Learn to Read and Understand Your Labwork

So, as promised my most recent labs are back.  I did have them before I saw the kidney doctor, and primary care doctor, but I wanted to wait and get feedback from them too.

I am basically stable, no ups, no downs.  That is good.  However, my kidney doctor kind of annoyed me because he said my blood Creatinine levels will never improve, they can only get worse.  Now, I have said before how much Negative Nancy’s annoy me, especially when I have proof it is not true.  In January 2018, 1 year after I was diagnosed my Creatinine was 1.13, normal, is 1.10.  That means my kidneys were able to clear most of the Creatinine from my blood.  So, I know he is wrong.  I just have to figure out what I am doing different now.  One thing I can think of, is Summer of 2018 my labs were almost as identical to now.  Since it is so hot here in Florida, I may be sweating out more fluids than I am taking in, and I had my blood drawn after working, and I do not get to drink as much at work.  Hence I may have been dehydrated, which can make Creatinine a smidge higher.  Creatinine is made by muscle use, so increased muscle use can increase Creatinine, not a lot, but a little, and when you have CKD a little is a lot.  So, the fact that I am lifting weights can also explain some of that.  That does not mean I will stop lifting light weights, but I may stop a week before my next lab draw, in 6 months, to see if there is a difference.  I have to be more aware of drinking enough while at work, as well.  Why the big fuss, on my part, if I am basically stable?  Because, when my Creatinine level was 1.13, my kidney functions was 88%, now with my Creatinine at 1.30, my kidney function is 76%.  So, you can see why I would rather have it be as low as it can.  To me, and maybe my kidney doctor does not see it this way, If I can get 1 1/2 kidneys to function at close to 100% that is obviously what I would want.  He did finally explain to me, it only took 2 years, how you figure out how much kidney function you actually have.  If you are like me, and your GFR is 50, then you may assume you have 50% kidney function.  This apparently is incorrect.  You take 100, and divide it by your blood Creatinine level.  So, 100 divided by 1.30 is actually closer to 77%.  The GFR is a filtration rate, estimate.  Everything else on my labs was completely normal.  I had zero protein in my urine, which is awesome.  So, a couple things I can take away from this visit.  1-  I can probably safely increase my protein intake just a little bit, to accommodate the weight training.  I will increase to 65mg per day, and I probably will not venture any higher than that.  If I start noticing signs of protein in my urine, I will cut back down.  He did not order a Vit D level, or an Intact PTH, which also annoyed me, because I eat very little Calcium, and I need to make sure my bones are healthy.

That brings me to my primary care doctor, who did order those for me, but she did say the kidney doctor, if I was going to continue to see him for the kidney, needs to order those things in the future.  I know he did not order them for the next round in 6 months either.  So, I will have to call ahead to see if he wants to add them.  Annoying!  I have to see her again, in November, for Cholesterol and all that stuff.  Cardiac Disease does run in my family, as does Diabetes, and while I do not have either of those, they need to be monitored.  The only other issue, is my BP.  I am exercising 5-6 days a week, and have lost some weight, so the fact that my BP is a little higher than 6 months ago, is a little concerning.  The kidneys regulate BP, and high blood pressure can decrease kidney function.  So, now I am taking BP, daily, rotating arms, and logging it.  For people with kidney disease, a normal BP is 135/85.

I am already tweaking the monthly small group sessions.  I will post about that probably on Saturday.  For now, though, you can still sign up for the Better Sleep group sessions, starting Sept 4th and running all month.  You can read about that here.

If you would like to learn more about reading, and understanding your labs, and then advocating for yourself, use the contact form below to message me about a free meet and greet.

You can see all of my available plans, here.  Don’t forget I am almost done with the Guided Imagery class, and will be able to offer Guided Imagery plans.  I have moved on to the Herbalism class.  So much to learn there.  Wow!

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My Latest Labs for CKD and What They Mean

OK, I am not an expert on lab readings, but I do know how to read them, and ask questions where needed.  I will share my most recent labs, and for the previous year, and tell you what I think is significant.  If you have CKD, then you know it is a balancing act trying to keep everything in line.  The kidneys don’t just remove waste, they also make a hormone called Erythropoietin that plays a very important roll in the body’s ability to make Red Blood Cells.  Kidneys also control blood pressure.  Healthy kidneys are rich with Vitamin D receptors that turn Vitamin D into it’s active form to be used by the body.  This helps control Calcium and Phosphorus levels.  Keeping everything working correctly with a damaged kidney is like a seesaw.

First let me say, I thought I was GFR of 57 last July, just 3 points away from being stage 2.  This was so encouraging, but alas I forgot I actually had my Nephrologist cancel that appointment, so I never actually saw those labs.  I have since downloaded the app from my Lab provider so I can check all my labs, whether I see the MD or not.  So far, except when I was initially sick, I have been able to maintain all my levels, including Iron, which is encouraging.  So, I will stop taking the multivitamin, and just take the Vitamin D supplement.  Multivitamins with Iron cause constipation, and trust me that is not fun.

So here are the labs, that have been out of range over the last year for January, July and then January again:

Creatinine in my blood:  1.13, 1.29, and 1.23  While this is only slightly high it is still the  most frequent marker for kidney disease.  I will continue to try to figure out a safe way to decrease it.  Now that I am working out regularly, I might have to cut protein intake to get it down to normal.  Of course there is the chance that may never happen, but won’t stop me from trying.

estimated GFR:  57, 49, and 51.  GFR is an estimate, but when I pulled up the graph of the values, when my GFR was highest, my urine protein was actually below normal.  So, that leads me to believe that I can keep my protein levels high enough to maintain body functions, but low enough to help my kidney status improve.  I do have to clarify this with the MD to  make sure there is not some other reason my urine protein would be below normal.

PCR: below normal, 113, 139  Again, note that in January of last year, when my GFR was it its highest, my PCR was below normal.  PCR is the protein creatinine ratio in a random urine sample.  While the other 2 numbers are normal, my GFR was also lower.

Creatinine urine:  19, 53, 36.  Again note with the higher GFR one year ago, the amount of creatinine in my urine was below normal at 19.  In July of last year, the appt I missed it had gone all the way to 53, and a huge dip in my GFR all the way to 49.  I have been racking my brain because I was still following the renal diet.  But, I also sustained an injury while pushing myself when walking.  We were speed walking, and I ended up with a pretty severe case of Plantar Fasciitis.  The injury took many months to completely heal, and I started a new job during that time where I was literally on my feet 8 hours.  It is my opinion that the injury caused my body to have increased protein synthesis to help aid the injury to repair causing the changes without diet change.

Protein urine:  less than 4, 6, 5  Again, below normal protein meant a higher GFR.  How they calculate the GFR, and PCR is still not completely understandable to me, but I am hoping he will take a minute to try and explain it to me.  I will also be discussing with him having a Cystene C with my next set of labs, in July to see what the GFR shows.

In conclusion, I felt the same no matter the GFR, and I know for a fact when my GFR was lower in 2017 I felt awful.  That leads me to think that the GFR may not be the most effective way to test my kidney function.  It is scary though, if I have to worry every time I get an injury, or infection, that my kidney is going to lose some of its function.

If you would like help reading your labs, and the important questions to ask your MD, sign up with the contact button for a free meet and greet.

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