. It is not worth panicing about. Yes it should be watched and blood pressure is critical , but it is not that bad .
One piece of advice is to make sure one of the blood pressure meds is either an ace inhibitor or an ARB , as they are renal protective. Otherwise there is not too much else to do. Diet and excercise help.

[obsidianom]

This was a paragraph from an article on estimated GFR from creatinine. It is VERY inaccurate.


"He told Reuters Health, "The CKD-EPI equation was derived from a large cohort of patients and itself is limited in its accuracy; the equation estimates GFR to within 30% of true GFR in only 4 out of 5 patients. It is no surprise that when one takes a small subset (obese women), that the accuracy of CKD-EPI suffers more."

[kristina]

My kidneys first failed in 1971 (coma and uraemia), and then over the years my kidneys recovered to about 40% function  - without ever needing dialysis...
(In 1972 I had a kidneys biopsy and I was diagnosed with chronic proliferative glomerulonephritis with hypertension...)
...and now, 43 years later, my kidneys are still functioning without dialysis, but they are finally getting seriously exhausted and tired...
... and right now I am being checked-up for a transplant... (no dialysis yet...)
How was it done over all these years? In 1971 I  met a professor of medicine whose "hobby" was preventative medicine and he advised me to go completely vegetarian
...He told me that he could not prove it, but he was sure it was right and he told me that he would go vegetarian if he were in my position and that was good enough for me...
... and I have been on fresh vegetarian food ever since... I have never touched fast food, kept myself very slim and trim,
kept myself as fit as I possibly can with regular walks and I cook my vegetarian food (which I buy from the farmers market) fresh every day...
I don't drink any cows milk, because the artificial hormones and injections they give cows these days have been completely artificially induced to produce as much milk as possible......
... Did you notice that cows only last about 5 years these days ...? After about 5 years they die of complete exhaustion, malnutrition and sickness...
 ... Have you ever wondered where all those huge amounts of milk in super markets come from, every single day of the week...?
I drink chamomile and peppermint tea and don't smoke...and I only have one cup of coffee every day with a tiny little bit of almond milk...
I know my food choices sound very restrictive, but after a short while you notice, that eating and eating more every day is a very modern obsession...
... and once your friend discovers some hobbies or anything else she likes to do, any wish to eat gets better into proportion...
Unfortunately that is all I can say about this, I have not discovered any other way to keep my kidneys functioning for as long as possible and I do wish your friend good luck.
I am certain that if she really wants her kidneys to function a little longer, nothing will be too much for her to achieve that goal, I am sure!

Good luck from Kristina.

[Simon Dog]

Otherwise there is not too much else to do. Diet and excercise help.

Except avoid NSAIDS except asprin.

[kristina]

I could not say anything about NSAID's because I happen to be allergic to them
NSAID's are usually prescribed for SLE/MCTD patients as an anti-flare-up-treatment,,
but because of my allergies to NSAID's I could never use them as a therapy...

... But I happen to know a little about Aspirin and have experienced, that Aspirin can become pretty dangerous,
because whilst I took every day 75 mg of Aspirin to prevent another stroke from happening,
I noticed very quickly, that my nose started to bleed very regularly and every little scratch caused me bleeding
and I thought, if that happens to me on the "outside", what happens to my insights...if I continue to take Aspirin every day...?
So I stopped Aspirin straight away and through the Internet I learnt to take one little teaspoon of pure honey every day instead
because it has the same effect but is so much safer and healthier... and does not cause any nose-bleed or any other bleeding...

[obsidianom]

I could not say anything about NSAID's because I happen to be allergic to them
NSAID's are usually prescribed for SLE/MCTD patients as an anti-flare-up-treatment,,
but because of my allergies to NSAID's I could never use them as a therapy...

... But I happen to know a little about Aspirin and have experienced, that Aspirin can become pretty dangerous,
because whilst I took every day 75 mg of Aspirin to prevent another stroke from happening,
I noticed very quickly, that my nose started to bleed very regularly and every little scratch caused me bleeding
and I thought, if that happens to me on the "outside", what happens to my insights...if I continue to take Aspirin every day...?
So I stopped Aspirin straight away and through the Internet I learnt to take one little teaspoon of pure honey every day instead
because it has the same effect but is so much safer and healthier... and does not cause any nose-bleed or any other bleeding...

Sorry but I totally disagree on aspirin. There is so much data on aspirin and its multiple positive effects on millions of patients. Your individule response is your own but is not typical of most patients . There is no evidence in major studies that a teaspoon of honey will do the same.
I take aspirin a day and will continue .
I will add that renal patients should be careful with aspirin as they often have coagulation issues. They are in a different catagory then non renal patients.

[Deanne]

My nephrologist put me on daily full-dose aspirin at least 10 years ago after I had a blood clot (DVT) and I've had no adverse affects from it. I had about 30% kidney function at the time and only reached ESDR a year ago, so I don't think it affected my kidney function at all. My transplant team asked me to continue taking it post-transplant.

[obsidianom]

My nephrologist put me on daily full-dose aspirin at least 10 years ago after I had a blood clot (DVT) and I've had no adverse affects from it. I had about 30% kidney function at the time and only reached ESDR a year ago, so I don't think it affected my kidney function at all. My transplant team asked me to continue taking it post-transplant.

Aspirin shouldnt effect kidney function negatively. It may actually help. The issue is only clotting . Some are ok , some not on it.

[WifeofDiaylsisPatient]

Thank you all for your input.  My friend says she is absolutely committed to losing the weight and to do whatever she can to slow down the decreasing kidney function.  She has already lost 5 pounds.  Good for her....something I need to do too!

[kristina]

I agree with obsidianom  and the others, that many people tolerate Aspirin and it is very beneficial to their health and well-being…
...but there are  also many other people, whose body cannot tolerate Aspirin and Aspirin can do some harm to their body.
...Unfortunately I belong to the people, who cannot tolerate Aspirin…
There are many different medical write-ups by doctors to be found on the Internet etc, about people whose body cannot tolerate Aspirin
and I just give you a few examples:
According to Jeremy S. Paikin, MD, FRCPC and John W. Eikelboom, MBBS, FRCPC (courtesy of google Cardiology Patient Page),
(Correspondence  to Jeremy S. Paikin, MD, FRCPC, Hamilton General Hospital, 237 Barton St E, Hamilton, ON, L8L 2X2 Canada.
E-mail paikinjs@mcmaster.ca
it has been medically proven, that 1 in every 1000 patients is being treated because on an Aspirin allergy.
Another medical article “Aspirin’s Mostly Unrecognized Connection to Serious Medical Problems” by Dr. Mercola it is written,
that even a "low-dose aspirin" (LDA), may do more harm than good.
It is debatable whether or not Aspirin may have some beneficial actions in heart disease protection....

I am not against Aspirin, but I personally cannot touch it because of my allergies.
I could mention many more medical articles I have studied, before deciding that because of my allergy to Aspirin -
and despite the fact that I have suffered a stroke and really should take a low dose Aspirin every day,
I could not continue with Aspirin, because of my allergy against it..
...But my personal medical circumstance is not the point.
The point is though, that some people are allergic to Aspirin and some other people are not allergic to Aspirin
and they are able to tolerate a low dose of Aspirin every day of the week....

I have written about my own experiences about Aspirin to people, who are allergic,
to assist them to save time, because it took me ages, to find out that it was the daily low dose of Aspirin
which was giving me these terrible side-effects...
... and I only found this out by a very slow process of eliminating bit by bit over a long period of time...

Best wishes from Kristina.