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Kidney Diseases

Stage 3/4 ckd progression

08/30/2011

Question:

Hi, I`m 29 yrs old female & have the following diagnosis: - Solitary right kidney with scarring - Hypertension (I take 3 diff meds) - Proteinuria (protein 3+) - high cholesterol (take Lipitor) - B12 deficiency. (take b12 shots) In past 3 years my egfr has reduced from 60 to 29.  No-one seems able or willing to tell me what will happen, but given your experience can you give any idea as to how likely end stage renal failure is for me?

Answer:

End stage renal failure is considered to occur at approximately a eGFR of 15 or less.  So considering how much your eGFR has declined in the past year, end stage disease seems pretty close.  If your left kidney was removed because of infection or stones, it is possible that the same process is affecting your right kidney.  If you were born with just one, there is an extra strain on the solitary kidney that can result in damage.  The protein in your urine is a sign of that damage.

There may not be much that you can do to prevent end stage disease; but standard suggestions are:
1) keep your blood pressure and cholesterol levels well-controlled with meds.
2) don't smoke.
3) see your doctor right away if you have signs of bladder or kidney infection, since infection can cause more damage.

You should also ask your kidney doctor to provide you with information about dialysis, so that you can start doing some of the procedures that help to prepare for starting dialysis.

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University