Wednesday, January 23, 2008

My first "Annual" Kidney Exam

Good evening everyone!

I had my one-year post-transplant Glofil appointment on Tuesday. My score was 81. For those of you keeping track, I was 86.1 right after the transplant, 82 at the six-month mark. I asked the doctor (physician's assistant), and she said that the "normal" range for a post-transplant patient was between 40 and 60, so I am doing very well.

I received a Glofil-related question on my comments (on the last blog). Here's the question:
Jugie C has left a new comment on your post "You're a Genius":

My grandson (Montgomery, TX -- 10yo) had his 1st GloFil test today (01/15/08). He was born with inadequate kidney function. Can you point us to an explanation of what "normal" is (his was 21.9). My daughter was informed that 70-140 is the adult normal.

Well, Jugie, I asked the nephrologist about your question. She printed me a list from about Glofil results. For a person with Chronic Kidney Disease, the kidney function is measured (or estimated) with a GFR (Glomerular Filtration Rate). There are five stages but kidney function is normal in Stage 1, and minimally reduced in Stage 2.

Stage 1 is a GFR of 90+: Normal kidney function but urine findings or structural abnormalities or genetic traits point to kidney disease.
Stage 2 is a GFR of 60 - 89: Mildly reduced kidney function, and other findings (as for stage 1) point to kidney disease.
Stage 3 is a GFR of 30 - 59: Moderately reduced kidney disease.
Stage 4 is a GFR of 15 - 29: Severely reduced kidney function.
Stage 5 is a GFR of < 15: Very severe, or endstage kidney failure (sometimes called renal failure)

The nephrologist said that UNOS (the transplant people) require you to score less than 20 in order to qualify for a transplant. She also said that once you fall below 15, they normally recommend dialysis (depending on the patient, but it's <15 for almost everyone).

I also got my lab results back. My creatinine remains at 1.0 (which is good). My cholesterol levels all looked good. My bad (LDL) was at 61 (which is on the low end). My good (HDL) was a little lower than they like (only 36.0). And my triglycerides were at 139, which is excellent. The only recommendation is cardio-vascular exercise to improve my good cholesterol numbers. Aside from that, she was happy. My Phosphorus was a little low this week at 2.5 (with the normal being between 2.6 and 4.4). The doctor said to keep eating the foods that are higher in phosphorus (all the stuff I could not have on dialysis).

From glancing at the second page, my MONOCYTES were a little high at 0.84 (and the normal range is 0.10 - 0.50). The Internet said that monocytes are a second line of defense against infection. I'm guessing they are elevated due to this foreign kidney being in my body. I'll have to watch it on the next lab report and see if it remains a problem. This level has not been elevated in the past.

That's it for this week. I have another appointment on my birthday. I'm going to try and go in early to see if that helps with the congestion at the office. They have been remodeling their office, and are serving patients in a smaller rental building. It's crowded and there is never any parking. I'm hoping that perhaps being the first appointment of the day will give me a chance to get seen quickly and to get a place to park.

Have a great week. I'll try to post again before mid-March!
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