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Urology (Expert Forum)
Rate of probable kidney decline
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Rate of probable kidney decline
by Seaweed, Mar 08, 2004 12:00AM
Dear Med Help:
Is it possible, given the range of my BUN/creatinine levels for the last three years, that you can estimate my rate of kidney decline? And if so, will you, in fact, do that? Essentially I'd like to know how many more years I can continue to avoid dialysis. I have only one kidney. My other kidney, a horse-shoe kidney, was removed when I was 62. In 2000, my creatinine was 1.6. I underwent heart surgery in 2002 to repair a mitral valve, and after the surgery, my creatinine level shot up to 2.9. with a BUN of 48. I was experiencing the symptoms of uremia, anemia, and excess phosphorus in my system. After some time of strictly regulating my diet and taking procrit, my bloodwork #s are as follows: Creatinine - 2.3, BUN - 25, Phosphorus, Potassium and Sodium levels are normal, and my hematocrit is 38.4. I am 79 years old. I am 6 ft. tall and weigh 190 lbs.
Judging from my history and present improvement, can you tell me what the possible range of years might be that I can continue to avoid dialysis?
Thank you,
Robert Reed
Is it possible, given the range of my BUN/creatinine levels for the last three years, that you can estimate my rate of kidney decline? And if so, will you, in fact, do that? Essentially I'd like to know how many more years I can continue to avoid dialysis. I have only one kidney. My other kidney, a horse-shoe kidney, was removed when I was 62. In 2000, my creatinine was 1.6. I underwent heart surgery in 2002 to repair a mitral valve, and after the surgery, my creatinine level shot up to 2.9. with a BUN of 48. I was experiencing the symptoms of uremia, anemia, and excess phosphorus in my system. After some time of strictly regulating my diet and taking procrit, my bloodwork #s are as follows: Creatinine - 2.3, BUN - 25, Phosphorus, Potassium and Sodium levels are normal, and my hematocrit is 38.4. I am 79 years old. I am 6 ft. tall and weigh 190 lbs.
Judging from my history and present improvement, can you tell me what the possible range of years might be that I can continue to avoid dialysis?
Thank you,
Robert Reed
Doctor's Answer
by Kevin Pho, MD, Mar 09, 2004 12:00AM
, Mar 09, 2004 12:00AM
Typically dialysis is instituted when the creatinine is above 4, if the GFR (glomerular filtration rate) of less than 25, or if there is a rapid rate of regression. The rate of regression would differ from patient to patient.
In your case, your GFR is noted to be 31. It is difficult to predict how rapid the GFR would continue to decrease - since this can vary based on the disease present and the patient. Currently, the values are on the cusp of dialysis.
If you are not in the care of a nephrologist, I would consider this.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
In your case, your GFR is noted to be 31. It is difficult to predict how rapid the GFR would continue to decrease - since this can vary based on the disease present and the patient. Currently, the values are on the cusp of dialysis.
If you are not in the care of a nephrologist, I would consider this.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
