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  Wednesday, 06 November 2024
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I just sent this message to my former primary. I'd be interested in reading your thoughts. I do understand that my numbers are great compared to many with serious kidney disease, but as I wrote in the message, I'm not loving the trend. I'm a guy pushing 63 years old, if that matters. I am leaking protein into my urine, FWIW. My Albumin, Unrine Detection is at 367, which is high, but stable for me. Urine Creatinine is 94.6, which they show as normal.

Hi Dr. X,

I realize that you have dropped me as a patient (too many patients), but it didn't give me the option to message anyone else. Normally I'd address this to Dr. K in Nephrology, but I didn't have the option.

As you may know, I'm T2 diabetic with some lower-level kidney damage. I'm concerned about my EGFR results. I do realize that a value of 81 is considered normal, but my concern lies in the pace of decline. 10/22 at 100, 10/23 99, 05/24 93, and now only 6 months later, I'm at 81, a drop of 13 points.

Correct me if I'm wrong, but my understanding is that when kidney damage is present, the kidneys work harder to filter, which explains the high numbers (100, 99, 93) and then when they can't keep up, the numbers start to drop.

Seems like a large decline in a short time. Not loving the trend, & looking beyond the here & now. Anything I can do to improve this?

Feel free to forward to Dr. K and anyone else you think should be involved.
1 month ago
·
#2988
Hello,

Please provide an image showing your albumin to creatinine test results. I would like to see the units used. Please block out any identifying medical information as will be visible on the site.

Dr. Jordan Weinstein
1 month ago
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#2989
Ok here it is.
1 month ago
·
#2991
Hello,

This is consistent with a modest amount of protein in the urine. There seems to be some inconsistency with the way this is reported on that form unless I am misunderstanding it. Nevertheless, you might discuss this matter with your nephrologist as it should be followed and addressed with medication. One possibility would be to use an SGLT2 inhibitor or else an MRA such as Finerenone. Theoretically both drugs could be used together as well but this is something to discuss with a nephrologist. This is not an emergent finding but an important one that I would not ignore.

Dr. Jordan Weinstein
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