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A common topic to crop up in Gout and meds- for both it, and other conditions, is Kidney function.
The Estimated GFR [Glomular Filtration rate] is often used to access kidney function.
It decreases with age [surprise, not] and is a handy way to gauge condition without intrusive and probably expensive tests.
A cardio specialist recently commented as an aside that mine was Ok- in context with BP meds I assumed, but how good is the estimation, if 'on the edge' of kidney problems, and what tests are due otherwise?
Trev…I'm new to goutpals, and have similar kidney concerns since my transplant 10 years ago. I have recently been diagnosed with gout after several years of joint issues and 2 big toe attacks that prompted my first requested uric acid test about 30 days ago. Came back 10.4, no big surprise to me…only to my Doctor. Gave me colchicine, which helped. I suggested allopurinol, and was put on 100mg to start.
In answer to your question about tests, I am assuming that you have already had a blood test to check creatinine? Unfortunately, kidney failure has no symptoms and by the time your creatinine increases to a high range, it can be a complete surprise. The GFR is a fairly routine test for kidney funtion, as is a 24-hr urine test for protein. Too much protein in your urine is a sign of loss of kidney function. As you mentioned, there are lots of expensive tests such as biopsy and scans. I would push your Nephologist for the best route for your condition. And stay on him. Kidney failure is no fun at all!
By the way, are you aware of any interaction issues with allopurinol to the kidneys?
Yes, Lyn- I have an annual check on blood and the creatinine has been stable @95 – up till now!
However as I was getting a return of tenderness in the old area under L. ribs I was wondering if the eGFR from that Creat. rdg. was really that useful. From the calculations on Wiki, which has a calculator for eGFR, I got a figure 10% lower than on the lab assessment- which is in the wrong direction. However, I read that the lab calc may be more accurate due to measurement considerations. I see my figures as on the wrong end of good!
Either way, the figure of 70 or 80 is in scale for 'normal' [59-300]- yet the Wiki calc. flags this as potential stage 2 kidney disease!
Many meds say watch out for kidney issues- AlloP says this, and for liver too- but presumably your Dr knows this and unless you get other reactions, as I did, you may find no problems.
Your having had a transplant is bound to sharpen your appraisal somewhat on this!
The other factor in this is that urate stones are transparent to ultrasound scans. Ain't life great?
I delved a little this morning and calculated my GFR from a couple of the Internet formulae. Seems for preciision you need to find out whether your creatine was tested using IDMS or nor…and I haven't a clue what that means. Anyhoo, WITH IDMS, my GFR would be 70mL/min/1.73 square meters. WITHOUT IDMS, the value would 74. Anything over 60 seems to be acceptable for someone of my age. (My blood creatine was 1.07 last year and 1.00, back in 2003…and also 1.0 back in 1982 {I keep my blood results})
Kidneys seem normal and I've taken an average of 300 mg. allopurinol every day for over 20 years.
From the formulae it seems inevitable though that our kidneys are destroyed with age and time. I guess that's why in so many cases of impending death you hear the term “the end is near, his kidneys are shutting down.” I even heard the same comment about my CAT, the sweetest pet that ever lived.
Funny, from all the calcualtions, if I read them right, for any given creatine level blacks have a much higher GFR. I guess that implies the black races have better kidneys? I wonder why that would be?
BTW, Functioning kidneys should allow NO protein to leak into the urine.
I think the adjustment for Black ethnicity is because of their higher natural muscle mass , Zip. This increases Creatinine residue in the blood.
I think the comment about levels 'holding up' * for a long ways towards failure is a good caution.
An eGFR of 30 is considered to be getting really worrying, from what I read. 60 without any other symptoms would seem just OK.
tbh- I think more frequent blood tests would be helpful during time establishing drug regimes that could affect kidney [and liver] function- as they are rather essential items, to put it mildly! This would cover the above* issue to a large extent.
In the long run, a standard blood test is better than having dialysis/ICU suites in hospitals
Long term meds are a big help, or they wouldn't exist- but I wonder if 'fire and forget' drugs aren't all too easy an approach, that the medics adopt as standard.
If only the promotional effort that goes into Drugs sales was pushed in this direction…
Sound of pigs flying?
Needles too cheap?…[even if subsequent analysis isn't] – maybe a meter like Kernels' for Creatinine?
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