Tudor Lodge Surgery
If we have sent you a link to this page, your blood tests show that your kidneys are not working quite as well as they should. This is called chronic kidney disease (CKD), and for most people it is stage 3. Please do not worry: it is very common, especially as we get older, it usually causes no symptoms, and there is a lot you can do to protect your kidneys.
What stage 3 means
3a
Mild to moderately reduced kidney function. Your kidneys are still doing most of their job.
3b
Moderately reduced kidney function. We will check your blood and urine more often and look closely at your medicines.
Most people with stage 3 feel completely well. Some notice tiredness, swollen ankles or hands, itchy skin, muscle cramps, or needing to pass urine more or less often. Let us know if you notice any of these.
How you can help yourself
The same things cause both kidney disease and heart disease: high blood pressure, high cholesterol, diabetes and smoking. So everything that keeps your heart healthy also protects your kidneys and helps stop CKD getting worse.
Also: avoid anti-inflammatory painkillers such as ibuprofen, naproxen and diclofenac unless a doctor has said they are safe for you, as they can harm your kidneys. Paracetamol is usually a safer choice. Always tell your pharmacist you have CKD before buying medicines, herbal remedies or supplements.
Sick day rules
Some medicines can harm your kidneys if you become dehydrated. If you are unwell, you may need to stop them for a short time and restart once you are better. These are called sick day rules.
Only if you take them and only while you are unwell. Keep drinking fluids if you can.
The medicine groups are listed below.
Restart your usual doses 24 to 48 hours after you are eating and drinking normally. Do not take extra to make up for missed doses.
If you are no better after 48 hours, contact us.
Your tests
We check your kidneys with two simple tests, usually at least once a year. Together they tell us your CKD stage and how closely we need to keep an eye on things.
eGFR
eGFR stands for estimated glomerular filtration rate. In plain English, it is an estimate of how much blood your kidneys clean every minute. It is worked out from a waste product in your blood called creatinine, along with your age and sex.
You can think of it roughly as a percentage of normal kidney function: an eGFR of 50 means your kidneys are working at about half the rate of healthy young kidneys. A higher number is better. Over 90 is normal, and it naturally falls a little as we get older.
ACR
ACR stands for albumin to creatinine ratio. Healthy kidneys work like a fine sieve: they let waste out into your urine but keep useful things, such as a protein called albumin, in your blood. When kidneys are damaged, some albumin leaks through into your urine.
The ACR test measures how much albumin is in your urine. A lower number is better. Under 3 is normal. Please bring an early morning urine sample if we ask for one, as it gives the most accurate result.
Enter your latest results (you can find them in the NHS App), or tap a square on the chart.
| eGFR | A1ACR under 3 | A23 to 30 | A3over 30 |
|---|
Your result
Enter your eGFR, or tap a square on the chart, to see what it means.
CKD is only diagnosed when results stay abnormal for more than 3 months. One low result can be caused by dehydration, illness or a big meat meal the day before. This tool is a guide only. Please talk to us about your own results.
Kidneys and your heart
The same things cause both: high blood pressure, high cholesterol, diabetes and smoking. CKD also increases your risk of heart attack and stroke. That is why we may offer you a statin to lower your cholesterol, even if your cholesterol level is normal. Medicines such as SGLT2 inhibitors (for example dapagliflozin) can also help slow CKD and protect your heart.
When to get help
For chest pain, or signs of a stroke such as a drooping face, arm weakness or slurred speech, call 999.
Support and more information
Based on NICE guideline NG203, NICE Clinical Knowledge Summaries, NHS sick day guidance, Kidney Care UK and Kidney Research UK. General information for our patients; it does not replace advice about your own care.
Did you know?
Alcohol can raise blood pressure, add hidden calories, upset blood sugar and strain your liver and kidneys. That pint could have as many calories as a cheeseburger!