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  1. John
  2. General Nephrology Questions
  3. Friday, 13 July 2018
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33 yr old male
186cm, 88kgs
Left kidney removed shortly after birth (due to infection)
24ml/min/1.73m2 (stage 4 CKD?)

Hi,

I've been to see several doctors in recent weeks as there seems to have been a decrease in kidney function - spike in uric acid and creatinine. They have all been hesitant to give me estimates about the likelihood of needing a transplant - one speculated I may never need one while the other guessed I will in 3-5 years. I have sat down with a dietician and will make the necessary changes to keep an eye on potassium, phosphate etc. but I was wondering if you might be able to offer an opinion in terms of the likelihood of a transplant, or further complications I should be wary of, with the heart for eg?

Thanks very much,
John
Responses (8)
Accepted Answer Pending Moderation
Hi John,

Thanks for your post.

Before providing any opinion, can you tell me what your GFR was prior to the 24 ml/min and how long ago was that done? Also, do you have any knowledge of how much protein you have in your urine?

Thanks,

Dr. Jordan Weinstein
  1. more than a month ago
  2. General Nephrology Questions
  3. # 1
Accepted Answer Pending Moderation
Thanks so much for your quick reply,

So I've attached some recent labs here - it seems 'total protein' is 70?

I've reached out to the hospital now to get my records to see how this fits in with the broader picture, and will update you as soon as possible.

One doctor told me I'd probably need a transplant in 3-5 years while the other thought this was not something I'd have to worry about until much later in life, so I'm really just trying to get as many opinions as possible (and trying not to freak out!)

Thanks very much,
John
  1. more than a month ago
  2. General Nephrology Questions
  3. # 2
Accepted Answer Pending Moderation
Ok, so yet to get my hands on recent GFR, but the broader picture looks something like this (if that helps at all):

1990 56.7
1994 49.2
1996 48.4
1999 53.7
2002 50.4
2003 42
  1. more than a month ago
  2. General Nephrology Questions
  3. # 3
Accepted Answer Pending Moderation
I removed your lab data posted below as it included your name. I have purged the file from our servers as well. Please ensure if posting such material that you crop your name out.

The total protein posted is in your blood not urine. We would need to know a quantity of urinary protein to answer more fully.

That said, you are very young and the amount of kidney function you have needs to last a long time. If I knew your previous GFRs and current urinary protein, I could speculate better. But you are likely going to need some form of kidney replacement as you age. Predicting when that will happen is harder but with the requested information, I could try.

Jordan
  1. more than a month ago
  2. General Nephrology Questions
  3. # 4
Accepted Answer Pending Moderation
Oh ok, apologies

I've attached here the urine labs, and am following up for a fuller GFR history

Thanks so much Dr. Weinstein,
John
  1. more than a month ago
  2. General Nephrology Questions
  3. # 5
Accepted Answer Pending Moderation
Based on your rate of progression which is about 1.16 ml/min/year, it would take an additional 8 years or so to reach 15 ml/min which is about the level we consider performing renal replacement therapy. This assumes that the rate of progression from here on in remains constant. Please understand that this is an estimate only.

Jordan
  1. more than a month ago
  2. General Nephrology Questions
  3. # 6
Accepted Answer Pending Moderation
Ok, thanks very much

I guess I had hoped I'd be able to avoid a transplant, but given my history that was probably a little naive.

Thanks so much for taking the time to chat, really really appreciated

Best regards,
John
  1. more than a month ago
  2. General Nephrology Questions
  3. # 7
Accepted Answer Pending Moderation
It's my pleasure. Feel free to post additional follow-up.

Jordan
  1. more than a month ago
  2. General Nephrology Questions
  3. # 8
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