Guest guest Posted September 15, 2004 Report Share Posted September 15, 2004 Hi Donna, Welcome aboard, although of course sorry you had a reason to find your way here. That is great news that you have been able to stabilize yourself so well. My creatinine stayed around 2.3 for a number of years before I started to decline. It may be that the Ace inhibitors are doing their job and protecting your renal function, or it may also be that the 3.3 was a spike during a flare up for some reason. Everyone is different and progresses at their own rates so it is difficult to tell when you might reach end stage exactly. The objective is to monitor you closely for uremic symptoms, and to start dialysis before you get in an emergency situation where you have to start without having access prepared. On the MDRD formula, I think that as function declines, creatinine clearance tends to overestimate function. My Nephrologist told me that the MDRD formula is more accurate, but I am not a physician so don't take my word. Welcome to the group! In a message dated 9/15/2004 8:09:17 PM Pacific Daylight Time, craftd@... writes: > Hi all, > I am new to this site. I was diagnosed about a two years ago with a > comfirmation by biopsy in Feb of 2003. I was told at the time I would > be on dialysis with in a year and a half. But I started to stablize > last spring and my last blood work up was the best it has been in the > last two years. Is this normal to have such a bad prognosis and then > to become stable again? My worse creatine was 3.3 with a creatine > clearance of 28% Now my creatine is 2.3 and my last creatine > clearence was 32%. I have reduced my protein a lot and linispril has > helped keep the BP down. My NEph said I could go another two years > before dialysis. Has anyone one else had this experince? > > The one thing I am confused about is when I plug the number in to the > MDRD chart(creatine,age, white ,female) it comes out with a GFR of 26 > which is less than the creatine clearence. Which one is mor accurate? > My Neph goes with the creatine clearence. > > This site is so wonderful. I just want to tell everyone to come and > read the post. It has calmed me down many of nught I have been > depressed. Thanks so much to all of you for sharing your stories. > Donna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 15, 2004 Report Share Posted September 15, 2004 Hi all, I am new to this site. I was diagnosed about a two years ago with a comfirmation by biopsy in Feb of 2003. I was told at the time I would be on dialysis with in a year and a half. But I started to stablize last spring and my last blood work up was the best it has been in the last two years. Is this normal to have such a bad prognosis and then to become stable again? My worse creatine was 3.3 with a creatine clearance of 28% Now my creatine is 2.3 and my last creatine clearence was 32%. I have reduced my protein a lot and linispril has helped keep the BP down. My NEph said I could go another two years before dialysis. Has anyone one else had this experince? The one thing I am confused about is when I plug the number in to the MDRD chart(creatine,age, white ,female) it comes out with a GFR of 26 which is less than the creatine clearence. Which one is mor accurate? My Neph goes with the creatine clearence. This site is so wonderful. I just want to tell everyone to come and read the post. It has calmed me down many of nught I have been depressed. Thanks so much to all of you for sharing your stories. Donna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 15, 2004 Report Share Posted September 15, 2004 Hi Donna, is a pro here, but I just had to put my 2 cents in. I also am under the impression from local nephs here and by reading tons of most current sources, the MDRD equation is more accurate, especially if you incorporate the albumin, and all other variables you can. Like mentioned creatinine clearance is not as accurate as GFR as renal function deteriorates. It is not quite as reliable with the elderly folks, but none the less gives me a MUCH better picture of what is really going on with my patients. (Average estimated GFR by age only goes to 75, and my patients are up to 99!!!! ( " I'm into Seniors " who obviously have less renal function to begin with (normally) plus add on some hypertension, diabetes with protein spill etc) ..... Therefore I monitor everyone's renal function at my place, (CLOSELY). GFR's on everyone. And interestingly enough, that's exactly what the local nephs asked me when I volunteered there last week. " Are you measuring GFR's on everyone? " Gladly I could answer YUP!! Bonnie W4JC@... wrote:Hi Donna, On the MDRD formula, I think that as function declines, creatinine clearance tends to overestimate function. My Nephrologist told me that the MDRD formula is more accurate, but I am not a physician so don't take my word. Welcome to the group! In a message dated 9/15/2004 8:09:17 PM Pacific Daylight Time, craftd@... writes: > Hi all, > I am new to this site. I was diagnosed about a two years ago with a > comfirmation by biopsy in Feb of 2003. I was told at the time I would > be on dialysis with in a year and a half. But I started to stablize > last spring and my last blood work up was the best it has been in the > last two years. Is this normal to have such a bad prognosis and then > to become stable again? My worse creatine was 3.3 with a creatine > clearance of 28% Now my creatine is 2.3 and my last creatine > clearence was 32%. I have reduced my protein a lot and linispril has > helped keep the BP down. My NEph said I could go another two years > before dialysis. Has anyone one else had this experince? > > The one thing I am confused about is when I plug the number in to the > MDRD chart(creatine,age, white ,female) it comes out with a GFR of 26 > which is less than the creatine clearence. Which one is mor accurate? > My Neph goes with the creatine clearence. > > This site is so wonderful. I just want to tell everyone to come and > read the post. It has calmed me down many of nught I have been > depressed. Thanks so much to all of you for sharing your stories. > Donna Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 16, 2004 Report Share Posted September 16, 2004 Hi Donna. When you're down to about 30% kidney function, creatinine clearance can overestimate kidney function of little (usually by about 30%, but in some people, up to 30%). This is because while kidney function is glomerular function (which is why we call it " glomerular filtration rate " ), some of the creatinine is also cleared from your blood by the " tubular function " . Each nephron has a glomerulus, and downstream from it, where urine is produced, it has a renal tubule. Now, sometimes this tubular function is taken into account when arriving at the creatinine clearance, and sometimes it isn't (most of the time it isn't, as far as I know). So, because of that, the MDRD formula can be more accurate. That being said though, the practical difference for you of having numbers like 32, 28 and 26 for kidney function is really zilch. It's not that much difference. If your serum creatinine has gone down from 3 to 2, but your creatinine clearance has remained more or less the same (28% to 32% is not really that significant), my guess would be that your kidney function hasn't really improved. Your serum creatinine may be lower because, reducing your protein intake a lot, you may have less muscle mass than you had before. In this way, your serum creatinine may appear to improve, but you might not have really gained anything in terms of actual kidney function. Keep in mind that the amount of creatinine itself in your blood isn't really bad in the sense that it does anything. It's only used in nephrology because it's a convenient indicator of how well the kidneys are clearing stuff from the blood. As we advance in kidney failure, we don't feel sick because of the creatinine, but because of the other things that the kidneys aren't clearing well. Of course, you should still be encouraged by the fact that your creatinine clearance went up a tiny bit, rather than going down. Pierre MDRD > Hi all, > I am new to this site. I was diagnosed about a two years ago with a > comfirmation by biopsy in Feb of 2003. I was told at the time I would > be on dialysis with in a year and a half. But I started to stablize > last spring and my last blood work up was the best it has been in the > last two years. Is this normal to have such a bad prognosis and then > to become stable again? My worse creatine was 3.3 with a creatine > clearance of 28% Now my creatine is 2.3 and my last creatine > clearence was 32%. I have reduced my protein a lot and linispril has > helped keep the BP down. My NEph said I could go another two years > before dialysis. Has anyone one else had this experince? > > The one thing I am confused about is when I plug the number in to the > MDRD chart(creatine,age, white ,female) it comes out with a GFR of 26 > which is less than the creatine clearence. Which one is mor accurate? > My Neph goes with the creatine clearence. > > This site is so wonderful. I just want to tell everyone to come and > read the post. It has calmed me down many of nught I have been > depressed. Thanks so much to all of you for sharing your stories. > Donna > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 16, 2004 Report Share Posted September 16, 2004 Sorry about the typo in my reply below. That should have read: When you're down to about 30% kidney function, creatinine clearance can overestimate kidney function of little (usually by about 10%, but in some people, up to 30%). Pierre MDRD > > > > Hi all, > > I am new to this site. I was diagnosed about a two years ago with a > > comfirmation by biopsy in Feb of 2003. I was told at the time I would > > be on dialysis with in a year and a half. But I started to stablize > > last spring and my last blood work up was the best it has been in the > > last two years. Is this normal to have such a bad prognosis and then > > to become stable again? My worse creatine was 3.3 with a creatine > > clearance of 28% Now my creatine is 2.3 and my last creatine > > clearence was 32%. I have reduced my protein a lot and linispril has > > helped keep the BP down. My NEph said I could go another two years > > before dialysis. Has anyone one else had this experince? > > > > The one thing I am confused about is when I plug the number in to the > > MDRD chart(creatine,age, white ,female) it comes out with a GFR of 26 > > which is less than the creatine clearence. Which one is mor accurate? > > My Neph goes with the creatine clearence. > > > > This site is so wonderful. I just want to tell everyone to come and > > read the post. It has calmed me down many of nught I have been > > depressed. Thanks so much to all of you for sharing your stories. > > Donna > > > > > > > > > > To edit your settings for the group, go to our Yahoo Group > home page: > http://groups.yahoo.com/group/iga-nephropathy/ > > To unsubcribe via email, > iga-nephropathy-unsubscribe > Visit our companion website at www.igan.ca. The site is entirely supported by donations. If you would like to help, go to: > http://www.igan.ca/id62.htm > > Thank you > Quote Link to comment Share on other sites More sharing options...
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