I am a 42 year old woman. I have a history of having pregnancy induced hypertension that wasn’t consistently elevated to require medication (2/3 of my pregnancies). Never been overweight, I exercise and eat a mostly plant based diet with a lean meat portion once per day. Over the past 8 years, my creatinine has gone up at each lab screening. It started around 0.8 and has gradually crept up to 1.05 at my last lab draw in July 2019. I mentioned this to my pcp but she said she wasn’t worried. My gfr per calculation was 67. I know this is CKD stage 2! Is this something I should be worried about? I should also note that I was just diagnosed with hyperthyroid, likely Graves’ disease. I’m concerned. What should I do next? I do not have a family hx of kidney disease requiring dialysis. Thank you.
Hello,
Dr. Jordan Weinstein
- By any chance do you have any knowledge of your urinary protein levels?
- Did you have protein in the urine during your pregnancies?
- Have you had an ultrasound?
- Is your blood pressure well controlled now?
- Do you take any medications including supplements?
- What is your ethnic background?
Dr. Jordan Weinstein
I don’t know if I have any protein in my urine now, but my most recent serum albumin was 4.6 (I know this doesn’t rule out Microalbuminuria).
My urinary protein was negative in all pregnancies but the last one. And it was positive on a dipstick right before I delivered, But I tested negative for pre-eclampsia (24 hour urine). My blood pressure is up right now, but the endocrinologist thinks this is due to Graves/hyperthyroid. I’m taking 25 to 50 mg of atenolol depending on my pulse and BP. I checked it today and it was 114/75. I also take 10 mg methimazole, 2000 IU of vitamin D and a fish oil (but I don’t always take that everyday). I am white.
My urinary protein was negative in all pregnancies but the last one. And it was positive on a dipstick right before I delivered, But I tested negative for pre-eclampsia (24 hour urine). My blood pressure is up right now, but the endocrinologist thinks this is due to Graves/hyperthyroid. I’m taking 25 to 50 mg of atenolol depending on my pulse and BP. I checked it today and it was 114/75. I also take 10 mg methimazole, 2000 IU of vitamin D and a fish oil (but I don’t always take that everyday). I am white.
And I have had an abdominal ultrasound in November that said that my kidneys measured and appeared normal, but I’m not sure if that is the correct imaging for a kidney-specific study.
Hello,
Knowing your urinary protein is an important variable. If you have none, then whatever is going on will likely have an indolent course. If your kidney function stabilizes at this level and you lack proteinuria then in my opinion, there is little cause for concern. However, if your urinary protein is significantly elevated and/or kidney function declines, then I would think a nephrologist might suggest undergoing a renal biopsy to know what is causing this. In all cases, maintaining excellent blood pressure is very important and use of ACE inhibitors or angiotensin receptor blockers might have particular value especially if urinary protein is elevated.
I can only base my opinion on the information provided and your health-care provider might arrive at different conclusions once you have provided an entire history and had a physical examination performed. As always, this forum provides general medical information only and is limited to educational use only. Please discuss the above remarks with your health-care provider.
Dr. Jordan Weinstein
Knowing your urinary protein is an important variable. If you have none, then whatever is going on will likely have an indolent course. If your kidney function stabilizes at this level and you lack proteinuria then in my opinion, there is little cause for concern. However, if your urinary protein is significantly elevated and/or kidney function declines, then I would think a nephrologist might suggest undergoing a renal biopsy to know what is causing this. In all cases, maintaining excellent blood pressure is very important and use of ACE inhibitors or angiotensin receptor blockers might have particular value especially if urinary protein is elevated.
I can only base my opinion on the information provided and your health-care provider might arrive at different conclusions once you have provided an entire history and had a physical examination performed. As always, this forum provides general medical information only and is limited to educational use only. Please discuss the above remarks with your health-care provider.
Dr. Jordan Weinstein
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