Kidney function test, eGFR results of concern Kidney function test, eGFR results of concern - Page 2

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Thread: Kidney function test, eGFR results of concern

  1. #11
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    Going through this nonsense now myself. Creatinine-only GFR estimates are not accurate for our population. There is another test that can be done, serum cyctatin C and several different formulas that use one or the other or both. Here is a calculator that does four different ways:

    GFRF Calculator | National Kidney Foundation

    When I plug in my (last week) test results I get a range between 64 and 106, the latter using only cystatin. 85 using the creatinine + cystatin one. The test used by my original PCP that started all this was 53 last week and 39 to begin with. Been off creatine for nearly 2 months since. I've tried telling the doc about effects of creatine use and false positives, muscle mass high protein diet to no avail. Had to do a 24 hr urine test too, results all within range. Seeing the nephrologist early next week to be told it was all a waste of time and money.

    Some interesting info from the link above on the cystatin-only test which applies here:

    Data suggests that 3.6% of U.S. adults would be classified as having CKD solely on the basis of a creatinine-based GFR estimate of 45 to 59 ml per minute per 1.73 m2. A strategy of measuring cystatin C when the creatinine-based estimate is in this range and then reestimating GFR with the use of both these markers could correctly reclassify a substantial proportion of such patients as not having chronic kidney disease and not being at high risk.

  2. #12
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    Quote Originally Posted by Matt James View Post
    I think I've told this story before, but my (former) primary care doc flipped out when my creatinine was .02 outside the reference range, despite me reporting my exercise habits and creatine supplementation. I ended up talking to his PA to follow up, as he was on vacation, and asked her, "You are familiar with the effects of muscle breakdown and dietary creatine on serum creatinine, right?" "....um, yes."

    It's unfortunate that your career depends on a doc's ability to pull their head out of their ass, but here we are.
    To be fair to her, I donít think she thinks thereís anything wrong. She said the appointment post the results was on the insistence of the principal medical officer.

    Also, these are airforce doctors, and in general, Iíve found the airforce to be much more cautious with absolutely everything. Iím convinced Iíd have been fine had I been at a navy base seeing a navy doctor. Iím pretty sure I could have an arm hanging off and a navy doctor would give me some paracetamol, tell me to make sure I eat breakfast and drink plenty of water then send me back to work instead of loafing.

  3. #13
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    Quote Originally Posted by Theseahawk View Post
    Also, these are airforce doctors, and in general, I’ve found the airforce to be much more cautious with absolutely everything.
    Definitely a different Air Force than the one I retired from several years back. Now that I've had an experience with a civilian doc for several years, we realized how out of whack some of my values have been compared to standards for several decades and none of the military docs flagged a thing. That meant that I have spent the last several years visiting one specialist or another to establish that many of those values are just my normal.

    It was a good run with this doc, but I've had to fire her for consistent reactions similar to Matt James' "(former) primary care doc". It was getting to the point that every blood draw had some value that she wanted to throw a prescription at. Surprisingly, the creatine levels weren't one of them.

  4. #14
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    Quote Originally Posted by Bill Anders View Post
    Definitely a different Air Force than the one I retired from several years back. Now that I've had an experience with a civilian doc for several years, we realized how out of whack some of my values have been compared to standards for several decades and none of the military docs flagged a thing. That meant that I have spent the last several years visiting one specialist or another to establish that many of those values are just my normal.

    It was a good run with this doc, but I've had to fire her for consistent reactions similar to Matt James' "(former) primary care doc". It was getting to the point that every blood draw had some value that she wanted to throw a prescription at. Surprisingly, the creatine levels weren't one of them.
    Ah, this is the British armed forces. Iím Royal Navy, but at a Royal Air Force base. I was British Army a long time a go too and have worked in joint service environments throughout my naval career. There is always inter-service banter as youíd expect, with the RAF often being stereotyped as wet blankets. Well, I have to say thereís some truth to it. Civvies in uniform most of them! Well maybe not quite, but theyíre certainly a different breed to the the other arms of her majís forces.

  5. #15
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    This same bullshit happened to me a few years ago.

    My doctor got all upset about a high creatinine lab number during my yearly checkup. I asked him if my strength training had anything to do with it. He said no and that I had CKD and sent me to the nephrologist.

    While at the Nephrologists office - all nice and worked up because my kidneys are failing - they did the usual blood pressure test, and I was at 155/85 or thereabouts. So now I'm a CKD patient AND hypertensive. Nephrologist sent me for more labs - had me do a 24 hour creatinine clearance test, a kidney ultrasound, and had me wear a blood pressure cuff that took my BP every 20 minutes over the course of a day and night. This was all a royal pain in the ass. Results were my BP was excellent and my kidneys were able to flush out all the creatinine my musculature could produce. The Nephrologist gave me some great "advice" at the conclusion of our appointment. He said "Don't take any protein powder - it's hard on the kidneys." He also said to do "more cardio".

    At that point, I learned that I had to take control of my own health. The pharmaceutical/medical/insurance "complex" will not be there for you when you need medical attention - except to clean out your wallet.

  6. #16
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    Quote Originally Posted by Theseahawk View Post
    Ah, this is the British armed forces. I’m Royal Navy, but at a Royal Air Force base. I was British Army a long time a go too and have worked in joint service environments throughout my naval career. There is always inter-service banter as you’d expect, with the RAF often being stereotyped as wet blankets. Well, I have to say there’s some truth to it. Civvies in uniform most of them! Well maybe not quite, but they’re certainly a different breed to the the other arms of her maj’s forces.
    I had picked up on that based on phrasing in your earlier posts, but wanted to comment anyway. Because it's definitely a different Air Force.

    Yep, there's truth to all stereotypes. Even ours, depicted as the Chair Force, is based on quite a bit of truth. But I also found that that perception worked in my favor during my work with our Marines and Army. It was entertaining to see them dying, pissed at themselves to falling behind someone who was supposed to be soft.

    Anyway, back to the docs. If you haven't already, I'd suggest building a spreadsheet of all of your bloodwork values, keeping track of highs, lows, and, if so inclined, your standard deviations for each. You're going to continue facing medical professionals who will chase singular lab results. If you already know what your typical values are and how wide of a variation you typically encounter, it's easy to pick out those wild results and keep the docs in check.

  7. #17
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    You might not be able to see the full text without a login but the abstract will give you an idea of how automatic calculation of egfr based on serum creatinine and limited other input values ( usually only age sex and ethnicity) can falsely show kidney disease Protein and creatine supplements and misdiagnosis of kidney disease | The BMJ

    Bear in mind we all lose some kidney function as we age with no ill effects whatsoever

  8. #18
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    Quote Originally Posted by Bill Anders View Post
    I had picked up on that based on phrasing in your earlier posts, but wanted to comment anyway. Because it's definitely a different Air Force.

    Yep, there's truth to all stereotypes. Even ours, depicted as the Chair Force, is based on quite a bit of truth. But I also found that that perception worked in my favor during my work with our Marines and Army. It was entertaining to see them dying, pissed at themselves to falling behind someone who was supposed to be soft.

    Anyway, back to the docs. If you haven't already, I'd suggest building a spreadsheet of all of your bloodwork values, keeping track of highs, lows, and, if so inclined, your standard deviations for each. You're going to continue facing medical professionals who will chase singular lab results. If you already know what your typical values are and how wide of a variation you typically encounter, it's easy to pick out those wild results and keep the docs in check.
    I'll do that, but once my form is signed, I'll be trying my best to avoid seeing the docs again. Only time in the past 18 years of service I have been to the docs was when I fainted during a five-a-side indoor soccer game in 2004 and got concussion from my head hitting the court. I was 150 lb at 5 foot 11, ran long distance several times a week, ate once or twice a day and smoked half a pack of cigarettes a day. It's quite obvious why I fainted, but they decided to send me for an echocardiogram. The hospital found potential abnormalities, give me the paper work and told me to deliver it to my doctor. I put it in the bin and never followed up. Maybe my heart is a ticking time-bomb, who knows, but I've never had to see the docs again recently.

    I only had the blood work done Feb 2020 to rule out anything causing difficulty with my wife conceiving. If that hadn't been recorded, I'd have got away with a quick chat and sent on my way with a signed form.

  9. #19
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    I had a kidney and bladder ultrasound today. Everything was fine. I have a telephone appointment with my GP next week. Hopefully, thatís enough and sheís happy. But I know they trying to book me in to another hospital for some sort of other kidney function check.

  10. #20
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    Quote Originally Posted by Theseahawk View Post
    I had a kidney and bladder ultrasound today. Everything was fine. I have a telephone appointment with my GP next week. Hopefully, thatís enough and sheís happy. But I know they trying to book me in to another hospital for some sort of other kidney function check.
    UPDATE:

    A different doctor rang today and has summoned me in for another blood test. He had a letter back from the kidney specialist. The letter said to have me stop creatine supplementation, and no weight training 24 hours before taking another blood test. If the test comes back within range, no further investigation required. If it comes back still out of range, take a urine test and a kidney ultrasound. I've already had both of these and they showed no abnormalities. But the doctor still wants the blood test anyway.

    This doctor also noted my blood pressure was high (the previous one wasn't concerned about it), and he wants to take that again. If its high, he wants a 24 hour blood pressure monitoring and if still high, wants to treat me for that. He doesn't like me being 111 kg either. I tried explaining that every male on my paternal side has been told they have high blood pressure and they've all ignored it and don't seem to have any health problems and that Grandad is mid-80s old and still able to get up a ladder and paint his ceiling (he was a painter and decorator and always used a brush and not a roller on a pole for some mad reason).

    Getting annoyed. If they insist on treatments before signing me up for the extension to service, I'll tell them to ram it. I'll take my Navy pension at 22 years. I MIGHT consider dropping some weight if that is the only treatment they insist on, I normally do anyway when fitness test time comes around.

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