firewatcher Posted December 30, 2008 Report Share Posted December 30, 2008 Just reviewing my labs for my ump-teenth new doctor appointment and a footnote caught my eye: if there is a persistent low GFR then there is Chronic Kidney disease (don't look it up, it's scary!) Well, mine has been "low" for a year and nobody has mentioned it. My creatinine is consistently high and my GFR is <60, usually in the low 50's. Most docs simply look at the levels and go, yup dehydration. The ONLY time it's come back normal was when I was actually overhydrated (serum osm 273)[my blood glucose level was 63 on this occasion] Should I be concerned? Dialysis or kidney transplant are not options that I want to think about! I know I've asked this before, but have ANY of you shown lab results like this: high serum/urine creatinine, low GFR, high hematocrit?Is it a POTS thing that goes along with the hypovolemia or is that "unknown endocrine dysfunction" rearing it's ugly head?Somebody please?! Quote Link to comment Share on other sites More sharing options...
flop Posted December 30, 2008 Report Share Posted December 30, 2008 Hi,the combination of high serum + urine creatinine and high haematocrit suggest dehydration with appropriately concentrated urine. I know later stages of kidney disease cause low haematocrit as the kidneys are involved in erythropoetin production that stimulates red cell formation.How much fluid do you drink? Have you ever measured the volume of urine that you produce in 24 hrs?GFR rates are tricky things they only give normal readings for healthy Caucasians in a specific age group!If you are worried about it ask for a referral to a renal physician / nephrologist.Flop Quote Link to comment Share on other sites More sharing options...
delphicdragon Posted December 30, 2008 Report Share Posted December 30, 2008 My insurance company thinks that I have Chronic Kidney Disease as I don't urinate much, if at all, when I'm having the most severe POTS attacks. I think my total urine output was 400ml in 24 hours because of the POTS attack. Without a POTS attack I urinate about 1000-1500 ml. My creatinine is always low. I agree with Flop, if you're worried see a nephrologist. Sara Quote Link to comment Share on other sites More sharing options...
firewatcher Posted December 30, 2008 Author Report Share Posted December 30, 2008 Hi Flop, It was the nephrologist who originally dxed me with diabetes insipidus due to polyuria and low urine osm. He has said my kidney function was good, but that was at the beginning of all this (about 12 tests and one year ago!) It is the consistently low GFR despite my "dehydration" level (fasting/not fasting) that have me concerned. I have not seen anyone here who has been tested and had results like these. I did not know if this was typical or consistent for hypovolemia, hypoperfusion (reduced blood flow to the kidney due to hyperadrenergic vasoconstriction?), neuropathy, or who knows what! As hard as I have looked, I can't find anything relating it to POTS! All I can figure is that either it has not been studied yet (in the context of POTS) or it is not POTS related. Quote Link to comment Share on other sites More sharing options...
flop Posted December 30, 2008 Report Share Posted December 30, 2008 Hi, sorry I hadn't realised you had diabetes insipidus as well - that would explain chronic dehydration (constantly peeing too much fluid will leave you relatively fluid depleted). Are you seeing the nephrologist again? I would ask them about the results, they may be able to tell you a what results are okay for you and at what level they would want you to ring up for further evaluation of your kidneys. I never believe any of the "automatic advice" on the bottom of lab results / ECGs, if they were true most of us would be dead several times over by now!One of my test results suggested possible prostate cancer as an explanation - I'm female!!!Flop Quote Link to comment Share on other sites More sharing options...
Maxine Posted December 30, 2008 Report Share Posted December 30, 2008 My GFR was off, and showed moderate kidney disease, but my PCP blew it off, and said my kidneys are fine.I don't urinate enough, and deal with urine retention. I get sick of it because after lying down a while-----then my body wants to let go of the urine, so I'm up to pee three times a night.I have not gotten any answers for this, and I have stopped trying. When the doc at NIH study said I need to get it checked out, I gave it a shot, but ony A shot. After my PCP blew it off I didn't want to fight trying to get answers. I'm in a rut, and just don't want to deal with Docs and their obtuse behaviour for a while.For now I'm hanging low until I get my fighting bearings back----- Watch out when I do----- This is why I save every record from every doc. You just never know when you might need to show their mistakes to them in balck and white. It's happened to me on several occasions when I had to ask different doctors why their information was wrong, and although they admit they made a mistake, I still get NO ANSWERS------------just a big black hole of nothing.Maxine :0) Quote Link to comment Share on other sites More sharing options...
firewatcher Posted December 30, 2008 Author Report Share Posted December 30, 2008 My GFR was off, and showed moderate kidney disease, but my PCP blew it off, and said my kidneys are fine.I don't urinate enough, and deal with urine retention. I get sick of it because after lying down a while-----then my body wants to let go of the urine, so I'm up to pee three times a night.I have not gotten any answers for this, and I have stopped trying. When the doc at NIH study said I need to get it checked out, I gave it a shot, but ony A shot. After my PCP blew it off I didn't want to fight trying to get answers. I'm in a rut, and just don't want to deal with Docs and their obtuse behaviour for a while.For now I'm hanging low until I get my fighting bearings back----- Watch out when I do----- This is why I save every record from every doc. You just never know when you might need to show their mistakes to them in balck and white. It's happened to me on several occasions when I had to ask different doctors why their information was wrong, and although they admit they made a mistake, I still get NO ANSWERS------------just a big black hole of nothing.Maxine :0)Maxine, I am almost there too! I am so sick of doctors, but the fear of that "unknown endocrine dysfunction" and having two family members die because of the "if we'd only caught it sooner..." excuse have me dragging myself to yet another doctor. I have come to the realization that they aren't really any smarter than I am, they just have a different education (and a lot bigger ego!) I am tired of going through the whole 4 inches of medical file with them and then hearing "I don't know." I am trying to downgrade my medical searching and just live my life as best I can with the symptom control that I have (which is pretty good if I don't push it.) sigh Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.