Tuesday, April 7, 2009
Today I got new test results. Unfortunately they don't show the improvement I was hoping for and in fact seem to show a worsening compared to tests a month ago.
This is very disappointing and a little depressing. I don't want to passively submit myself to the standard medical prognosis of "gradual decline until failure" but it is disheartening not to see any results after making fairly big changes in my lifestyle.
Of course I still have many things to try on my "possible solution" list but this condition is taking a lot of my time and energy as it is. More drastic steps might even involve moving to another country for better medical care... but does it make sense to end most of my life's activities just to try and preserve my body? Spending the rest of my life dedicated to trying to stay alive doesn't really appeal to me... maybe it would be better to quit trying to solve the problem and just get on with making the best use of the time I have left?
The main marker for renal (kidney) function is creatinine and my history has been as follows:
23-Feb-09: 2.0mg/dL (start taking Cozaar, which I've read elevates creatinine levels 20%)
07-Apr-09: 2.3mg/dL (about two weeks after stopping Cozaar)
Creatine Clearance Rate
This is an estimate of GFR, the measure used to compare kidney function and categorize it:
06-Mar-09: 42.0 mL/min (normal is over 61mL/min)
07-Apr-09: 33.0 mL/min
This level is categorized as CKD stage 3 (moderate). Below 30.0 mL/min is stage 4 (severe). Kidney failure is below 15 mL/min. My understanding from the studies I've seen is that the time period for kidney function to halve can be as little as 3 years.
I don't really understand why there has been such an big apparent drop in kidney function in this last month, after all I've probably had the condition for years. I feel it must be related to the changes I've made in that time (drugs and diet) but who knows what? Or maybe a result of thinking about it constantly?!
Urea and Blood Urea Nitrogen (BUN)
Previously I had slightly high levels of urea in the blood. Now I have slightly low levels. According to Wikipedia this suggests malnutrition (i.e. low protein intake). Apparently urea in the blood isn't toxic but it is marker for other toxins, so lower is better. Some GFR estimatiations take BUN into account, and so these estimate more kidney function than those shown on the lab results.
Protein in urine
The two 24 hour collections of Urine I've done show:
06-Mar-09: Total protein 1,881mg/día (normal: 42 - 225mg/day)
07-Abr-09: Albumin 1,485mg/día (normal: 42 - 225mg/day)
As one test is total protein and the other is just albumin (the most common protein), I'm not sure if this shows an improvement or not. In any case it's obviously still way to high. This is importante because apparently proteins passing through the kidneys damages them further. How I wish I'd paid more attention to this when protein was first found in my urine 7 years ago! (In my defence the doctor at that time didn't suggest further investigation)