New risk factor for chronic kidney disease

In my 33 years since diagnosis with type 2 I have had very good BG management. I do whatever it takes to achieve this. First it was diet and exercise, later Metformin, then Lantus, MDI and currently diet, exercise, Metformin and a pump.

Diabetes is a major risk factor for developing CKD alone with hypertension. The later has never been an issue with me. Quite a few years ago my PCP prescribed a low dose of the ACE inhibitor Lisinopril as a kidney protective measure.

Over the last year there have been some troubling lab results with some microalbumin in urine the last two labs showed a substantial increase of the Calculated Albumin:Creatinine ration - 9 months ago normal, 6 months ago above normal and most recently a sudden spike. My eGFR is in the mid 90s supposedly OK for someone over 70. My endo and I agreed that I should start Farxiga and see a nephrologist.

I saw the nephrologist who has ordered more urinalysis and a sonogram of the kidneys. I see him again in early September.

So, I’ve been going along thinking that I was not at real risk of DCKD with good HbA1c at 6% or lower and staying 96% TIR of 70-140mg/dl, and with a long history of normal on the low side blood pressure.

About the time that we started seeming possible kidney issues I suffered a mild bout of Covid-19 lasting about 10 days with exercise induced shortness of breath for another 30 days. That seems to have passed.

I didn’t make any possible connection to Covid-19 and kidneys. It was from reading a couple of study papers from search results on other causes of CKD in the absence of uncontrolled diabetes and hypertension.

Those with existing CKD who contracted Covid-19 were susceptible to more kidney damages, but some with out CKD developed CKD. I don’t know if this is the case for me or just years of being diabetic finally caught up with my kidneys.

I hope everyone here gets regular blood and urinalysis to check kidney function as we are all at risk for diabetic chronic kidney failure. Caught early drugs like SGLT2 Inhibitor and Kerendia con preserve kidney function preventing the need for dialysis or transplant.

Stay healthy.

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I am sorry to hear of your recent test results, and am surprised with your excellent BG control and exercise regimen that diabetes would be the cause of CKD. Interesting that there is a link to covid-19. According to media, most of the population has experienced covid. Thanks for sharing and reminding us all to remain vigilant.

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An update, The nephrologist ordered more labs and a sonogram of the kidneys and bladder. The labs showed the same odd numbers, blood tests showing good kidney function, urine showing some protein and blood. Also I passed visible blood in urine several times. The sonogram showed an enlarged prostrate which was troublesome because it has been gone for 10+ years.

Next stop the urologist. He ordered a current PSA (too low to measure) a CAT scan and did a cystogram. There clear as day on the monitor were 2 tumors. I am scheduled for ureteroscopic surgery on Friday Oct.6 to excise them and begin post-operative treatment.

The urologist said that my kidney function is probably OK. The protein, microalbumin and creatinine in the urine were coming from the tumors.
A bit of good news mixed with the not so good.

I am sharing this with the rest of you because it is important to have these tests on blood and urine for kidney function regularly. Catching diabetic kidney failure early is always good, and as in my case, may lead to catching something else early.

We also need to be careful to not assume every health issue we have is related to diabetes. Yeah, there are a lot of things that are, but not everything.

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Best wishes for you @CarlosLuis. Hope everything can be resolved easily.

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Thanks, Eric, it goes without saying that I concur. I’m having difficult wrapping my head around it. My sister’s husband died yesterday, my go to stress relief is riding my bike out on the road, but my bicycle has the recalled Shimano cranksets, so it’s at the bike shop.

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@CarlosLuis I am so sorry you are dealing with this. Thank you for bringing us into your confidence; please know that I am sending my very best thoughts your way and hoping you get your bike back soon! I know how much biking/tennis/running can keep some of us sane. Hoping you will keep us updated on all treatment – as one of my favorite peloton instructors often says “hands on your back” xoxo

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Thank you for your thoughts. As unsettling as this is, it is good to get a diagnosis. I thought I was slipping into CKD. While bladder cancer is not bettter than CKD there is good reason to hope for it never coming back, and we know what to look for.

Sharing this on FUDiabetes is helpful to me and I hope it will help others to be diligent about CKD if not cancer, well both.:

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Glad they found the stuff early and hope all goes well! Am sure you have/are coordinating all the T1 stuff with the surgery folks! Look forward to hearing from you after all is said and done!

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My condolences to you and your family for the passing of your brother in law. Difficult times seem to come in groups. Biking would definitely help out and I hope you get your bike back soon to de-stress before the surgery. Thank you for reminding us all to be diligent with our medical exams. Sending our best for a painless and speedy recovery.:pray:

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Well, the surgery went well, but the cancer was also in the muscle of the bladder. Next a course of chemo and the surgical removal of the bladder. Options are urostomy bag or orthotopic neobladder reconstruction from a portion of the small intestines.

Sorry if this is too much information and is not diabetes related, but you are the one group I can depend upon, Thanks.

Oh, and I am home, feeling pretty good. I wish that the T U R B T (trans urethral resection of bladder tumor) had been the end of it. But we all do what we need to do.

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I am so sorry @CarlosLuis. This all sounds overwhelming and I hope you have support at home through this process, too. Please continue writing here-- we are here for you! Sending you the biggest hug – Jessica (PS – how are your blood sugars? Glad that you are feeling well!)

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Sorry for the news, not familiar with the procedure, but if it gets rid of the bad and provides some quality of life then go for it! As to the subject, I’m sure you’ve got a lot of support here!

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Jessica, last week while waiting for the surgery I think I was stressed out and my BG was elevated. It has settled down, It is better knowing than anticipating. Thanks for the hug those are alway appreciated.

Tom, yes, get rid of the bad, and learn new procedures - keeps life interesting.

The powers that be, “Oh he’s figured out pumping insulin, he must be bored let’s give him new challenges.” :star_struck:

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@CarlosLuis I know nothing of what you speak regarding the bladder cancer, but I trust you are very well informed.

Thank you for sharing your journey here on FUD. I personally don’t know you very well, but if there is something I can do for you beyond being a cheerleader in your corner, count me in.

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I love you all!:heart:

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May I share your spirit when it’s needed!

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You’re welcome, anytime. I will probably need some spirit lifting in the future.

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Wow, Carlos, yes, indeed, the powers did in deed throw you some more challenges. Knowing you based on all of your inspiring posts here on FUD, you are surely up to the challenge. Sending you hugs and best wishes for a speedy recovery and learning the new procedures.

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@CarlosLuis This sux! Sorry, that’s the best I could come up with. I hope your cats are giving you good purrs, and not sleeping on sensitive parts! You know we’ll all keep you in our thoughts/prayers.
:heart::heart:

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Much appreciated, some rough days in the future with chemo and surgery. And trying to figure out how to get everything done at home.

On the plus side I’ve been eating bigger meals to gain a bit of weight I shouldn’t lose any weight.

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