Kidney function

Jo123 said:

Hi, I had pre diabetes in 2009, I asked for a test as I had lots of symptoms. By low carbing I've kept normal readings ever since. But it's hard work, I never go off the rails, my blood sugar goes up.
Well now my kidney function is going down, it was 86 in nov23, 74 in January now 67. I've got a normal hba1c, really good blood pressure (has to be due to other health condition). I really don't know what to do. Any advice or reassurance welcome.

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Hi Jo. One thing I will say is, not all chronic kidney disease is related to diabetes. I recall a few years ago being astonished by the percentage of over 60s with CKD, and even moreso once folks reach 70 and beyond. Most of them have no idea as their GPs are just monitoring by regular bloods.

I have no idea where you are in terms of age, but keeping your diabetes status and blood pressure in good shape will be standing yo in good stead.

I don't know if you've had input from your GP yet, but likely worth a discussion with them - even if just to ease your mind and agree any relevant next steps.

It's easy to say, don't panic, but it honestly helps nothing.

Jo123 said:

Thank you both for your comments.

I'm 67 so I agree it's expected for my kidney function to decline due to age, however it was the fact it went down quite rapidly in 3 months. I've spoken to my gp after my January blood test, appointment booked re the current test on the 16 May.

I have a very basic bupa and spoke to a gp from there about my current test, she said in view of the rapid decline to see a kidney consultant. I think that shocked me I expected her to say oh don't worry it's age related. I was feeling a bit sorry for myself yesterday as I looked at the kidney diet and I'd find it extremely difficult to do that and low carb. Plus the other health condition I have may potentially need a long serious operation if it worsens so I was a bit why me, but hey ho, I feel better today.

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Jo, in my experience I'm not in the least surprised by the private GP's reaction - to be clear, not so much because of the decline in your apparent kidney function, but because, again, in my experience, private medics are much more likely to intervene in any given situation, and they are much more acute in their rear covering.

In your shoes, I'd probably be keen to have some further checks and investigations on my kidneys too, so do press for it. If your GP isn't keen to refer you, ask him to explain to you why - IN WRITING. In my experience, GP notes can be scant, to pay them a compliment, and I'd want a decent record of events - just in case.

Whatever transpires, keep us up to date. Fingers crossed for you.

Melgar said:

@AndBreathe I agree with asking your GP to put in writing their reasoning. However, when I lived in the UK (a long time ago) I had private health insurance. I had bleeding stomach ulcers, I had poor quality service from the NHS while in hospital, so I discharged myself. I went private. I had all the tests and scans the NHS should have given me immediately , but didn't. Going private I was immediately put on medications. My private consultant also worked in the NHS.

I do not have a downer on the NHS. Much more recently , In 2018/19, I has sepsis pneumonia and the team at the Royal Stoke University hospital , my care could not have been better, they saved my life.

To be honest I believe differences in private and public health service and the quality of service is to down to the availability of resources and management. @Jo123 If you have the opportunity to be sent to a specialist take it. It could easily bring you peace of mind or expedited treatment.

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I have had top-notch platinum level PMI via an employer, and have paid from my pocket for private medical care. I am absolutely not saying it's a waste of space or they are ALL money grabbing, BUT I have had experiences which lead me to believe some private medics can be a bit gung-ho, when they know an insurer is footing the bill.

Yes, I think Jo should be pressing for a specialist opinion, and if her PMI will cover it, then to press on by that route as indeed it is highly likely to be faster.

A year ago, my gfr was 90 (I was 79). I have blood tests fairly often because I tend to be anaemic and have liver problems. All along the Health Centre has been giving me information about both of those and lately referred me for an iron infusion. They never gave me information about anything else (their secret, not mine!) but 6 months ago, I happened to see a result on a screen a nurse was checking which indicated that my gfr was 42. When I commented on it, the nurse checked back and told me it was nothing to worry about because it was up from 26. That means that at some stage, I was stage 4 CKD and even with the improvement, I was stage 3b. Not really surprising, given my age, but so much of a drop in 6 months! I've been trying to get an appointment to see a GP with absolutely no success. I wonder why it is such a secret.

I now wonder if the low carb diet I have been on to try to reduce my weight and BG has damaged my kidneys but I am waiting to get an appointment with a dietician to see if I can get advice on a diet suitable for both conditions (a forlorn hope, I suppose). I know that the dietician has already said she knows little about diabetes, so I'm not hopeful.

One bit of good news, however, is that my liver has healed itself a bit. That, I am certain, is the result of lchf.

I also need to find out how much fluids I should be drinking in a day for my kidneys. Diabetes nurse says about 1.5 litres. Notices I have seen say 2 litres. Another nurse I spoke to says everyone should be drinking up to 4 or 5 litres daily to keep kidneys functioning. I don't have a clue so I just try to keep to the middle road of 2 litres.

Is treatment for kidneys expensive or something, making doctors unwilling to embark on a course of treatment with patients?