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08/07/09 03:19 PM

"I have 29% kidney function now and want to know what I can do to raise it or stop the decrease. My last A1C was 5.9. I take Januvia 100 mg Amaryl 1 mg"
Asked By: chodges43  
Category: Kidney Disease

Background Info Hide
I also take one per day of the following: Omeprazole 20mg, Lipitor 20mg, Tricor 145mg, Doxazosin 8mg, Hydrochlorothiazide 12.5mg two per day Metoclorpramide 5mg I'm 66 and have been diabetic for 10 years and was on Metforman until last year when I was chenged to Januvia. My Nephrologist keeps saying once you loose kidney function there is nothing you can do to stop the lose or gain it back. I just can't accept that because I increased my function from 20% six weeks ago to 29% just by drinking enough water to get myself back hydrated.

Expert Answers (2)

08/10/09 11:46 AM

Studies indicate people who keep tight control of blood sugars may decrease the progression of kidney disease. An A1C as close as possible to 6 is considered tight control, so you have already achieved a giant step. You wil also need to control your blood pressure and cholesterol. Ask your doctor if you are on an ACE inhibitor or ARB. These are blood pressure medicines that may delay progression of kidney disease. Ask to see a dietitian about your intake of salt and protein. You may benefit from other dietary recommendations based on your blood work results. Discuss your fluid intake with the dietitian. I strongly recommend that you see a Certified Diabetes Educator for education, information, and support. Diabetes Self-Management classes (offerred at many hospitals) and Diabetes Support groups may also provide with with additional support and information. Good luck.
Answered By: Donna Yuscavage
Accreditations: RN, BSN, CDE
Sources Show
08/10/09 11:36 AM

Morning CHodges43: Stabilizing kidney function , requires aggressive and proactive control, I hope this helps.

Yes, your Nephrologists' is correct regarding the kidney's filtering ability, however, there are things you can do to stabilize and maintain what filtering capacity the kidney's still retain. Totally optimize diabetes control, get back to the basics:

  • A1C<6.5 %( without significant hypoglycemia, Blood Pressure<130/80mmHg, to aggressive control to 120/70mmHg, (your medications seem appropriate, what are your actual numbers)? Limit dietary protein :< .8g/Kg body weight.
  • The ADA's standards suggest some additional lifestyle modifications :
  • weight loss if needed,
  • reduction of sodium intake and
  • reduction in alcohol intake, and
  • activity/exercise within medical recommendations/functionality.

    Monitoring your own blood pressure complements educational efforts and helps your healthcare team to work together in detecting, treating and evaluating risk for renal complications.

  • Several components are monitored to assess the functions of the kidney. Your Nephrologists' has looked at the filtration ability via markers of microablumin, albumin to creatinine ratios as to obtain an estimated glomular filtration rate (eGFR). Aggressive management of blood pressure can decrease the rate of fall of the GFR. The extra salt and fluid can stay in the body. Causing a rise in blood pressure and making the kidneys work harder and possible cause more damage. Coordination of care involves your physician, nurse and registered dietitian. I would encourage you to work closely with these disciplines as to optimize blood glucose and blood pressure control the key factors to prevention of nephropathy. Early detection using the annual albumin-to-creatinine ration identifies those at risk, meriting aggressive treatment for delay of the progression of the disease.

    Regards Sue

    • Answered By: Susan Throop
    Accreditations: RD, CDE, MA
    Sources Show

    Community Answers (5)

    08/20/09 07:58 PM

    I have been a type 1 diabetic for 30 years, I was on blood pressure pills and zocor, which was raising my liver #s about a year and a half ago i started walking in the morning 1/2 @least 5 days a week. Well, w/in 4 weeks I no longer take blood pressure medication or zocor and liver and kidney are right @ the mark where they should be. I really really cannot stress the exercise !!! I just take 2 pills now plavix and atenolol and that s it . Its GREAT ....
    Answered By: veeez10m
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    08/17/09 08:06 AM

    This more of a question than a answer. My grandmother is also on the same boat. She is struggling to control her blood pressure, in and out of the hospital. They have changed her medications and i feel like shes taking so many of them without any working. Is there anything she can do to have more control without so many medications? She is also diabetic no insulin injections just medication. She controls that well overall. I have started monitoring her sodium and sugar intake and feel like this might help her. She also went to go see a nephrologist and he told her the samething watch the intake on sodium and sugar. Is there any or natural way of reducing the kidneys from continuing to lose function? Any suggestions would really help!
    Answered By: daemap52
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    08/15/09 10:39 AM

    I am on kidney dialysis as a result of mega doses of drugs given to me by doctors in 2008. I am working daily on improving my kidney function using an Ayurvedic remedy for the kidneys, have BP under control, have BS under control, and TAKE NO MEDS. One person replied they are on statin drugs - see Dr. Mercola's devastating article this week on the effects of statins on diabetics, in particular! Go to mercola.com. This can save lives. I would not take a statin at gunpoint. I also use visualizations of my kidneys as well, and indeed they are improving every month! I WILL GET THEM BACK. It can be done, but you MUST BELIEVE IT FIRST.
    Answered By: sunniegal
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    08/14/09 12:52 PM

    You may want to check with your doctor reguarding taking lipator. Lipator caused my mother to have the muscle breakdown( rhabdomyolysis) which caused her kidney failure. she went from 65% function to 17% function in 6 months. She is now off Lipator, and is following a renal diet( 2000 mg potassium, 2000 mg sodium and 50 grams of protein a day) and has restored her function to 30% and stable. good luck!
    Answered By: joyceqlts
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    08/14/09 09:50 AM

    Hello There are a few piece of info missing here that might be helpful: 1) A non-diabetic A1C is 4.2-4.6 so you do have more "wiggle" room if you wish to try. The definition of normal is NOT non-diabetic. It is the target range the ADA has set. In fact, if you do the math, you'll see it is a high % above normal and thus, can't help but do harm. 2) The body does have an inate ability to heal itself but only if we help it along with diligence and with time. Frequent testing of blood sugar, testing to see what foods cause you to spike in the hour after eating might help you see what's going on. I realize type 2's are not encouraged to test as frequently as type 1s. I don't find that a helpful, healthful approach. It does not provide you with complete knowledge, data or ability to anayze what you're body is doing. 3) Perhaps taking rapid acting insulin would help (don't fear it; embrace it) because it seems based on the switch to Januvia you still don't have enough phase 1 insulin left to match up to carbs. Thus, you likely go several hours each day high before dropping back down to a reasonable range. 4) Byetta or Symlin might help accomplish the same task as they slow down absorption of rapid acting carbs. Only testing of foods and blood sugar will show you. These recommendations are in addition to what the nurses mentioned. Good luck and best wishes. Doris J. Dickson
    Answered By: dorisjdickson
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