Stage 2 CKD?

[Cdr777]

Hi all,

I am a 36 year old male. Back in 2010 I a complete metabolic panel and lipid panel done as part of a routine physical. At that time my eGFR was 73. Serum Creatinine was 1.3 (range 0.8 -1.3) BUN was 24 (range 6-23). My lipid profile was borderline low HDL, triglycerides were high at 323. LDL was optimal at 66. Doc said everything was acceptable except the hdl and triglycerides. I never gave any thought to my kidney function because the doc didn't seem concerned. Doc's suggestion was to put me on a new diet and retest the lipid panel later. Of course, my doc took a hiatus from medicine and I got transferred to another doc and I never followed up with the lab work. In 2012, I had another lipid and metabolic panel done. My eGFR was 78 this time and the Serum Creatinine was 1.2 (range 0.8 - 1.3) and Bun was 22. Lipid panel showed even lower hdl, higher triglycerides at 468 and a optimal LDL of 66.

Doc said that eGFR had improved but was likely the same as 2-years previous just cuz of lab variables. The doc explained that some people just have a certain level that their kidneys functioned at and mine may just be at that level. The doc also put me on the Mediterranean diet becuz I have been eating a high caffeine, high red meat, high fructose corn syrup, high carbohydrate diet and live a very sedentary lifestyle and recommended I start exercising. The docs biggest concern was the lipids - which makes sense.

So my question for this group is can a eGFR for one person be consistently in the same range? And if so, is that actually kidney disease?

I've had protein in my urine since I was a small child... usually +1.

I've read that kidney function can be affected by high triglycerides. By clearing up the triglycerides could I help improve my kidney function?

My doc isn't concerned. Should I be?

Thanks, all

-Craig

[Cdr777]

Thank you for responding, Dr Santos. Since my post I have had another CMP done as well as a lipid profile. My HDL increased from 29 to 35. My triglycerides have decreased from 468 to 237. My ldl went up from 66 to 107. And vldl was in the 70' s.

However, my serum creatinine did go up as did my uric acid, both in the low end of high. All other values were "optimal" per my physician. Including the BUN - which went down.

I got copies of all my blood tests for the last 7 years.
My serum creatinine has been 1.3 since 2006. Dropped to 1.2 in 2012 and is now at 1.5. But my physician says there's nothing wrong with the 1.5 at this time because I have no other criteria for CKD.  I apparently just naturally run borderline/high.

Her biggest concern is the lipids which, while better, are still out of sorts.

I still can't help but being scared.

Since I have no hypertension, no diabetes and no protein in my urine, is an eGFR applicable?  My physician and her partner both agree that a eGFR is not determinate of my kidney function absent because all other metabolites and electrolytes are being filtered properly...

They told me that I should adopt the Mediterranean Diet and begin exercising to get my lipids under control since that is their biggest concern. They seemed fairly certain that if I took better care of my heart the rest would come with it.

Does that sound about right?

-Craig

[Dr Santos]

HI Craig,
I understand your concern regarding your lab results. Stage 2 CKD or mildly reduced kidney function with GFR 60-89 usually requires other evidence of kidney disease, such as proteinuria or hematuria, genetic diagnosis of kidney disease, as well as evidence of structurally abnormal kidneys.  Also, eGFR is an estimate and there are many factors that may affect the readings. While some studies  have associated high triglycerides with diabetic coma and  DM complications, it is still important to manage this high triglyceride findings. It is best that you discuss this with your attending physician for proper management. Take care and do keep us posted.