RE: Spiro and Breast Pain -kidney damage -Val

[Guest guest]

Val,I don't know your particular situation in regards to kidney function but I can tell you what I think happened to me and you can see if anything might apply to your situation.My kidney's had to have been under some pressure from years of uncontrolled HBP, but I had Creatinine and GFR serum tests right before my first CT scan and before starting Spiro and Dashing. Results were as follows: 7/8/10 = 0.90 (<1.11) normal for that lab. GFR= >60 (standard >60)8/3/10 = 0.80 GFR= ?Had a CT scan with contrast dye the next day on 8/4/109/13/10 = 1.11 (<l.11)

GFR=49 (>60)9/22/10 = 1.23 GFR =449/29/10 = 1.13 GFR=4810/1/10 = 1.21 GFR=4410/20/10 = 1.28 GFR=4212/21/10 = 1.72 GFR=2912/28/10 = 1.52 GFR=34Given second CT scan with contrast dye on 1/28/10By the way after Dr. G had mentioned (in November of 2010) a possible link between contrast dye and my drop in kidney function I asked the CT scan tech if he was sure my Neph had ordered contrast dye? Yes, it had been ordered. 1/4/11 = 1.62 GFR=321/24/11 = 1.74 GFR=295/20/11 = 1.34 GFR=39With adherence to a LS diet and a

lower BP my numbers have improved somewhat, but the damage is done. My next tests will be in November for a six month routine testing.My Nephrologist insists that my numbers just reflect the uncovering of damage that was already done to my kidney's by years of uncontrolled HBP, but he's also just protecting himself as ordering contrast dye for someone with proven kidney damage is a no-no, which is what he did for my second CT scan. I was too dumb to refuse it.My last numbers look better than they have been, so some limited recovery does seem possible, but I think it has more to do with diet than actual recovery. Unfortunately K is an enemy of kidney function. With renal damage you have to limit K, limit protein and avoid phosphorus. The numbers for your Creatinine are more telling than your GFR. Kidney function can also drop somewhat with age, but not drop like a stone as mine

did.Hope this is of some help to you.Dianne

Diane, If your kidney function falls say, after a difficult hospitalization not related to the kidney, would a slightly low GFR come back up? If it falls after a MRI with contrast, will it ever go back up? Mine came in at 55 in April and I just did a whole kidney panel today. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Dianne strongDianne69, bi-lateral adenomas 1.2cm rt, 1cm left25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July

2010Had to demand tests to confirm PA, from scoffing NPCKD. Kidney function fell after use of contrast dye during CT scan 8/2010.Now on 75mg Spiro, 12.5mg AtenololBP avg. 130/70Dashing with very low Na (aim for 1,000mg) and high enough K to keep me in range, but not so high as to further damage kidneys. .

[Guest guest]

Some with renal damage can have K losing problem as well but more conMost common is the prob with getting too much K. Too much K does not damage kidney but will cause other problems including the heart stopping which we like to avoid. The fact that your GFR dropped after each of 2 studies seems convincing to me that it was the contrast. I would not retest the hypothesis again however. Be certain your medical chart is flagged as possible kidney damage from Ct contrast so u don't get another hit by not knowing this history. We have at least one other here who had the same problem. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jul 11, 2012, at 11:26, Dianne strong <dianstrong@...> wrote:

Val,I don't know your particular situation in regards to kidney function but I can tell you what I think happened to me and you can see if anything might apply to your situation.My kidney's had to have been under some pressure from years of uncontrolled HBP, but I had Creatinine and GFR serum tests right before my first CT scan and before starting Spiro and Dashing. Results were as follows: 7/8/10 = 0.90 (<1.11) normal for that lab. GFR= >60 (standard >60)8/3/10 = 0.80 GFR= ?Had a CT scan with contrast dye the next day on 8/4/109/13/10 = 1.11 (<l.11)

GFR=49 (>60)9/22/10 = 1.23 GFR =449/29/10 = 1.13 GFR=4810/1/10 = 1.21 GFR=4410/20/10 = 1.28 GFR=4212/21/10 = 1.72 GFR=2912/28/10 = 1.52 GFR=34Given second CT scan with contrast dye on 1/28/10By the way after Dr. G had mentioned (in November of 2010) a possible link between contrast dye and my drop in kidney function I asked the CT scan tech if he was sure my Neph had ordered contrast dye? Yes, it had been ordered. 1/4/11 = 1.62 GFR=321/24/11 = 1.74 GFR=295/20/11 = 1.34 GFR=39With adherence to a LS diet and a

lower BP my numbers have improved somewhat, but the damage is done. My next tests will be in November for a six month routine testing.My Nephrologist insists that my numbers just reflect the uncovering of damage that was already done to my kidney's by years of uncontrolled HBP, but he's also just protecting himself as ordering contrast dye for someone with proven kidney damage is a no-no, which is what he did for my second CT scan. I was too dumb to refuse it.My last numbers look better than they have been, so some limited recovery does seem possible, but I think it has more to do with diet than actual recovery. Unfortunately K is an enemy of kidney function. With renal damage you have to limit K, limit protein and avoid phosphorus. The numbers for your Creatinine are more telling than your GFR. Kidney function can also drop somewhat with age, but not drop like a stone as mine

did.Hope this is of some help to you.Dianne

Diane, If your kidney function falls say, after a difficult hospitalization not related to the kidney, would a slightly low GFR come back up? If it falls after a MRI with contrast, will it ever go back up? Mine came in at 55 in April and I just did a whole kidney panel today. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Dianne strongDianne69, bi-lateral adenomas 1.2cm rt, 1cm left25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July

2010Had to demand tests to confirm PA, from scoffing NPCKD. Kidney function fell after use of contrast dye during CT scan 8/2010.Now on 75mg Spiro, 12.5mg AtenololBP avg. 130/70Dashing with very low Na (aim for 1,000mg) and high enough K to keep me in range, but not so high as to further damage kidneys. .

[Guest guest]

Dianne, are you diabettic?

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> Diane,  If your kidney function falls say, after a difficult

hospitalization not related to the kidney, would a slightly low GFR come back

up?  If it falls after a MRI with contrast, will it ever go back up?  Mine

came in at 55 in April and I just did a whole kidney panel today.  Val  From:

hyperaldosteronism [mailto:hyperaldosteronism ]

On Behalf Of Dianne strong

> Dianne69, bi-lateral adenomas 1.2cm rt, 1cm left25yr hx of HBP and low K.

Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via

Internet July 2010Had to demand tests to confirm PA, from scoffing NPCKD. Kidney

function fell after use of contrast dye during CT scan 8/2010.Now on 75mg Spiro,

12.5mg AtenololBP avg. 130/70Dashing with very low Na (aim for 1,000mg) and high

enough K to keep me in range, but not so high as to further damage kidneys.

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[Guest guest]

Will GFR improve over time with BP control and no more contrast? My GFR fell to 55 two months after surgery, a time during which I was still having lots of pain and using pain medications. It was normal at surgery.   Creatinine rose to 1.06 (0.5 - 0.99) from .80 in Feb. BUN went from 10 (6 - 25) to 18.9 m(16 - 22).  Should I be concerned?  Everything else is normal except for slightly low  WBC, Hemoglobin and slightly high RDW.  The last MRI with contrast was 1.5 years ago. I'm seeing my breast surgeon next week and will talk to her about my continuing back pain. If she wants an MRI with contrast, should I allow it? Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Clarence Grim Some with renal damage can have K losing problem as well but more conMost common is the prob with getting too much K. Too much K does not damage kidney but will cause other problems including the heart stopping which we like to avoid. The fact that your GFR dropped after each of 2 studies seems convincing to me that it was the contrast. I would not retest the hypothesis again however. Be certain your medical chart is flagged as possible kidney damage from Ct contrast so u don't get another hit by not knowing this history. We have at least one other here who had the same problem. On Jul 11, 2012, at 11:26, Dianne strong <dianstrong@...> wrote: Val, I don't know your particular situation in regards to kidney function but I can tell you what I think happened to me and you can see if anything might apply to your situation. My kidney's had to have been under some pressure from years of uncontrolled HBP, but I had Creatinine and GFR serum tests right before my first CT scan and before starting Spiro and Dashing. Results were as follows: 7/8/10 = 0.90 (<1.11) normal for that lab. GFR= >60 (standard >60)8/3/10 = 0.80 GFR= ?Had a CT scan with contrast dye the next day on 8/4/10 9/13/10 = 1.11 (<l.11) GFR=49 (>60)9/22/10 = 1.23 GFR =449/29/10 = 1.13 GFR=4810/1/10 = 1.21 GFR=4410/20/10 = 1.28 GFR=4212/21/10 = 1.72 GFR=2912/28/10 = 1.52 GFR=34 Given second CT scan with contrast dye on 1/28/10By the way after Dr. G had mentioned (in November of 2010) a possible link between contrast dye and my drop in kidney function I asked the CT scan tech if he was sure my Neph had ordered contrast dye? Yes, it had been ordered. 1/4/11 = 1.62 GFR=321/24/11 = 1.74 GFR=295/20/11 = 1.34 GFR=39 With adherence to a LS diet and a lower BP my numbers have improved somewhat, but the damage is done. My next tests will be in November for a six month routine testing. My Nephrologist insists that my numbers just reflect the uncovering of damage that was already done to my kidney's by years of uncontrolled HBP, but he's also just protecting himself as ordering contrast dye for someone with proven kidney damage is a no-no, which is what he did for my second CT scan. I was too dumb to refuse it. My last numbers look better than they have been, so some limited recovery does seem possible, but I think it has more to do with diet than actual recovery. Unfortunately K is an enemy of kidney function. With renal damage you have to limit K, limit protein and avoid phosphorus. The numbers for your Creatinine are more telling than your GFR. Kidney function can also drop somewhat with age, but not drop like a stone as mine did. Hope this is of some help to you. Dianne Diane, If your kidney function falls say, after a difficult hospitalization not related to the kidney, would a slightly low GFR come back up? If it falls after a MRI with contrast, will it ever go back up? Mine came in at 55 in April and I just did a whole kidney panel today. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Dianne strongDianne69, bi-lateral adenomas 1.2cm rt, 1cm left25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July 2010Had to demand tests to confirm PA, from scoffing NPCKD. Kidney function fell after use of contrast dye during CT scan 8/2010.Now on 75mg Spiro, 12.5mg AtenololBP avg. 130/70Dashing with very low Na (aim for 1,000mg) and high enough K to keep me in range, but not so high as to further damage kidneys. .

[Guest guest]

Yes? I say that because my A1C has never been higher than 6.4. For years it hovered around 5.7 to 6.2 and I could never figure it out. When I last saw my PCP he said, flat out, "you're not diabetic". His reasoning was that PA and low K caused those numbers. Before he became my PCP my NP wanted to put me on Metaformin (sp?) when my A1C was 6.0. I told her that I could bring the number down and giving me a drug to control something that I thought I could control with diet was ridiculous when I was clearly borderline diabetic. A few years ago 6.0 was not even considered diabetic.That's when I got my first "non-compliant patient" tag attached to my medical record. Because my number was over the cut off point that Kaiser has for medicating patients my NP would get a mark against her record for not giving me medication. This was medicine treating the statistic and

not the patient.I clearly have to watch my diet as to diabetes, but so far have not gotten any worse over that last 10+ years. Could happen though and then I will have to reassess.Dianne

Dianne, are you diabettic?

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> Diane,  If your kidney function falls say, after a difficult hospitalization not related to the kidney, would a slightly low GFR come back up? If it falls after a MRI with contrast, will it ever go back up? Mine came in at 55 in April and I just did a whole kidney panel today.  Val  From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Dianne strong

> Dianne69, bi-lateral adenomas 1.2cm rt, 1cm left25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July 2010Had to demand tests to confirm PA, from scoffing NPCKD. Kidney function fell after use of contrast dye during CT scan 8/2010.Now on 75mg Spiro, 12.5mg AtenololBP avg. 130/70Dashing with very low Na (aim for 1,000mg) and high enough K to keep me in range, but not so high as to further damage kidneys.

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[Guest guest]

And there isn't any chance that they snuck in any of the 13 drugs that contain

Metformin, right? (Drugs are listed in our files.)

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> > Diane,  If your kidney function falls say, after a difficult

hospitalization not related to the kidney, would a slightly low GFR come back

up?  If it falls after a MRI with contrast, will it ever go back up?  Mine

came in at 55 in April and I just did a whole kidney panel today.  Val

 From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Dianne strong

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> > Dianne69, bi-lateral adenomas 1.2cm rt, 1cm left25yr hx of HBP and low K.

Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via

Internet July 2010Had to demand tests to confirm PA, from scoffing NPCKD. Kidney

function fell after use of contrast dye during CT scan 8/2010.Now on 75mg Spiro,

12.5mg AtenololBP avg. 130/70Dashing with very low Na (aim for 1,000mg) and high

enough K to keep me in range, but not so high as to further damage kidneys.

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