I am a 51 y.o. caucasian woman with a GFR of 45, Creatinine of 1.27, 4.3 Albumin and BUN of 11. I am overweight, have slightly elevated cholesterol (204) though I exercise religiously 3x a week – 180 minutes total – doing cardio exercise, circuit training, and weight lifting. My BP is pretty average and I am not diabetic. My question is this: Am I at a point that I should pursue treatment with a nephrologist, or is it still relatively early? My GFR has dropped steadily for years and this is the highest creatinine reading I’ve had as well, so I am concerned.

The information that you provide would suggest that you have Stage 3 chronic kidney disease (CKD).  Most primary care physicians (PCP’s) are very capable of managing Stage 3 CKD.  The main treatment for your disease is likely to lose weight, keep your blood pressure less than 130/80, eat a healthy diet and exercise regularly.  You should not smoke and you should visit your physician at least twice per year.  You should have both blood and urine testing for your CKD.  There will likely be no benefit to seeing a nephrologist unless your PCP feels there is a need for a kidney biopsy in order to determine the cause of your kidney disease.

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