The Diagnosis

Typically a kidney disease does not just alert you that it has started.  There weren't any sudden changes that I noticed except I was really tired all the time, but I had been for several months, so it did not alarm me.  I went to my family practice doctor for my annual check up in January 2016 and told my doctor I was feeling a little more tired than usual.  She checked my heart and heard a murmur that she had never heard before and I told her I sometimes hear my pulse beating so loud in my ears it was nerve racking!   She ordered a blood test to check my hemoglobin levels for possible anemia.  Bingo! Blood tests showed I was very anemic.  Seems my blood volume was so low that my heart was beating extra hard to push what blood I had where it needed to go.  Thus hearing my murmur, because with less blood and more pressure the murmur was louder.  And that explained the pulse thumping in my ears night and day too.  My doctor was concerned and wanted to find out the source of the anemia so she sent me for an endoscopy and colonoscopy to rule out internal bleeding.  The test results were all clear and everything was looking good.  Still concerned where my blood was going she did a urine test to look for hematuria and proteinuria.  There it was.  Blood and Protein in the urine that was not supposed to be there.  She referred me to a kidney specialist, called a Nephrologist.

When I met the Nephrologist he told me about several common kidney diseases they would be checking me for.  Blood work was done, and came back with just slightly elevated creatinine and GFR levels.

Here is a great article by Davita Kidney Care that really helped me understand my blood tests and the new terminology I was hearing.

Stages of Chronic Kidney Disease
About chronic kidney disease (CKD)

With chronic kidney disease, the kidneys don’t usually fail all at once. Instead, kidney disease often progresses slowly over a period of years. This is good news because if CKD is caught early, medicines and lifestyle changes may help slow its progress and keep you feeling your best for as long as possible.
Five stages of chronic kidney disease

To help improve the quality of care for people with kidney disease, the National Kidney Foundation (NKF) created a guideline to help doctors identify each level of kidney disease. The NKF divided kidney disease into five stages. When the doctor knows what stage of kidney disease a person has they can provide the best care, as each stage calls for different tests and treatments.
Glomerular Filtration Rate (GFR)

Glomerular filtration rate (GFR) is the best measure of kidney function. The GFR is the number used to figure out a person’s stage of kidney disease. A math formula using the person’s age, race, gender and their serum creatinine is used to calculate a GFR. A doctor will order a blood test to measure the serum creatinine level. Creatinine is a waste product that comes from muscle activity. When kidneys are working well they remove creatinine from the blood. As kidney function slows, blood levels of creatinine rise.

Below shows the five stages of CKD and GFR for each stage:

Stage 1 with normal or high GFR (GFR > 90 mL/min)

Stage 2 Mild CKD (GFR = 60-89 mL/min)

Stage 3A Moderate CKD (GFR = 45-59 mL/min)

Stage 3B Moderate CKD (GFR = 30-44 mL/min)

Stage 4 Severe CKD (GFR = 15-29 mL/min)

Stage 5 End Stage CKD (GFR <15

When I was diagnosed, my creatinine was 1.7 and my GFR was 32.5, so I was Stage 3B, a moderate kidney disease. But what kidney disease was it? The only way to find out was to get a kidney ultrasound and kidney biopsy.  More on that in my next blog post.
Here is the link to Divita article I referenced above.

Disclaimer:  I am not a doctor.  I am not a medical professional.  NO information on this site should be used to diagnose, treat, prevent or cure any disease or condition.


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