Re: Spiro and Breast Pain -kidney damage

[Guest guest]

The hospital I work at requires anyone having a CT scan with contrast to have a GFR drawn first. If it comes back <60 you do not get contrast, no matter how the doctor writes the order. In addition, if you are on metformin you must be off it it for 72 hours prior. I just figured this was a standard of care now but evidently now. I'm on met and have had a couple of GFT's come back in the high 50's. My Endo wanted me to have a CT to compare size of adenomas from my last one four years ago. I had it about a month ago and insisted that it be done without contrast and it showed her what she wanted to know, no change in size.

a

From: Dianne strong <dianstrong@...>hyperaldosteronism Sent: Wednesday, July 11, 2012 12:26 PMSubject: RE: Spiro and Breast Pain -kidney damage -Val

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 =44

9/29/10 = 1.13 GFR=48

10/1/10 = 1.21 GFR=44

10/20/10 = 1.28 GFR=42

12/21/10 = 1.72 GFR=29

12/28/10 = 1.52 GFR=34

Given second CT scan with contrast dye on 1/28/10

By 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=32

1/24/11 = 1.74 GFR=29

5/20/11 = 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 strongDianne

69, bi-lateral adenomas 1.2cm rt, 1cm left

25yr hx of HBP and low K.

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

Diagnosed myself via Internet July 2010

Had to demand tests to confirm PA, from scoffing NP

CKD. Kidney function fell after use of contrast dye during CT scan 8/2010.

Now on 75mg Spiro, 12.5mg Atenolol

BP avg. 130/70

Dashing 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]

Thanks.So I would expect you should never need another one unless you change.Ask her next visit how many does she see change. CE Grim MD On Jul 11, 2012, at 5:28 PM, a Hall wrote: The hospital I work at requires anyone having a CT scan with contrast to have a GFR drawn first. If it comes back <60 you do not get contrast, no matter how the doctor writes the order. In addition, if you are on metformin you must be off it it for 72 hours prior. I just figured this was a standard of care now but evidently now. I'm on met and have had a couple of GFT's come back in the high 50's. My Endo wanted me to have a CT to compare size of adenomas from my last one four years ago. I had it about a month ago and insisted that it be done without contrast and it showed her what she wanted to know, no change in size. a From: Dianne strong <dianstrong@...>hyperaldosteronism Sent: Wednesday, July 11, 2012 12:26 PMSubject: RE: Spiro and Breast Pain -kidney damage -Val 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 =44 9/29/10 = 1.13 GFR=48 10/1/10 = 1.21 GFR=44 10/20/10 = 1.28 GFR=42 12/21/10 = 1.72 GFR=29 12/28/10 = 1.52 GFR=34 Given second CT scan with contrast dye on 1/28/10 By 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=32 1/24/11 = 1.74 GFR=29 5/20/11 = 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 strongDianne 69, bi-lateral adenomas 1.2cm rt, 1cm left 25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July 2010 Had to demand tests to confirm PA, from scoffing NP CKD. Kidney function fell after use of contrast dye during CT scan 8/2010. Now on 75mg Spiro, 12.5mg Atenolol BP avg. 130/70 Dashing 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]

Thanks a. The doctor did order a Creatinine/GFR test the day before my first CT scan. It came back at 0.80 (<1.11) and not specified for GFR but >60, which meant "normal". It was after the CT scan that the kidney function tanked. I was not on, and have never been on Metformin. The big mistake the doctors made was with my second CT scan. Those readings clearly indicated kidney's that were struggling, yet they went ahead with the CT scan using contrast dye. Careless medical practice and I'm paying the price.For those of us who have had undiagnosed and untreated PA for a while, our kidney's have to have been under stress. That's why I like to issue a warning to anyone on this PA site to really question their doctor if a contrast dye is needed for any scan. On top of all the other problems we have we don't need tanking kidney's

too.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 strongDianne

69, bi-lateral adenomas 1.2cm rt, 1cm left

25yr hx of HBP and low K.

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

Diagnosed myself via Internet July 2010

Had to demand tests to confirm PA, from scoffing NP

CKD. Kidney function fell after use of contrast dye during CT scan 8/2010.

Now on 75mg Spiro, 12.5mg Atenolol

BP avg. 130/70

Dashing 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]

Or question anyone who seems to keep ordering xrays or CT's even without contrast. But you are so right the there are many many many cases of one-time contrast dye damaging kidneys.

I have had in a 10 year span at least 5 abd CT's with, 2 chest CT's with, and maybe 6 or 7 head CT's (maybe in a little more than 10) without. But each time also got a chest xray just about. Scary.

It's tough because all along the way we want to know what's wrong so we let thm do it again, and we always hope "this time is it" and whoever will listen and put the signs and symptoms together, but alas, doesn't happen.

It's a hell of a lot harder being a patient than I ever imagined. I certainly have a new respect.

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 strongDianne

69, bi-lateral adenomas 1.2cm rt, 1cm left

25yr hx of HBP and low K.

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

Diagnosed myself via Internet July 2010

Had to demand tests to confirm PA, from scoffing NP

CKD. Kidney function fell after use of contrast dye during CT scan 8/2010.

Now on 75mg Spiro, 12.5mg Atenolol

BP avg. 130/70

Dashing 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]

That's standard everywhere in America, getting a BUN/Cr before you have one. I have never been to another country let alone work in one, so I don't know about them. But that is standard in America and due to liability as this is a common lawsuit, they all should be doing it. Some probably get it, but didn't realize it, and what varies is the acceptable time frame - does it need to be "today"; what if it is a week old?, etc.

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 strongDianne

69, bi-lateral adenomas 1.2cm rt, 1cm left

25yr hx of HBP and low K.

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

Diagnosed myself via Internet July 2010

Had to demand tests to confirm PA, from scoffing NP

CKD. Kidney function fell after use of contrast dye during CT scan 8/2010.

Now on 75mg Spiro, 12.5mg Atenolol

BP avg. 130/70

Dashing 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]

My Ho is that the fibrosis in the kidney and the heart caused by excess aldo and high salt diet (in the aldo salt model of HTN in animals) sets the stage for damage from contrast used in CTs. BTW it is not a dye.CE Grim MDOn Jul 11, 2012, at 8:13 PM, Bingham wrote: Or question anyone who seems to keep ordering xrays or CT's even without contrast. But you are so right the there are many many many cases of one-time contrast dye damaging kidneys. I have had in a 10 year span at least 5 abd CT's with, 2 chest CT's with, and maybe 6 or 7 head CT's (maybe in a little more than 10) without. But each time also got a chest xray just about. Scary. It's tough because all along the way we want to know what's wrong so we let thm do it again, and we always hope "this time is it" and whoever will listen and put the signs and symptoms together, but alas, doesn't happen. It's a hell of a lot harder being a patient than I ever imagined. I certainly have a new respect. 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 strongDianne 69, bi-lateral adenomas 1.2cm rt, 1cm left 25yr hx of HBP and low K. Previously on 5 BP meds & 80MEQ K with ever increasing BP Diagnosed myself via Internet July 2010 Had to demand tests to confirm PA, from scoffing NP CKD. Kidney function fell after use of contrast dye during CT scan 8/2010. Now on 75mg Spiro, 12.5mg Atenolol BP avg. 130/70 Dashing 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. .