Low eGFR Values and Kidney Disease.

[gustavo77]

Well, i got some blood work done recently and my doc thinks i have kidney disease. My creatinine was 127 and my eGFR is 56 (consistent with moderate chronic kidney disease). My eGFR values have gotten worse since 2005, going from 69 down to 56. I know that creatinine is one of the main values these use to determine eGFR and that creatinine is often higher in high intensity training athletes and those that use creatine. I stopped taking creatine 2 days before the blood test and also did not train for two days prior the test...seemed to have no positive effect on my eGFR. I have now been off creatine for 2 weeks and am not gonna train for four days before my next test. I have also lowered my protein intake to see if this will have a positive effect.

I would really like to hear from some of you regarding your kidney values. It would be interesting to see if there is a link between AAS, high protein consumption and elevated creatinine values and lower eGFR values.

[Bowlcut]

I have had creatinine come in high before, but not recently. However I've talked this over with my brother (Doc), among others, and the consensus is that people with a more muscular frame from lifting weights will always have "high" levels according to the standard range but it should not be a concern most of time.

Now the question is does your family have a history?
What is he doing for follow up? How are your other blood levels?

[Seth]

I might just be repeating things you know already, most eGRF tests are calculated with your creatinine levels. 2 weeks off creatine supplement is what's recommended before your tests; stopping 2 days before may not have done much. Don't sweat it unless your next test comes back similar

http://www.renal.org/pages/pages/other-info/ckd/about-egfr.php

[gustavo77]

I have had creatinine come in high before, but not recently. However I've talked this over with my brother (Doc), among others, and the consensus is that people with a more muscular frame from lifting weights will always have "high" levels according to the standard range but it should not be a concern most of time.

Now the question is does your family have a history?
What is he doing for follow up? How are your other blood levels?

Just my mom has kidney problems due to diabetes but i have no signs of that...blood sugar is always around 4-5. My cholesterol is perfectly within range and my liver values are the lowest they have been in years. I do not do orals that much anymore but i have been on test for just over a year. The only problem seems to be with my kidneys...oh and my BP was 90/50 last week when i went in to see the doc. I was pretty surprised considering i just started tren the week before. Now i am concerned obviously with the tren and it's effect on my kidneys. There are some who say tren is hard on the kidneys and other that say it is not.

I have noticed my urine is very foamy from time to time and i have read that this could indicate protein in the urine. Another cause for concern.

[juice555]

Im in the same boat. mine was down to 52, i got mine back up to 72 a few weeks later by cutting out creatine totally, stopped the protein shakes (wasnt dirnking much anyways), drank a boatload of water, and a little cranberry juice thrown in for good measure. i didnt train 3 days before my test.

get them to run a 24h (urine) clearance test on you. this is more accurate, and measures your GFR, rather than estimating it. I made the mistake of training during my collection, and taking creatine cause the dumb nurse said it was ok.

I will tell ya. My eyes have been opened during the past year with my experience with our medical profession. They know alot less that you think. Always a good idea to get a 2nd and 3rd opinion.

[gustavo77]

Im in the same boat. mine was down to 52, i got mine back up to 72 a few weeks later by cutting out creatine totally, stopped the protein shakes (wasnt dirnking much anyways), drank a boatload of water, and a little cranberry juice thrown in for good measure. i didnt train 3 days before my test.

get them to run a 24h (urine) clearance test on you. this is more accurate, and measures your GFR, rather than estimating it. I made the mistake of training during my collection, and taking creatine cause the dumb nurse said it was ok.

I will tell ya. My eyes have been opened during the past year with my experience with our medical profession. They know alot less that you think. Always a good idea to get a 2nd and 3rd opinion.

Hey brother, good to see you here again. Well, i am going to get another blood test and possibly a 24hrs urine clearance test (if my doc ordered it. :( ) tomorrow. I have been off creatine for about 3 weeks now and have not trained or taken a protein shake since last Friday. In fact my protein intake has been limited since Monday...i will update the thread as soon as i have the results.

[purelife]

wish you all the best Gus

[gustavo77]

wish you all the best Gus

Thank brother...i will keep this thread updated.

Also, it would be great to hear others regarding their kidney function...

[L3]

hey big guy im seeing my real doc on wednesday and i'll post up my results. ive been chugging whey like nobodys business so we'll see if that has effect on the kidneys

myself and im sure the rest of cbb would like to say good luck and hopefully its just a common level fluctuation

[Namelessone]

I have no info to provide but I'm praying for your recovery Gus. I wish you all the best. If there is ANYTHING you need or I can help with dont hesitate to contact me.

[gustavo77]

hey big guy im seeing my real doc on wednesday and i'll post up my results. ive been chugging whey like nobodys business so we'll see if that has effect on the kidneys

myself and im sure the rest of cbb would like to say good luck and hopefully its just a common level fluctuation

I am sure things will be fine.. I mean it is pretty common for bodybuilders that use creatine to have higher than normal creatinine values.

Thanks for the support though...means a lot...

[gustavo77]

I have no info to provide but I'm praying for your recovery Gus. I wish you all the best. If there is ANYTHING you need or I can help with dont hesitate to contact me.

Thanks brother...much love..

[Mr Ontario]

ya..don't die on us now :)

[nisser]

I have noticed my urine is very foamy from time to time and i have read that this could indicate protein in the urine. Another cause for concern.

Yup, that's absolutely a sign. I'm glad you made this thread man. I've believed this for a long time but I think people use way too much protein than they need to and it will have an effect on their kidneys over their lifetime.

Let us know what your values are after your re-test.

[gustavo77]

Yup, that's absolutely a sign. I'm glad you made this thread man. I've believed this for a long time but I think people use way too much protein than they need to and it will have an effect on their kidneys over their lifetime.

Let us know what your values are after your re-test.

I re-tested today...about 3 weeks off creatine, have not trained since last friday and have not had any shakes since then either. Lowered my protein intake also the last few days and increased my water. The only thing i have continued to take is test and small dose of tren E i started a couple weeks ago just before i got my test results back. If my results from today come back poorly or worse even, i am dropping the tren, lowering my test dose and getting more blood work done in 3-4 weeks.

Anyways, i should have my results back monday or tuesday, so i will update this thread then...

[nisser]

that's good although I wonder if you will go back to your old habits if the test comes out better?

[gustavo77]

that's good although I wonder if you will go back to your old habits if the test comes out better?

Not entirely...i will not take creatine anymore...I will limit my liquid protein intake, as i think large amounts of fast digesting protein can put a strain on already stressed kidneys. Whey protein digests pretty fast and i usually take in about 60 grams or more per serving...any protein not used for muscle repair or energy will go straight through the kidneys. I will limit my liquid protein to 2-3 shakes per day, of only 40 grams per shake.

Also, even though i rarely use orals for very short durations (3-4 weeks), i may entirely avoid them now.

[juice555]

Make sure you insist on these tests you need. do your research, and be an informed patient. doctors will respect you more, and listen to what you have to say - at least the good ones will. You might also suggest he refers you to a kidney specialist now, because you are going to be probably waiting for 6 months anyways...this is canada afterall

[juice555]

F**k me. got another call from the doctor today. why wont they just leave me alone?!

the 2nd 24h creatinine clearance/protein urine test came up off again. Bloodwork was good last time (eGFR from 52->72). But that damn proteinuria has got me again.

Anyone else have these troubles? Or are Gus and I the only ones?

[gustavo77]

Got the results back today...eGFR is at 54 (down from 56), creatinine at 132!!! My kidneys are getting worse! **** me, i did not train for 5 days before the test, no protein shakes, lower protein diet, no creatine, no anti-inflammatory drugs. But i was still on low dose tren E for this test, no more though...i think it is the tren E that effected this blood test. Although someone with healthy kidneys may not have problems with tren, i now think that anyone with compromised kidney function should steer clear of tren. I have not taken any tren since last week though and i will get another blood test in 3-4 weeks, until then, i have an ultra-sound scheduled for next week on my kidneys, bladder and lower abdomen.

[St]

Got the results back today...eGFR is at 54 (down from 56), creatinine at 132!!! My kidneys are getting worse! **** me, i did not train for 5 days before the test, no protein shakes, lower protein diet, no creatine, no anti-inflammatory drugs. But i was still on low dose tren E for this test, no more though...i think it is the tren E that effected this blood test. Although someone with healthy kidneys may not have problems with tren, i now think that anyone with compromised kidney function should steer clear of tren. I have not taken any tren since last week though and i will get another blood test in 3-4 weeks, until then, i have an ultra-sound scheduled for next week on my kidneys, bladder and lower abdomen.

Hey sorry to hear the bad news gus,but you should come off the tren & test now until your test are better.I had Kidney problem in the past 2001.I came off,lower my protein intake a bit,stop all Caffeine,lowered my sodium and after one year i was fine.Had to do Urine sample every 6 month for 24 hours for 2 year since i had blood in my urine had fear for the first time.

[gustavo77]

Hey sorry to hear the bad news gus,but you should come off the tren & test now until your test are better.I had Kidney problem in the past 2001.I came off,lower my protein intake a bit,stop all Caffeine,lowered my sodium and after one year i was fine.Had to do Urine sample every 6 month for 24 hours for 2 year since i had blood in my urine had fear for the first time.

Thank you for your thoughts bro.. I took my last shot of tren early last week and am dropping my test dose down to 200mg per week for now. I figure low dose test will be a lot less stressful to my kidneys than a bunch of PCT drugs. I have been on for over a year so coming off cold turkey would not be an option.

[petem]

ask you doc to send your urine for and ACR test (albumin to creatinine ratio test). 24hours are more accurate, but they are always messed up somehow - it's a very difficult protocol to follow accuratley

[juice555]

Dont worry too much now Gus... your eGFR may never be super high, but I bet you my last vial that it goes up 10-20 points after you stop the Tren. I dont know if you have been taking any orals, but stop those if you are.
It took me 1 1/2 months after i stopped for my eGFR to climb back up just for reference.
I agree with you about not stopping the test and adding PCT chemicals. You never know what it might do to your test results. I do believe that your need a certain level of test for healthy organ health. For example (and this may help you) I ran across a post in another forum that talked of a doctor in Texas who prescribes the following for people with very low eGFRs (<20) who are waiting dialysis. Apparently this regimine worked for a few patients so well they no longer required dialysis and transplant!

Here you go:
of what that doctor in Texas suggested I take, tell me what you think.

hgh - 2 to 4 iu's every morning
cortef - 10mg every morning & noon- to get fasting AM cortisol level up to 20
DHEA - 100mg. every morning
Test - get levels up to 700 or greater
T4 - 100mg. every day
arginine - 7gm. 2/day
glutamine - 7gm. 2/day
HMB - 1000mg. 3/day
Vitamin D - 50000 units/week
*****3 - 3000mg/day
Alpha lipoic acid - 200mg. 2/day
Acetyl-L-Carnitine - 1000mg. 3/day
CoEnzymeQ 10 - 200mg. 3/day


Good luck, my friend. Take care of those things!

[Sean Summers]

I got mine done about 3 weeks ago...
Creatinine - 101
eGFR - 76
SS

[gustavo77]

Dont worry too much now Gus... your eGFR may never be super high, but I bet you my last vial that it goes up 10-20 points after you stop the Tren. I dont know if you have been taking any orals, but stop those if you are.
It took me 1 1/2 months after i stopped for my eGFR to climb back up just for reference.
I agree with you about not stopping the test and adding PCT chemicals. You never know what it might do to your test results. I do believe that your need a certain level of test for healthy organ health. For example (and this may help you) I ran across a post in another forum that talked of a doctor in Texas who prescribes the following for people with very low eGFRs (<20) who are waiting dialysis. Apparently this regimine worked for a few patients so well they no longer required dialysis and transplant!

Here you go:
of what that doctor in Texas suggested I take, tell me what you think.

hgh - 2 to 4 iu's every morning
cortef - 10mg every morning & noon- to get fasting AM cortisol level up to 20
DHEA - 100mg. every morning
Test - get levels up to 700 or greater
T4 - 100mg. every day
arginine - 7gm. 2/day
glutamine - 7gm. 2/day
HMB - 1000mg. 3/day
Vitamin D - 50000 units/week
*****3 - 3000mg/day
Alpha lipoic acid - 200mg. 2/day
Acetyl-L-Carnitine - 1000mg. 3/day
CoEnzymeQ 10 - 200mg. 3/day


Good luck, my friend. Take care of those things!


Thanks bro...great info.

I have not used orals in a while...in fact i rarely use orals and my AST and ALT values, coming back recent their best in years, is why...oh and i rarely drink anymore..lol

I know it was stupid for me to continue the tren but it was low dose and i had started just before i got my results back. My results from my cholesterol tests a couple weeks before were excellent, so i went ahead with the tren. I have been off tren though like i said for about a week and half now, so in a few weeks i will get another test done for eGFR and creatinine. I am still gonna get the ultra-sound done though, why not...if there is a problem with function, i need to know.

I have to be honest though, since this last kidney function test i have been pretty depressed and have not trained. I love bodybuilding and now i will have most likely have to change my training and diet habits for good. No more 350-400 grams of protein per day...

Questions: what is coref?? Also, t-4 should be 100mcg per day not 100mg correct??

[juice555]

Thanks bro...great info.

I have not used orals in a while...in fact i rarely use orals and my AST and ALT values, coming back recent their best in years, is why...oh and i rarely drink anymore..lol

I know it was stupid for me to continue the tren but it was low dose and i had started just before i got my results back. My results from my cholesterol tests a couple weeks before were excellent, so i went ahead with the tren. I have been off tren though like i said for about a week and half now, so in a few weeks i will get another test done for eGFR and creatinine. I am still gonna get the ultra-sound done though, why not...if there is a problem with function, i need to know.

I have to be honest though, since this last kidney function test i have been pretty depressed and have not trained. I love bodybuilding and now i will have most likely have to change my training and diet habits for good. No more 350-400 grams of protein per day...

Questions: what is coref?? Also, t-4 should be 100mcg per day not 100mg correct??

Yup, I know what you mean about the depression. But dont go there yet until you have a good 1-2 months off the heavy stuff.

Yes, I should have payed closer attention to what i was pasting. 100mcg of T4, not 100mg.

Cortef is hydrocortisone. Hydrocortisone belongs to the family of medications known as corticosteroids. It is used to treat several different conditions. It works by reducing swelling, inflammation, and irritation.

I will talk to my doctor tonight. i passed on this information for him. I will see what he thinks.

[gustavo77]

Yup, I know what you mean about the depression. But dont go there yet until you have a good 1-2 months off the heavy stuff.

Yes, I should have payed closer attention to what i was pasting. 100mcg of T4, not 100mg.

Cortef is hydrocortisone. Hydrocortisone belongs to the family of medications known as corticosteroids. It is used to treat several different conditions. It works by reducing swelling, inflammation, and irritation.

I will talk to my doctor tonight. i passed on this information for him. I will see what he thinks.

I get depressed from time to time no matter what..lol..it is in my nature.. i always come out of though, so it never gets too too bad...:pb...i just go on a nice little binge for a nite or two or three and i wake up wanting to get back to normal..

How is the hydrocortisone administered??

[gustavo77]

whoops....

[juice555]

You can ask the doctor directly. See his website at: http://drlewisclarke.com/Home_Page.php

Let us know what you find.

[juice555]

Sir Gus,

I have researched more about the eGFR as it pertains to people with higher than average muscle mass. Didnt come up with anything other than a general statement that the values may not be accurate.
I came upon some information today I found at numerous web sites, here is a sample: http://www.medscape.com/viewarticle/529930_5

The important bit is: "African American ethnicity was an independent predictor of higher GFR as on average, black persons have greater muscle mass than whites." It may be true you have a higher muscle mass than an average African American even, but at least you can get a little closer to your 'real' value if you calculate using this attribute.

Now to the calculations... There are a few formulas which calculate GFR using your measured creatinine level. Most formulas use a standarized body surface area of 1.73 squared. This works out for your average Joe, but not for the likes of us.

So, I have found another calculated method which takes into consideration your bodyweight. You can find the calculator here: http://www.kidney.org.uk/Medical-Info/kidney-basics/calc-kidney-fn.html

So using your creatinine level of 132, and age of 35 (guessing), 114kg (guessing) I calculated a eGFR of 128. Now I see in some places they specify 'lean mass'. So lets guess you are 100kg lean mass. even so, thats 112 eGFR. You're lookin good by this calculation.

I leave it up to you to plug in the values. Also, lets now forget its *highly* likely your creatinine will subside when at least the Tren has cleared, and your body is at a more baseline state. The only worry I'd have is the 20 point eGFR drop. One might explain away the low values because of your muscle mass, but a 20 point drop isnt good. I'd say it this goes back up to around 'normal' for you... i wouldnt worry too much.

of course you will put abit more weight into a real doctors opinion i hope.

[juice555]

also it is possible that Trenbolone (artificially) increases your creatinine levels like anavar does (http://medical-dictionary.thefreedictionary.com/Anavar).
however i read on the same site that exogenous testosterone actually lowers your creatinine. so there is no way to tell for certain since there arent any studies on this compound since its not approved in North america.

[gustavo77]

Thank you very much bro for sharing your research...this is some very positive info for me...according to that calculator my eGFR is 112.7, definitely in the normal range, to say the least. I will bring this up with my doctor immediately...not once was i asked how much i currently weighed and there were no questions or indications that body mass had any effect on eGFR readings...even though i asked. We really need to get a doc on CBB who knows his shit and can get us to educate our doctors a little...or a lot.. My doc is suppose to be a specialist in sport's medicine and is actually the doc for my town's OHL Hockey team....sad...

[juice555]

Thank you very much bro for sharing your research...this is some very positive info for me...according to that calculator my eGFR is 112.7, definitely in the normal range, to say the least. I will bring this up with my doctor immediately...not once was i asked how much i currently weighed and there were no questions or indications that body mass had any effect on eGFR readings...even though i asked. We really need to get a doc on CBB who knows his shit and can get us to educate our doctors a little...or a lot.. My doc is suppose to be a specialist in sport's medicine and is actually the doc for my town's OHL Hockey team....sad...

Ok, I just got back from my doctor. He had spoken with a nephrologist (kidney doctor) this week on my behalf. The specialist verified what I said above. Using the regular eGFR equation for those with above average muscle mass doesnt give an accurate kidney function representation. The nephrologist confirmed that using the cockcroft-gault equation that takes your bodyweight into consideration.

Our sudden drop in eGFR is a concern, but I am quite confident it is due to exogenous administered chemicals :beer

So chill out abit and wait at least a few weeks until you get tested again. I am willing to bet your ultrasound looks good.

[gustavo77]

Ok, I just got back from my doctor. He had spoken with a nephrologist (kidney doctor) this week on my behalf. The specialist verified what I said above. Using the regular eGFR equation for those with above average muscle mass doesnt give an accurate kidney function representation. The nephrologist confirmed that using the cockcroft-gault equation that takes your bodyweight into consideration.

Our sudden drop in eGFR is a concern, but I am quite confident it is due to exogenous administered chemicals :beer

So chill out abit and wait at least a few weeks until you get tested again. I am willing to bet your ultrasound looks good.

Thanks brother. Very assuring info.. I will keep this thread updated as there is some extremely valuable info for all of us that train hard and carry above average amounts of muscle mass.

[drdnj]

I know this is an old thread, but I figured I would add in my recent experience and blood work. I went to my family physician with high BP (160-190/90-110 mmHg). I became hypertensive in the past few months. I noticed foamy urine while preparing for a show a few years back and didn't do anything about it. My physician took bloods and urine and called me within 2 days to let me know I was in kidney failure (GFR <15 and Creatinine was 550). I saw a nephrologist within a day and have been put on beta blockers and a low protein diet (0.8g/kg body weight). Blood pressure is now normal and I am scheduled for renal biopsies on Nov. 5th.

Scared shitless!
Drdnj

[juice555]

Thats no good at all.
if your numbers are really that low life is going to be a rough go.
how do you feel? Any different than normal?
best be eating well, stay off the special vitamins and drink lots of fluids.
i wish you all the best. Keep us posted.

As far as the egfr mystery goes there are other more accurate methods of measuring gfr. A marker called cystatin-c is accurate and independant influencing factors that confuse the regular testing method; body weight, muscle mass, rage, age do not affect this test.
unforyunately in canada they know nothing of this test.
so yours truely is off to get a radionuclide 99mTc-DTPA scan.
i'll also get a conventional test done the day before to compare the two.


I know this is an old thread, but I figured I would add in my recent experience and blood work. I went to my family physician with high BP (160-190/90-110 mmHg). I became hypertensive in the past few months. I noticed foamy urine while preparing for a show a few years back and didn't do anything about it. My physician took bloods and urine and called me within 2 days to let me know I was in kidney failure (GFR <15 and Creatinine was 550). I saw a nephrologist within a day and have been put on beta blockers and a low protein diet (0.8g/kg body weight). Blood pressure is now normal and I am scheduled for renal biopsies on Nov. 5th.

Scared shitless!
Drdnj

[Praetorian]

The most important thing is to monitor blood pressure on or off a cycle. Tren has gotten a bad rap over this and this really is just an over simplification. The biggest culprit to most kidney issues is high blood pressure because it destroys the tubules in the kidneys slowly over time. Any aas will cause an increase in sodium retention and thus water so it is important to keep hydrated as well as to monitor blood pressure. Creatinine levels need to be interpreted correctly. Anyone engaging in resistance training will see an increase in creatinine whether they are using aas or not...it doesnt matter. The key here being even if you are not experiencing symptoms you still need to monitor blood pressure and get regular blood work. A ounce of prevention = a pound of cure.

DRdnj...stay positive and keep your chin up!

P

[drdnj]

Thanks guys... I actually feel miraculously good---which suggests that I am not in complete failure. I know that my kidneys aren't well, but since I feel decent I am assuming that my GFR/creatinine values are not as bad as they seem. I am following the prescribed diet to the book, not on any supplements, anabolics, or otherwise---I am anxious to see what my biopsies, urine and bloods say in a few weeks.

[juice555]

Thanks guys... I actually feel miraculously good---which suggests that I am not in complete failure. I know that my kidneys aren't well, but since I feel decent I am assuming that my GFR/creatinine values are not as bad as they seem. I am following the prescribed diet to the book, not on any supplements, anabolics, or otherwise---I am anxious to see what my biopsies, urine and bloods say in a few weeks.

Well, I finally got the best answer modern medical science can relay for non-invasive kidney testing. My iGFR (99mTc DPTA radionuclide) test shows 111 ml/min [corrected]. The next day I went for a conventional [creatinine] test. I finally calculated the eGFR based on a few popular methods. Here are the results:

Creatinine medical lab calculation: 61 ml/min eGFR
Mayo Clinic: 84 ml/min eGFR
Cockcroft-Gault: 103 ml/min eGFR
Radioisotope: 111 ml/min iGFR

The 'gold standard' isotope method turns out to be higher than the estimated calculation methods.
From reading, the C-G equation seems best for those who are outside of the 'normal' bodyweight.
The Mayo-clinic estimation was shown to be the most accurate from all the estimated methods (non-isotope) within +=1. This might be the case for 'normal' bodyweights. In this case C-G came out on top.

I was shocked of the difference between the 'real' GFR of 111 and the medical-lab-estimated of 61. I am no colossal BB @5.8" 220lbs. I'm surprised that there aren't larger individuals complaining of out-of-spec GFRs. If my numbers extrapolate to others [i don't assume], the competitive BBs should be in final stage kidney disease based on the conventional testing.

I wish drdnj all the best. I know what it's like to worry about possible failing organ health.
The moral

[scottlove]

If I recall, didn't Gustavo pass away a couple years ago? Was it the kidney problems that took his life?

[drdnj]

I thought I would share my pathology report with you all. Let my case be a warning to you to keep on top of your blood work and blood pressure measures. I am now left with 20% functioning kidney and will be discussing the procedures for a transplant in 2 weeks. I will keep you posted. All of this could have been avoided had I addressed symptoms years ago. KEEP HEALTHY!
Specimen

A Kidney biopsy, left - left native kidney

Clinical Information

The following information was submitted electronically by the ordering physician:
body builder, steroids, nephrosis and elevated creat

Gross Description

The specimen and patient identifiers are reviewed and are verified. The specimen consists of 2 cores of pale tan tissue. The larger core measures 1.3 cm. The shorter core measures 0.8 cm. The shorter core is divided (0.3 to EM) and (0.5 cm for IF). The larger core is submitted for light microscopy. ar/sg/sa 2014/11/05 10:00

Microscopic Description

Light Microscopy

Sections of kidney biopsy contain 9 glomeruli, 6 of which are globally sclerosed. The non-globally sclerosed glomeruli show focal segmental sclerosis. Otherwise, there is no significant increase in cellularity, no tuft necrosis, mesangial expansion and basement membrane changes. There is a background of mild tubular atrophy and interstitial fibrosis. There is no significant inflammation. The vessels are unremarkable. Histochemical staining with Congo red is negative for amyloid.

Immunofluorescence

Frozen tissue contains up to 9 glomeruli, 8 of which are globally sclerosed and one segmentally sclerosed. Immunofluorescence labeling is negative with IgA, IgG, IgM, kappa, lambda, fibrinogen and C3.

Electron Microscopy

3 globally sclerosed glomeruli are in the original tissue submitted for electron microscopy studies. Due to the lack of non-sclerosed glomeruli, the frozen tissue and paraffin embedded samples were reprocessed and made into toluidine blue stained sections. Toluidine blue stained sections examined contain 9 glomeruli, 8 of which are globally sclerosed and one segmentally sclerosed. Electron microscopy studies reveal diffuse sclerosis, with wrinkling of the basement membranes and hyaline deposition. There are dense areas, however, no definitive electron dense deposits or abnormal bodies are identified.

Diagnosis

Kidney (native, left), biopsy:
- advanced glomerulosclerosis, with focal segmental glomerular sclerosis (see comment).

Comment

The biopsy reveal severe glomerulosclerosis, with 17 of 21 glomeruli examined globally sclerosed. Of the non globally sclerosed glomeruli there is focal segmental sclerosis pattern. No electron dense or immunofluorescent deposits are identified.


Reviewed and electronically signed by:

[paolana]

ask you doc to send your urine for and ACR test (albumin to creatinine ratio test). 24hours are more accurate, but they are always messed up somehow - it's a very difficult protocol to follow accuratley