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  Tuesday, 29 January 2013
  4 Replies
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I am 42 years old.  A history of high blood pressure for 2-3 years, now controlled on medication.  Just had an ultrasound of the kidneys and found to have moderate bilateral cortical thinning.  Recent labs revealed an eGFR of 52.  I viewed labs back from 2008 and the eGFR was 70.  The last three results in the past 2 months have been 57, 56 and now 52.  Urine albumin is 48 and the urine creatinine is 390.1.  There is no blood in my urine on spot check.  Normal HgB A1c.  No history of diabetes.  Hemoglobin 14.7, hematocrit 44, and creatinine 1.14.  Do I have CKD?  Should I be seeing a nephrologist?  My family physician has taken no interest in any of this inofrmation and disregards my questions.  Please advise!  Thank you!
11 years ago

A nephrologist can certainly shed some light on these problems.

You have mild CKD insofar as your GFR is concerned. Regarding the protein levels in your urine, could you kindly post the units of both measurements as each lab uses different expressions for albuminuria and creatinine around the world, and I want to be sure what we are referring to. If your urinary protein is elevated, but only mildly so, then again, this would fall under the mild CKD category. The priority moving forward would be maintaining a blood pressure of less than 140/90 as an absolute maximum and some authorities would recommend even lower, 130/80. As well, it would be important to maintain urinary proteins in a low range with adequate BP control and possible use of ACE inhibitors or Angiotensin Receptor blockers. Once I know the precise urinary protein measurements, I will have a better handle on the degree to which this is the case at present.

11 years ago
I really appreciate your response.

Creatinine , UR Random (UCRR) Std Range 20-300
Albumin, Urine Random Std Range 0-23
Albumin/Creat Ratio (my total is 12) Std Range 0-30

Is this what you are looking for?
11 years ago
That helps.

As you see, your ACR ratio is normal, meaning your urinary albumin excretion is not high. Assuming your total proteins are not elevated (unlikely that they are), then your only concern is a mild reduction in kidney function, which in the presence of low urinary protein, is very unlikely to progress rapidly if ever. Maintaing good BP control will be your priority, avoidance of smoking and minimizing insults to the kidneys (NSAIDs and other medications known to be harmful to the kidney).

11 years ago
Thank you! That makes me feel much better and answered the concerns I had.
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