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Still confused about Creatinine and GFR

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

This is a quote from the National Kidney Foundation website in answer to a question from somebody whose creatinine level was 1.58:

"A creatinine level of 1.58 may be normal after removal of one kidney, especially if you are over 50 years of age. Removing one kidney always results in a decrease in total kidney function and an elevation in the creatinine test." Notice the "always."

From MedicineNet.com:
"A person with only one kidney may have a normal level of about 1.8 or 1.9." Notice the "normal."

My levels were normal before my radical nephrectomy and went bad immediately afterwards. The above statements pretty much jibe with what my urologist told me -- that my creatinine readings (currently 1.5) and GFR readings (currently 47) are normal for somebody with one kidney. Yet my nephrologist tells me I have chronic kidney disease (CKD), Stage 3. He is not "alarmed" but of course I am. I told the nephrologist what my urologist said and what I had read online and he said, "oh yes, that's true." But he still diagnosed me as having CKD and has ordered more blood tests at the end of July, which I don't have a problem with. As a matter of fact, I like being monitored this closely. But of course, I am confused. I plan to discuss this with my urologist in my second followup visit in August.

Thank you, Iceman, for sharing your results in my previous posting but I'd like to know how others' blood tests have gone since their surgeries. If you don't mind, may I ask who else has had high creatinine/low GFR readings? And if so, have you been told you have "chronic kidney disease?" Or have you been told that this is normal for your situation and nothing really to worry about?

Thanks.
Mike

icemantoo's picture
icemantoo
Posts: 1510
Joined: Jan 2010

MikeK703,

I plan on asking my Urologist and Nephrologist these questions with more specitivity when I see them in September. While we one kidney people have different normals on these tests we still must do all we can to keep our Kidney function as normal as possible. The way my Nephrologist explains it these abnormal numbers are not only a function of having one kidney which I can do nothing about, but also having Hypertension over the years which is a contributing factor to CKD and something we can do something about.I have got to get all this straightened out as I plan on sticking around for the weddings of my 5 grandchildren ages 15, 14, 13, 12 and almost 10 before I check out.

Icemantoo

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

Had my ultrasound today on my remaining kidney in response to the chronic kidney disease diagnosis. Have to wait official word from the radiologist and my doctor but the technician told me she saw no problems with the kidney or my bladder. As a matter of fact she told me I had a lovely kidney! I'm sure hers is lovely also. Now it's another wait until the end of this month for the next round of blood tests to see how the Creatinine/GFR levels are. The foreseeable future seems mapped out for me -- tests and waiting and more tests and more waiting. It's the waiting that bothers me. Too much time to worry. But at least the up days, like today, are worth the wait. I still wish folks would post their experience with creatinine and GFR levels, i.e., what they've been told are "normal" readings for people with one kidney. Has no one other than Iceman and I had "abnormal" readings?
Mike

donna_lee's picture
donna_lee
Posts: 398
Joined: Feb 2009

I raise my hand. If my eGFR is above 35-38, I'm happy. Let's face it, with only one kidney, and a 68 year old one, too, if my blood work shows I'm near what 2 good kidneys should be doing, I'm OK.
My PC has me on 2 blood pressure meds that combine ACE inhibitor & diuretic, and a BETA blocker to keep my BP down. Also a statin for high cholesterol. All to help the one kidney function better and longer.

My husband was Dx'd with CKD Stage III several years ago but is stable, now. He has 2 kidneys and finally was made to understand how the kidneys function as a filter for all fluids. Now he doesn't salt everything and he's doing much better.

My lab results are at home now. Next week, I'll try to remember to bring them in so I can let you know. It's been 5 years since my kidney was removed, with two separate node recurrences...so I'm 3 years "no evidence of disease."
Donna

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

Thanks, Donna. That's the kind of feedback I was looking for. I appreciate it. Bless you.
Mike

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

Sorry, hit the Post comment twice. Ignore.

AMichael50
Posts: 18
Joined: Apr 2009

A Creatine level of 1.56 or 1.62 would be normal for a 53 year old with 1 remaining Kidney?
My last visit to my Primary Care Dr. and LAB tests indicated my Kidney function was "normal".
I see an Oncologist, and she orders the CT Scans every six months with contrast.
However before every CT scan they check this level and decide NOT to do the scan with contrast.

Mike

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

Hi Mike.
Here is a web page where you can calculate your GFR, which is the reading they use to determine one's "stage" of chronic kidney disease. The question remains: are higher creatinine/lower GFR readings "normal" for people with one kidney? I have asked this question of my urologist, who did the surgery and told me my readings are normal. My nephrologist says I have chronic kidney disease. I am confused and am currently waiting for his response.

donna_lee's picture
donna_lee
Posts: 398
Joined: Feb 2009

Don't get hung up on whether your glass is half full or half empty. Yes, a nephrologist will look at your rates and tell you you have CKD. He doesn't care if you have one or two kidneys-it's the Creatinine and eGFR numbers that he uses as a standard.
Creatinine is a waste product filtered out of the blood by the kidneys. Increased concentrations in the blood may indicate a temporary or chronic decrease in kidney function. When the surgeon removes one kidney, it automatically cuts the perfect score in half; and a single "used" kidney is going to have a lower than 50% value.

I just checked some old records. Before the nephrectomy my Creatinine was 1.2 (0.6-1.2 mg/dl or high end of range that lab uses) and my eGFR was 48 (60-1000 ml/min/1.73m2). In June 2011, and with lab work every 3 months for the oncologist's office, and every 3-4 months for my primary care doc, my creatinine is still High at 1.38 abd eCFR Low at 38.

My advice...stop focusing on numbers and live your life. I was told I had 5-7 months to live just over 5 years ago and that palliative care was all that could be offered. When I was told surgery to remove a kidney, half my liver, my gall bladder and a set of lymph nodes would let me live beyond Christmas that year, I jumped at the chance. Two more surgeries the next two years, and I'm still here. (And that doesn't count the triple fracture and dislocate of my left ankle and the hospitalizations for pancreatitis and bronchitis mixed in there.)

So eat and hydrate to keep the one kidney functioning as well as possible and laugh all the way to old age.
Donna

DarrylPe's picture
DarrylPe
Posts: 75
Joined: Mar 2011

Hi Mike I had a radical Nephrectomy in midApril. Prior to the surgery my creatinine level was about 1.9 my nephrologist told me that it was proably due to my having diagnosised high blood pressure for over 15 year. My first blood test after surgery showed a creatinine level of 3.9 and is now at 3.2 as of my last blood test . Whats up with that ? I'm going to see a different Nephrologist next week . I'll be asking a lot of question during that visit. Hey could you post that site for calculating your eGFR ?

Thanks
Darryl

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

You're right to be asking your nephrologist questions about this. Looks like I missed putting the web page address in my reply above. It's http://www.kidney.org/professionals/kdoqi/gfr_calculator.cfm.

Was your neprhologist not concerned about your high creatinine level? My level was .9 before surgery and has fluctuated between 1.4 and 1.5 since then. I was told the same thing by my nephrologist, that my level was getting higher probably because of my high blood pressure over the years and he diagnosed me with chronic kidney disease. My urologist/surgeon had told me my latest readings are normal for one kidney. His recent email answer to my question about this apparent contradiction was simply, "I assume the nephrologist knew about your recent surgery and that he has given you guidelines to protect your remaining kidney." Which, of course, did not answer my question. I will pursue it on my next visit. Good luck, Darryl, and let us know how your visit with the new doctor goes.

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

Hi Donna,
I don't think I am getting hung up over this issue. I simply want a straightforward answer from my doctors about my condition. Either my creatinine levels are higher because I now only have one kidney (in other words, a normal consequence of the surgery) or it's diseased because of damage done over the years by high blood pressure. The first would indicate a less worrisome condition to me. The second would indicate a disease whose progression needs to be slowed down (which is exactly the term the nephrologist used).
Mike

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

By the way, the urologist's and neprhologist's nurses answered my original phone call about this. They took a look at my levels and said they looked normal to them. As nurses usually know more than doctors, I feel a little better about it.

MikeK703's picture
MikeK703
Posts: 235
Joined: Sep 2010

Here's the link I mentioned above but forgot to include.

http://www.kidney.org/professionals/kdoqi/gfr_calculator.cfm

Tahiri
Posts: 2
Joined: Jun 2011

Hi Mike, I had my right kidney removed on June 20th, due to RCC stage 1a, my creatinine after surgery came at 1.3 and GFR 44, my husband and my daughter (both physicians) say that it is normal to be elevated after nephrectomy, and that the renal function could be back to normal after three months after surgery. Just try to drink plenty of fluids,, low sodium intake, eat a lot fruits and vegetables, excercise, watch your weight, and do not forget to control your blood pressure (mine became normal after surgery). I am feeling really blessed with the outcome of my surgery. Wish the best to all of you, cancer survivors, like me.

Charmaine49
Posts: 1
Joined: Nov 2012

Hi It is a year and 1/2  later but I just gad the same despair and fear that I had serious CKD... untold and untreated.   well the docs at the VA never told me that with ONE kidney at age 63 my GFR IS normal at 37-40... Neph said 80 is OK for 2 kidneys, I will still lose 1% a year forever, so be at  GFR 20 age 80...if I can live and be healthy enough to get out of the house then I will also be happy.  I wish they had done a better job of informing me so the shock and distrust and anger was not so great. I raged at them for letting me "drop" to 37 AND want to  put the "F**ing contast dye into me last month  I refused.. it knocks you down...so if I had known YES I do have CKD but I am NOT SICK.  there is nothing to fix, I can't fix it.  But I had gone with high BP for 2+ years which really made me mad that no one saw this...it is important to keep it under 130/80 NOT 140s/80   because the one kidney has to struggle a bit more.

So I was in the SAME MENTAL STATE as the first poster here, and the others gave good advice, but I needed to talk to the Neph to really believe them..I asked all the same questions. i DID learn not to mess with the herbs, as you  still do not know what is in them, although there is a service $35 a year you can see if your herb meds have what they say.. but they only look at a limited amount..of course many have nothing, some too much, not good..I'd buy one of the ones they show as correct rather than another brand if I chose herbs,

MY renal diet has helped me, and my sodium is low, but I learned so much abotu food I CAN have at www.Davita.com  so check it out.  I am still not relaxed yet.( this just  happened 3 days ago at the Neph appt.)  .and blood tests show the H or L alarm next to Creatinine and GFR, but it looks like the test doesn't account for  number of kidneys.

 

all the news at NKF say to tell the patient about CKD, but they never did and that really pisses me off. so I wioll compain to chief of staff at Urology.

todd121
Posts: 557
Joined: Dec 2012

I don't know about GFR. I know that after my surgery my doc wanted to see my creatnine level be stable (radical nephrectomy). It was 1.9 after surgery and stable so he said it was ok to go home. He said he expected it would drop to 1.6 over the next few months as my other kidney improved. He told me before the surgery it was 1.2-1.3. Something like that.

They said I can eat whatever I want. Not sure that I trust that advice.

Todd

todd121
Posts: 557
Joined: Dec 2012

So I got my blood work done last week. My creatnine was 1.8 and my GFR was 40. They show up on the test outside normal, but the doctor seems ok with them.

I met with oncologist #2 yesterday, and he said he won't use the contrast unless my creatnine is 1.5 or maybe even 1.4. So I guess I won't be using contrast at my upcoming CT.

Todd

Eliezer2
Posts: 58
Joined: Aug 2012

I have observed that the creatine, urea and eGFR measures on blood tests are pretty sensitive to how much water you drink the evening and morning before the blood test.

 

SO I always drink a lot and it nudges all the measures towards the normal range.  I call this "studying for my blood test."

 

It does not really mean one's kidneys are any worse or better but psychologically I like seeing numbers closer to normal!  Try it!

Digger95
Posts: 59
Joined: Jun 2010

This topic worries me as well but I wonder how much is simply due to genetics?  I'm now over twelve years out from radical nephrectomy yet my doctor tells me that my creatinine (.78) and GFR are excellent even for a man my age who has two healthy kidneys.  I'd like to think that it is something I'm doing right, but to be honest I've treated my one remaining kidney like crap... drinking way too much alcohol, etc.  It's a crapshoot I think.

foxhd's picture
foxhd
Posts: 1897
Joined: Oct 2011

I agree with you digger. My numbers are awesome. So..just maybe....beer is the answer?...hum...I think I'll pop a beverage and think more about this.......

Honestly, I don't think I'll change much of what I do because I still don't know my longevity. So what am I saving anything for? I asked my wife 2 days ago, "Do you think I will ever have to buy a new shirt?" LOL.  As I have said before, "If I had a 3 piece suit, I would wear it to mow the lawn or work in the garden." Save it for what?

Digger95
Posts: 59
Joined: Jun 2010

Maybe 'excersising' our kidneys results in better kidney function...  though I don't drink beer here... it's all about the Jack Daniels.  :)

garym's picture
garym
Posts: 1651
Joined: Nov 2009



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