Age 34 - GFR went from 71 to 47 - sudden drop in month

[metallica]

Hi,

My first post, so I hope you all help me.

I am 34 year old male who has hypertension diagnosed at 31. I have been taking Irbesartan 300mg for last 2 years.
This has kept by BP under control - around 115/80 mark.

However at recent GP visit as part of hypertension review, I had a blood test done that came up with creatinine - 147 and GFR as 47. The glucose and cholestrol are well within normal readings.
The last time this was measured was in August when creatinine reading was 117 and GFR as 71. My GFR has always been between 70-80.

The GP has requested for a repeat test, but I am concerned by the sudden drop. Can anyone please advise what could this be? Anything I should do apart from waiting for test results?

I notice that my diastolic BP is not under control with average value of 110/90 now. Is that reason?

Want to add that 3 week ago, I woke up with sudden back pain. I thought this was muscular pain and use ointment. The pain lasted few days.

Very worried especially given my age.

Please advise what I can do.

[wagolynn]

I think the best plan is to wait for the retest results.

[AmandaClare]

Hi, I hope you get a better result with the retest.

With the back pain did you use creams containing ibuprofen? Or were you popping them to deal with the pain? NSAIDs like aspirin and ibuprofen are forbidden for kidney patients (apart from sometimes a prescribed low-dose daily aspirin to reduce cardiac risk) - the cream would be safer than ingesting it but if you were really slapping it on some could have got into your system.

Otherwise dehydration or minor illness or dieting or extreme exercise can cause blips. But sudden, lasting drops in kidney function do unfortunately also happen.

Best of luck. Let us know how it goes.

[metallica]

Thanks for your replies so far.

Yes, I will be waiting for the retest results but this is causing me a lot of anxiety with such large drop in less than 3 month. Hence my post here, to gather information based on all the expertise and people who have been in a similar situation. Also, what precautions I should be taking and if the results are consistent again then options that I have.

Regarding the pain, I took ibuprofen and also used a pain killer ointment on the back. I wasn't aware then that I should not take ibuprofen. I thought of it muscular pain.

[wagolynn]

The GFR result is usually an estimate (eGFR), and is not very accurate.

You can live normally with a kidney function of 41%.

Apart from staying well hydrated, and eating a sensible diet (look up 'Five-a-day fruit and Veg'), this will not improve your kidneys but will improve your general health, there is not a lot can be done.

As to 'curing' your kidneys, first the cause must be diagnosed, some conditions are treatable some are not.

It is better to get a diagnosis before making any changes, you need to keep your doctor up to date with any changes you make, best not to make any while the diagnostic process is going on, as some changes can affect the diagnostic results.

[metallica]

Thank you.

Understood.

Assuming if the results have improved on the retest, what tests or investigations I should ask my doctor for my own peace of mind. The GP may not voluntarily ask, should they be normal.

Even if the results are consistent, what investigations should be done?

[wagolynn]

A response to your last question - Further tests - depends very much on your individual case, and any diagnostic results.

If you are in the UK, I would expect your GP, if they think it necessary, to pass you on to a consultant or monitor blood results at shorter intervals to keep an eye on your kidneys.

This website may help you with blood results http://www.edren.org/pages/edreninfo/bl ... isease.php

There is lots of other info on this site if you start at the home page, it is a bit technical though.

Don't try and self diagnose, kidneys, and their effects on general health are far too complex.

[metallica]

Thanks you very much.

Had a result of the repeat test and the GFR came to 70. The GP said the 47 could be due to dehydration and said there is nothing I or they need to do.

Should I be relieved or is there anything I do? I mentioned about the severe back pain bout that I had but I was told it could have been muscular pain.
I was stressing to the GP that I have hypertension and hence was more anxious about any kind of kidney function. Anything else people suggest I do?

Yes, I am in the UK. I was taken aback when the GP said to me they dont refer people to a consultant until the GFR drops below 30. Is that normal for everyone? I am with a GP practice in London.

Thanks in advance

[rheaybou]

Is your gp concerned or treating your blood pressure? Getting your BP under control, a healthy diet and excercise(stay hydrated)will all help in the long term. You could ask for another opinion, maybe a GP with a better Renal background?

[wagolynn]

Thanks you very much.

Had a result of the repeat test and the GFR came to 70. The GP said the 47 could be due to dehydration and said there is nothing I or they need to do.

Should I be relieved or is there anything I do? I mentioned about the severe back pain bout that I had but I was told it could have been muscular pain.
I was stressing to the GP that I have hypertension and hence was more anxious about any kind of kidney function. Anything else people suggest I do?

Yes, I am in the UK. I was taken aback when the GP said to me they dont refer people to a consultant until the GFR drops below 30. Is that normal for everyone? I am with a GP practice in London.

Thanks in advance

GFR is usually estimated (eGFR), and tends to be error prone, it is usual to consider trends rather then individual results.

Dehydration or over-hydration will produce spurious results.
On average, eGFR of 30 does not cause problems.

Keeping reasonably hydrated will help your kidneys, about 2 - 3 liters per day will be OK.

Your blood pressure needs to be controlled, to this end, reduce or eliminate salt in your diet (may be referred to as sodium on some food labels), do not use salt in cooking food, and do not add salt at the table.
Processed foods tend to have relatively high salt content, I think, chefs tend to use unnecessary amounts of salt in foods.
Pepper and herbs can be used if you miss the salt, most food stuffs have sufficient salt in them to keep our sodium levels high enough.

Losalt, and similar products are best avoided.

If your BP does not drop within a month or so, go to your GP for more advise or medication.

High blood pressure, over time, will damage kidneys.

[metallica]

Thank You both.

I would like to clarify that I was diagnosed with BP 4 years back and I am taking medication of Irbesartan. This has controlled it so far, until recently when I noticed that the diastolic is not being controlled. The systolic is well controlled.

I am due to meet a BP specialist and will discuss with him regarding the BP.

My original post was when my GFR was 47 when 3 months back it was 70. The repeat came at 70 and GP advised no further action. I was only checking if there is anything I should do/ ask GP given that I am on BP meds and had massive back pain and cloudy urine.