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Low kidney function...

PK_Chicago
Posts: 29
Joined: Mar 2012

I went for my first set of post surgery CT scans today - I had my left kidney removed in January (RCC Chromophobic) and they were supposed to be with IV contrast - however they said my kidney function was a little low - so no IV.

Has anyone else experienced this?

They gave me some measure like 60 is normal, with one kidney it should be 55, I was at 43. They said I could be dehydrated a little.

Just curious...

PK

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

That sounds not unreasonable PK. From memory (iceman will be able to give chapter and verse) 100 is a normal level for younger adults with 2 kidneys. Below 60 is regarded as compromised function and there are risks with iv-administered contrast. Most older folks have lowish levels, so caution is necessary but it's a complicated decision. There are many factors to consider for each individual and there are quite a few different contrast dye products on the market and different specs of CT machines.

I've had 3 CT scans, all with contrast. I'm almost 70 and chromophobe RCC, like you (but, alas, turned mostly sarcomatoid. After a radical nephrectomy in Dec. I had an eGFR of 53 and they had no hesitation in using contrast for my second scan, but my physical performance level is generally high and they have the very latest CT scanner. In hospital for a second op in late March I was over 60 (the remaining kidney often compensates for a deficit so you eGFR can go up somewhat)and fell back to about 58. Again, no hesitation in using contrast for my scan 10 days ago but at Stage 4 and Grade 4 they may think the risks of iv contrast are outweighed by the desirability of getting the most informative imaging possible in order to spot any further nasties as early as possible.

You need to be well hydrated at the time of having the scan with contrast and to drink plenty of water afterwards to flush the dye out of your system asap.

donna_lee's picture
donna_lee
Posts: 388
Joined: Feb 2009

The IV contrast would have been released at the time you were undergoing the CT. It is an iodine dye and it's hard on the remaining kidney, and some people are allergic to the iodine so can't have the contrast. I've had many of them in the previous 6 years, with pre and post hydration and acetylcyst. All to help the kidney flush out the dye.
I would be ecstatic if my eGFR was 60; the highest I have ever had is a 38 with one kidney.
It is also a factor of age. I'm now 69. My husband is the same age, has both kidneys but Stage III Kidney Disease, and his eGFR is about 54.

The next biggie is to get your results on the CT and have reason to celebrate. Good Luck
donna_lee

lbinmsp's picture
lbinmsp
Posts: 266
Joined: Jun 2006

Hi PK - my GFR hasn't been over 45 in years - and still get CT's with contrast regularly. When it has fallen below 40 (and it has done that on a few occasions) the radiology department hooks me up to an IV of saline - runs half of it in before the scan - and I have to stay until the rest of it is done. This helps to ensure that the dye will be excreted fairly quickly and keeps the kidney well hydrated. Of course after I leave I continue to drink plenty of water to continue the flushing out of the dye.

LizB

icemantoo's picture
icemantoo
Posts: 1452
Joined: Jan 2010

Unfortuately those of us with one kidney and older than the rest (I will be 69 next month) have low GFR findings. The low 40's is indicitive of Stage 3 Kidney Disease, but is also normal for many of us with 1 kidney as we get older. One of the causes of a low GFR besides getting older and having 1 kidney is high blood pressure. I have been seeing a Nephrologist for about a year and 1/2 and my GFR has gone up from 41 to 45 as a result of more aggresively monitoring my BP. The moral of this story is that there are other concerns in addition to a recurrance of RCC that we must be aware of and that the RCC does place us at a greater risk for a heart incident as a result not of the Cancer, but as a result of decreased kidney function. My advice with a low GFR is to address these concerns with a Nephrologist. Both my Urologist and my GP refused to refer me to a Nephrologist after I had a bout with Gout (which is Kidney related) so I did it myself. Neither has complained about it to me since and all share my records with the other.

Icemantoo

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