- Messages
- 4,238
- Type of diabetes
- Type 2
- Treatment type
- Tablets (oral)
- Dislikes
-
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
One of the measures in the regular blood tests is eGFR (estimated glomerular filtration rate) which measures how effectively your kidneys are filtering your blood.
http://www.nhs.uk/Conditions/Kidney-disease-chronic/Pages/Diagnosis.aspx
and
http://patient.info/health/chronic-kidney-disease-leaflet
have more information.
In my case the eGFR seems to have gone up and down like the proverbial fiddler's elbow.
Now it is estimated by the level of creatinine in the blood.
"The eGFR test involves a blood test which measures a chemical called creatinine. Creatinine is a breakdown product of muscle. Creatinine is normally cleared from the blood by the kidneys. If your kidneys are not working so well and the glomeruli are not filtering as much blood as normal, the level of creatinine in the blood goes up."
Now a big chunk from Wikipedia:
"
Serum creatinine (a blood measurement) is an important indicator of renal health because it is an easily measured byproduct of muscle metabolism that is excreted unchanged by the kidneys.
Creatinine itself is produced[2] via a biological system involving creatine, phosphocreatine (also known as creatine phosphate), and adenosine triphosphate (ATP, the body's immediate energy supply).
Creatine is synthesized primarily in the liver from the methylation of glycocyamine (guanidino acetate, synthesized in the kidney from the amino acids arginine and glycine) by S-adenosyl methionine. It is then transported through blood to the other organs, muscle, and brain, where, through phosphorylation, it becomes the high-energy compound phosphocreatine.[3] Creatine conversion to phosphocreatine is catalyzed by creatine kinase; spontaneous formation of creatinine occurs during the reaction.[4]
Creatinine is removed from the blood chiefly by the kidneys, primarily by glomerular filtration, but also by proximal tubular secretion. Little or no tubular reabsorption of creatinine occurs. If the filtration in the kidney is deficient, creatinine blood levels rise. Therefore, creatinine levels in blood and urine may be used to calculate the creatinine clearance (CrCl), which correlates with the glomerular filtration rate (GFR). Blood creatinine levels may also be used alone to calculate the estimated GFR (eGFR).
The GFR is clinically important because it is a measurement of renal function. However, in cases of severe renal dysfunction, the CrCl rate will overestimate the GFR because hypersecretion of creatinine by the proximal tubules will account for a larger fraction of the total creatinine cleared.[5] Ketoacids, cimetidine, and trimethoprim reduce creatinine tubular secretion and, therefore, increase the accuracy of the GFR estimate, in particular in severe renal dysfunction. (In the absence of secretion, creatinine behaves like inulin.)
An alternate estimation of renal function can be made when interpreting the blood (plasma) concentration of creatinine along with that of urea. BUN-to-creatinine ratio (the ratio of blood urea nitrogen to creatinine) can indicate other problems besides those intrinsic to the kidney; for example, a urea level raised out of proportion to the creatinine may indicate a prerenal problem such as volume depletion.
Each day, 1-2% of muscle creatine is converted to creatinine.[3] Men tend to have higher levels of creatinine than women because, in general, they have a greater mass of skeletal muscle.[3] Increased dietary intake of creatine or eating a lot of protein (like meat) can increase daily creatinine excretion.[3]
"
Sorry about all the brain numbing gumph (left in for context) - the bold bits are the ones that interests me.
It seems possible (if I vaguely understand all this) that creatinine levels can be raise by eating a lot of protein. With your kidneys working 100% that just increases the level of excretion of creatinine. Presumably if your kidneys are a bit "slow" then the more protein you eat the higher your creatinine levels.
Also creatinine is a by-product of muscle metabolism, so presumably the more your muscles metabolise (such as when you are doing a lot of exercise) the more creatinine is produced.
So in my case I am wondering if the eGFR rate (which has bounced around over the years from about 52 to 82) is related to the amount of protein I have eaten before the test and the amount of exercise I have done prior to the test, plus possibly how much fluid I have flushed through my kidneys.
This last one is an interesting one as well - we are told that urine should be a pale straw colour and that if it is dark we may not be drinking enough. I tend to be a reluctant drinker because I am not prompted by thirst, and so do not drink a lot and wee a lot during the day.
So this in turn makes me wonder what my eGFR would be in the following circumstances:
(1) Eat a big steak a couple of hours before my blood test and cycle furiously to the surgery without drinking anything.
(2) Eat a few sticks of celery a couple of hours before my blood test, followed by 5 pints of weak lager and get my wife to drive me to the surgery (with a few emergency stops to pee along the way or a very large in-car bucket).
Assuming that the amount we drink governs the amount we pee, and the amount of flow through the kidneys affects the amount of material flushed through, this make make quite a difference.
It would be nice to get a good eGFR reading at my next blood test. I may just drink loads of water for a couple of days before hand and see how it goes.
http://www.nhs.uk/Conditions/Kidney-disease-chronic/Pages/Diagnosis.aspx
and
http://patient.info/health/chronic-kidney-disease-leaflet
have more information.
In my case the eGFR seems to have gone up and down like the proverbial fiddler's elbow.
Now it is estimated by the level of creatinine in the blood.
"The eGFR test involves a blood test which measures a chemical called creatinine. Creatinine is a breakdown product of muscle. Creatinine is normally cleared from the blood by the kidneys. If your kidneys are not working so well and the glomeruli are not filtering as much blood as normal, the level of creatinine in the blood goes up."
Now a big chunk from Wikipedia:
"
Serum creatinine (a blood measurement) is an important indicator of renal health because it is an easily measured byproduct of muscle metabolism that is excreted unchanged by the kidneys.
Creatinine itself is produced[2] via a biological system involving creatine, phosphocreatine (also known as creatine phosphate), and adenosine triphosphate (ATP, the body's immediate energy supply).
Creatine is synthesized primarily in the liver from the methylation of glycocyamine (guanidino acetate, synthesized in the kidney from the amino acids arginine and glycine) by S-adenosyl methionine. It is then transported through blood to the other organs, muscle, and brain, where, through phosphorylation, it becomes the high-energy compound phosphocreatine.[3] Creatine conversion to phosphocreatine is catalyzed by creatine kinase; spontaneous formation of creatinine occurs during the reaction.[4]
Creatinine is removed from the blood chiefly by the kidneys, primarily by glomerular filtration, but also by proximal tubular secretion. Little or no tubular reabsorption of creatinine occurs. If the filtration in the kidney is deficient, creatinine blood levels rise. Therefore, creatinine levels in blood and urine may be used to calculate the creatinine clearance (CrCl), which correlates with the glomerular filtration rate (GFR). Blood creatinine levels may also be used alone to calculate the estimated GFR (eGFR).
The GFR is clinically important because it is a measurement of renal function. However, in cases of severe renal dysfunction, the CrCl rate will overestimate the GFR because hypersecretion of creatinine by the proximal tubules will account for a larger fraction of the total creatinine cleared.[5] Ketoacids, cimetidine, and trimethoprim reduce creatinine tubular secretion and, therefore, increase the accuracy of the GFR estimate, in particular in severe renal dysfunction. (In the absence of secretion, creatinine behaves like inulin.)
An alternate estimation of renal function can be made when interpreting the blood (plasma) concentration of creatinine along with that of urea. BUN-to-creatinine ratio (the ratio of blood urea nitrogen to creatinine) can indicate other problems besides those intrinsic to the kidney; for example, a urea level raised out of proportion to the creatinine may indicate a prerenal problem such as volume depletion.
Each day, 1-2% of muscle creatine is converted to creatinine.[3] Men tend to have higher levels of creatinine than women because, in general, they have a greater mass of skeletal muscle.[3] Increased dietary intake of creatine or eating a lot of protein (like meat) can increase daily creatinine excretion.[3]
"
Sorry about all the brain numbing gumph (left in for context) - the bold bits are the ones that interests me.
It seems possible (if I vaguely understand all this) that creatinine levels can be raise by eating a lot of protein. With your kidneys working 100% that just increases the level of excretion of creatinine. Presumably if your kidneys are a bit "slow" then the more protein you eat the higher your creatinine levels.
Also creatinine is a by-product of muscle metabolism, so presumably the more your muscles metabolise (such as when you are doing a lot of exercise) the more creatinine is produced.
So in my case I am wondering if the eGFR rate (which has bounced around over the years from about 52 to 82) is related to the amount of protein I have eaten before the test and the amount of exercise I have done prior to the test, plus possibly how much fluid I have flushed through my kidneys.
This last one is an interesting one as well - we are told that urine should be a pale straw colour and that if it is dark we may not be drinking enough. I tend to be a reluctant drinker because I am not prompted by thirst, and so do not drink a lot and wee a lot during the day.
So this in turn makes me wonder what my eGFR would be in the following circumstances:
(1) Eat a big steak a couple of hours before my blood test and cycle furiously to the surgery without drinking anything.
(2) Eat a few sticks of celery a couple of hours before my blood test, followed by 5 pints of weak lager and get my wife to drive me to the surgery (with a few emergency stops to pee along the way or a very large in-car bucket).
Assuming that the amount we drink governs the amount we pee, and the amount of flow through the kidneys affects the amount of material flushed through, this make make quite a difference.
It would be nice to get a good eGFR reading at my next blood test. I may just drink loads of water for a couple of days before hand and see how it goes.
