GFR Question for you guys

DonMiller
DonMiller Member Posts: 109
in Kidney Cancer #1

I had my surgery on October 5, 2012.  11CM T3A Grade 3.  I know I am at high risk of reoccurence but so far my scans have been clear. When I had my last scan a few weeks ago it was noted my GFR has declined to 55.  I don't have a baseline because all my previous bloodwork just notes ">60". My creatinine is also a bit evalated at 1.38.  I can't seem to get a straight answer from my doctors some of who note I have tage 3 CKD and others say I am doing fine with one kidney. I also note I treated for hypertension and midly diabetic with an A1C of 6.1.  Any comments would be really appreciated.

 

Don

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Comments

  • GSRon
    GSRon Member Posts: 1,303 Member
    #2
    Hi Don..!

    I will gladly chime in here.. Yes you have reduced Kidney function.. as expected..   55 is not bad, not bad at all.. same with the 1.38 Creatnine number.  No not perfect, but you are no longer "whole"..  My GFR has been between 41 and 48 for the last almost two years.  Two weeks ago I tanked to 36.. booo...   My Creatnine varies from 1.6 to 1.9 post surgery. I am not allowed any Contrast with my scans with such low numbers..   But this is OK.. I think too many worry  about the lack of contrast..  Since I always get scanned at the same place, they KNOW what to look for..  and trust me they found the little buggers before they were 100% sure they were Mets.

    OK so you want to know the rest of the GFR stuff...  basically watch it... if it drops a little bit still no worry.. sound the alarm if it gets in to the 30's. Should it get to the low 20's then worry..!  Around / below 20 and most likely you get to find out what Dialysis is all about.  That said, I doubt you will have any issues.  I happen to have two cysts in my remaining Kidney and I suspect one or both may be growing.. either that or..??

    Now, I am sure you know that WATER is your best pal...  SALT and SUGAR are the enemy...  Foods that make your Kidney work hard need to be monitored / reduced.  I had a great session with a Dietician... she basically told me..  more Water, watch the red meat.   

    Also, look at your entire blood test results... look for any high or low numbers...  You may need to limit one type of food and increase another...  I suggest you trend your blood tests from as far back as you can.  This will help with you watching things in case something changes.  Do NOT just rely on your Doctor doing it for you...  Mine missed the 10 point drop in GFR... booo...  Glad I found it..!

    Hang in there..!

    Ron

  • todd121
    todd121 Member Posts: 1,448 Member
    #3
    Chronic Kidney Disease

    Your kidney numbers aren't bad. I think the upper limit on creatinine is 1.3 for "normal", so if you were a little lower you'd be fine with one or two kidneys. Mine is 1.6, and they say that's ok. I don't remember my GFR number, but I'm sure it's worse than yours. I think mine was 1.2 even with 2 kidneys.

    By definition we have CKD. I don't know that it means a whole lot since the definition is based on normal kidney function with 2 functioning kidneys.

    You may simply have been a little dehydrated when you did your test. That can shift your numbers on some of the blood tests. Drink plenty of water before your test each time.

    Because we are more at risk for kidney disease, we have to drink plenty of water and watch our blood pressure (high BP is very bad for kidneys), keep salt down, and do not overeat protein (high quantities can damage kidneys too). Also stay away from aspirin, ibuprofen and other drugs that are processed by the kidney instead of the liver.

    Todd

  • icemantoo
    icemantoo Member Posts: 3,361 Member
    #4
    todd121 said:

    Chronic Kidney Disease

    Your kidney numbers aren't bad. I think the upper limit on creatinine is 1.3 for "normal", so if you were a little lower you'd be fine with one or two kidneys. Mine is 1.6, and they say that's ok. I don't remember my GFR number, but I'm sure it's worse than yours. I think mine was 1.2 even with 2 kidneys.

    By definition we have CKD. I don't know that it means a whole lot since the definition is based on normal kidney function with 2 functioning kidneys.

    You may simply have been a little dehydrated when you did your test. That can shift your numbers on some of the blood tests. Drink plenty of water before your test each time.

    Because we are more at risk for kidney disease, we have to drink plenty of water and watch our blood pressure (high BP is very bad for kidneys), keep salt down, and do not overeat protein (high quantities can damage kidneys too). Also stay away from aspirin, ibuprofen and other drugs that are processed by the kidney instead of the liver.

    Todd

    Perspective

    Don,

     

    A GFR between 31 and 59 is Stage 3 CKD (Chronic Kidney Disease). So what we all have numbers in that range which is "normal" for 1 kidney and being over age 60.  Your 55 is a lot better than my number. Watch your Blood Pressure and see a Nephrologist. CKD is a lot more likely to kill you in the form of a heart attack or stroke than any type of Kidney failure. Just something more to be concerned with as we get older,

     

    Icemantoo

  • thaxter
    thaxter Member Posts: 124
    #5
    Glad you asked

    At the hospital for my brain scan on Monday I  found out my GFR was 45 and was alarmed when I looked that up.  Dr. confirmed that it was the same a few weeks ago when I saw him as well.  They did give me a weaker dye for the brain MRI.

    I definitely need to drink more water and cut back on sugar and salt.  I have gained 50 lbs since the nephrectomy in September (I had lost nearly 100 lbs before surgery).

  • foxhd
    foxhd Member Posts: 3,181 Member
    #6
    thaxter said:

    Glad you asked

    At the hospital for my brain scan on Monday I  found out my GFR was 45 and was alarmed when I looked that up.  Dr. confirmed that it was the same a few weeks ago when I saw him as well.  They did give me a weaker dye for the brain MRI.

    I definitely need to drink more water and cut back on sugar and salt.  I have gained 50 lbs since the nephrectomy in September (I had lost nearly 100 lbs before surgery).

    sounds like

    you are doing ok Don. As mentioned not perfect. But is your weight? or eyesight?or knees? perfect?  Just keep an eye on it.

  • Eliezer2
    Eliezer2 Member Posts: 85
    #7
    GFR always low if one kidney removed

    Goes with the territory.  

  • shamrocklady
    shamrocklady Member Posts: 20
    #8
    Hi Don,
    I do agree with what

    Hi Don,

    I do agree with what other's are saying here - there is reduced function of the kidney (not ideal), but a GFR of 55 is not so bad either.

    I have some experience with CKD and the lab values associated with them since I work in a hospital as a dietitian/nutritionist. If you can keep your blood glucose under control, keep blood pressure in healthy ranges, reduce excess sodium from your diet, and avoid excess animal protein (think serving size of 3-4oz fish/chicken vs 16 oz prime rib), it will help protect the kidney. I can give more specifics if you need.

    Perhaps also ask your doctors if any medications you are taking are also hard on your kidney and see if there are alternatives.

  • izzycohen
    izzycohen Member Posts: 80
    #9
    Sounds like you're doing well.

    Personally, I would love to turn in an A1C of 6.1

    I have done better since losing some weight.  The Creatinine figure isn't horrible.  my surgeon told me he has patients with readings of 2.0 who are doing fine.

  • donna_lee
    donna_lee Member Posts: 1,045 Member
    #10
    izzycohen said:

    Sounds like you're doing well.

    Personally, I would love to turn in an A1C of 6.1

    I have done better since losing some weight.  The Creatinine figure isn't horrible.  my surgeon told me he has patients with readings of 2.0 who are doing fine.

    Alphabet soup...BP, eGFR

    Your eGFR is great.  I don't know what mine was before surgery, but for the past 7 1/2 years it has been between 37-42.  eGFR and Creatanine are like stocks and bonds-if one is up, the other is down.  And the longer the kidney(s) have been functioning (think your age) the lower the average eGFR is for that age.

    And a good PC will really monitor your BP after a nephrectomy.  You need to keep the BP under control with meds so the remaining kidney isn't damaged.

    There are some pretty good websites that will eGFR -but don't confuse it with the sites for Growth Factor Hormone.  Just Google.

    Hang in there.

    Donna

  • adman
    adman Member Posts: 336
    #11
    Creatinine....

     

    I saw my Onc Dr today. I'm getting ready for 6 months scans. I used to have them every 4 months but insurance [ Cigna ] is now only approving every 6 months even though the Dr has ordered more often.

    Anyway, she is concerned about my last bloodwork that had my creatinine at 1.25 - up from 1.13 range the past 12-18 months. Even though that pegs my eGFR at high 60's, it was high 70's or more.

    Anyway, hopefully it will go back up again and not continue going down. She left me pretty scared and mentioned I may need to see a Nephrologist. We'll see.

    Thoughts?

  • GSRon
    GSRon Member Posts: 1,303 Member
    #12
    adman said:

    Creatinine....

     

    I saw my Onc Dr today. I'm getting ready for 6 months scans. I used to have them every 4 months but insurance [ Cigna ] is now only approving every 6 months even though the Dr has ordered more often.

    Anyway, she is concerned about my last bloodwork that had my creatinine at 1.25 - up from 1.13 range the past 12-18 months. Even though that pegs my eGFR at high 60's, it was high 70's or more.

    Anyway, hopefully it will go back up again and not continue going down. She left me pretty scared and mentioned I may need to see a Nephrologist. We'll see.

    Thoughts?

    Is your Onc serious..?  Your

    Is your Onc serious..?  Your eGFR is awesome for a person with one Kidney.. same for the Creatinine.  Your one Kidney is doing very well indeed..!  Keep in mind your diet and especially water intake will influence those numbers..  I would love to have numbers that good..!  My eGFR is 36 and Creatinine is 1.9

    Ron

  • adman
    adman Member Posts: 336
    #13
    GSRon said:

    Is your Onc serious..?  Your

    Is your Onc serious..?  Your eGFR is awesome for a person with one Kidney.. same for the Creatinine.  Your one Kidney is doing very well indeed..!  Keep in mind your diet and especially water intake will influence those numbers..  I would love to have numbers that good..!  My eGFR is 36 and Creatinine is 1.9

    Ron

    follow up thought.....

     

    To be clear, [ I think ] 'My Onc' was saying that she was concerned that my eGFR/ Creatinine had dropped like it has in such a short period of time. Not that the 'new' number isn't ok [ as long ] as it doesn't continue to drop.

    She did say that [she] would not give me contrast at my current level - Creatinine 1.25, which did surprise me a little since I do read many posts on this board and it appears that several people have said they 'do take' contrast & their #'s appear to even be lower than mine. 

    Thoughts?

     

  • GSRon
    GSRon Member Posts: 1,303 Member
    #14
    adman said:

    follow up thought.....

     

    To be clear, [ I think ] 'My Onc' was saying that she was concerned that my eGFR/ Creatinine had dropped like it has in such a short period of time. Not that the 'new' number isn't ok [ as long ] as it doesn't continue to drop.

    She did say that [she] would not give me contrast at my current level - Creatinine 1.25, which did surprise me a little since I do read many posts on this board and it appears that several people have said they 'do take' contrast & their #'s appear to even be lower than mine. 

    Thoughts?

     

    FYI, I had a 10 point drop in

    FYI, I had a 10 point drop in my eGFR in a 5 week period.. so the percentage is a lot more..!  I went from 46 to 36, but in all fairness my eGFR was in the 41 to 49 range over the last 21 months.

    Every Doc seems to have their own opinion on Creatnine and using contrast with scans.  But usually around 1.5 is the tipping point.  I have never heard of 1.25 being left out of the contrast group.  You may wish to ask for half dose of the contrast and see what your Dr says.  My first post surgery scans were with half contrast even though my numbers were pretty bad.. but my Dr thought the risk would be worth getting a good base line.  Since then no contrast and with my latest numbers definitely no contrast.

    I will await others to chime in, but it sounds like your Dr is a bit too conservative at this time..

    Ron

  • Eliezer2
    Eliezer2 Member Posts: 85
    #15
    test is sensitive to how much you drink the morning of test

    You can nraise it if you drink a lot in morning and evening before.   I call it "studying for my blood test"

     

  • adman
    adman Member Posts: 336
    #16
    Thanks....

     

    I actually have been - and 'do get' 1/2 doses of contrast, which I beleive is 50ml instead of the normal 100ml. Maybe 100ml is 1/2, hienstly not sure.

    What I've never been able to get a consensus on is whether the '1/2' dosage is really enough to get a good look or not. More specifically, if I were to chance a 'full dosage' what would they benefits actually be?

    We need to get a radiology professional on this board. We used to have a guy but I do not see him any longer. He was a Radiology Tech and actually told me at one time that 1/2 dosage is more than sufficient, but then when my 'Radiologist' provides the reports to my Onc-Dr. he includes the fine print ** " This scan was done with 1/2 contrast so there is a reduced level of ....bla bla bla" - which is probably covering their arse. Who knows.

     

    Thoughts?

  • foxhd
    foxhd Member Posts: 3,181 Member
    #17
    adman said:

    Thanks....

     

    I actually have been - and 'do get' 1/2 doses of contrast, which I beleive is 50ml instead of the normal 100ml. Maybe 100ml is 1/2, hienstly not sure.

    What I've never been able to get a consensus on is whether the '1/2' dosage is really enough to get a good look or not. More specifically, if I were to chance a 'full dosage' what would they benefits actually be?

    We need to get a radiology professional on this board. We used to have a guy but I do not see him any longer. He was a Radiology Tech and actually told me at one time that 1/2 dosage is more than sufficient, but then when my 'Radiologist' provides the reports to my Onc-Dr. he includes the fine print ** " This scan was done with 1/2 contrast so there is a reduced level of ....bla bla bla" - which is probably covering their arse. Who knows.

     

    Thoughts?

    adman

    the "Medscan" man popped in a week or so ago. I bet he is lurking so hopefully he can help out with this contrast business. For what it is worth, I always get a half dose for my scans. My numbers are always good. Creatinine of .8-1.0 and gfr of over 60. I review my scans with my doctor and those tumor buggers always show up and are easily seen.

  • adman
    adman Member Posts: 336
    #18
    foxhd said:

    adman

    the "Medscan" man popped in a week or so ago. I bet he is lurking so hopefully he can help out with this contrast business. For what it is worth, I always get a half dose for my scans. My numbers are always good. Creatinine of .8-1.0 and gfr of over 60. I review my scans with my doctor and those tumor buggers always show up and are easily seen.

    YES, that's it....thanx

     

    FoxHD,

    MedscanMan helped me before...a good man for sure.

     

  • donna_lee
    donna_lee Member Posts: 1,045 Member
    #19
    adman said:

    YES, that's it....thanx

     

    FoxHD,

    MedscanMan helped me before...a good man for sure.

     

    Yesterday's results

    I got a smiley face on my labs yesterday.  eGFR was 43; and as my PC says, for my age and 1 kidney, that's a great number.

    You're just a young fart-joke-so your eGFR can be higher.  55 is wonderful.

    Donna

  • Skagway Jack
    Skagway Jack Member Posts: 224 Member
    #20
    GFR

    I just had blood work done today in prep for a scan on monday.  My GFR was 46 and my creatine was 1.66.  I was told I would be required to have infusion of 500 ml prior to scan and another 500 ml after.  I am having the barium sulfate and IV contrast.  They said I should drink heavily before and after for several days....I said sounds like fun and they said that drink water heavily just to clarify.  My GFR was 48 in November, I had hoped it would improve but it appears not to be the case.

     

     

  • TillieSOK
    TillieSOK Member Posts: 252
    #21
    My last MRI (brain) blood

    My last MRI (brain) blood work showed my creatinine to be 1.69 and my GFR was 30.  They used 1/2 dose of contrast.  They generally always used 1/2 dose with me. I'm getting ready for bloodwork again tomorrow for my three month scans next week.  I'm going yo tank up on water this time.  I've usually just had my normal 5-6 pints of water a day, but I think I'll up it another pint or two and see if I can get some better numbers.

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