Decreased Kidney Function: When to Adjust Diet and Exercise

Decreased renal function?

Hello Dr.
Wang,
At the end of last year, my health check showed the following kidney function values: blood urea nitrogen (BUN) 18.0 mg/dL, creatinine 1.2 mg/dL, and glomerular filtration rate (GFR) 78 mL/min.
Since mid-year, I have started exercising and following a high-protein diet (1.5 to 1.8 grams of protein per kilogram of body weight).
At the end of this year, my health check showed the following kidney function values: blood urea nitrogen (BUN) 21.1 mg/dL, creatinine 1.5 mg/dL, and glomerular filtration rate (GFR) 60 mL/min.
I would like to know if these values are still within a reasonable range or if I need to stop or adjust my exercise and diet.
Thank you!

Niming, 20~29 year old female. Ask Date: 2017/11/07

Dr. Wang Weijie reply Internal Medicine

Hello, due to your high-protein diet and long-term exercise habits, it is likely that your muscle mass has increased, which may result in elevated levels of creatinine and blood urea nitrogen in your bloodstream compared to the average person.
This can lead to a decrease in the estimated glomerular filtration rate (eGFR) based on standard calculations.
Therefore, if you wish to assess your actual kidney function, it is recommended that you stop exercising and following a high-protein diet for one week before having your blood drawn.
This will provide more accurate measurements of creatinine and blood urea nitrogen.
Additionally, it is advisable to perform a routine urinalysis to check for proteinuria and hematuria, which can help clarify whether there are any functional abnormalities in your kidneys.
Wishing you safety and health.
Sincerely, Dr.
Wang Wei-Jie, Attending Physician, Department of Nephrology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/11/07

More Info

Hello! Thank you for your question regarding kidney function and dietary adjustments. Based on the information you've provided, it appears that your kidney function has declined over the past year, as indicated by the increase in creatinine levels and the decrease in your estimated glomerular filtration rate (eGFR).
To begin with, it's important to understand that kidney function can be influenced by various factors, including diet, exercise, hydration, and underlying health conditions. Your recent health check results show that your creatinine level has increased from 1.2 to 1.5, and your eGFR has dropped from 78 to 60. This decline suggests that your kidneys are not filtering waste as effectively as they used to, which is a concern that should not be taken lightly.

Dietary Adjustments
Given your current kidney function status, it is crucial to consider adjusting your diet. High-protein diets, such as the one you mentioned (1.5 to 1.8 grams of protein per kilogram of body weight), can put additional strain on the kidneys, especially if there is already a decline in function. While protein is essential for muscle repair and growth, excessive intake can lead to increased production of nitrogenous waste, which the kidneys must filter out.
The American Kidney Fund and other health organizations recommend that individuals with chronic kidney disease (CKD) should limit their protein intake to about 0.6 to 0.8 grams per kilogram of body weight, particularly in the earlier stages of CKD. For those in more advanced stages, protein intake may need to be further restricted. Since your eGFR is now at 60, which indicates stage 2 CKD, it would be wise to consult with a nephrologist or a registered dietitian who specializes in kidney health to create a personalized dietary plan that meets your nutritional needs while protecting your kidney function.

Exercise Considerations
Regarding exercise, maintaining an active lifestyle is beneficial for overall health, including kidney health. However, the type and intensity of exercise may need to be adjusted based on your kidney function. Resistance training and moderate aerobic exercise can be beneficial, but it's essential to listen to your body and avoid overexertion, which can lead to dehydration and further stress on the kidneys.

Hydration
Hydration is another critical aspect to consider. Adequate fluid intake is necessary to help the kidneys function properly, but the amount of fluid you need can vary based on your level of physical activity, climate, and overall health. If you are exercising regularly, it's important to stay hydrated, but you should also be cautious not to overhydrate, especially if your kidney function is compromised.

Monitoring and Follow-Up
Given your recent changes in kidney function, regular monitoring of your kidney health is essential. This includes routine blood tests to check creatinine levels, eGFR, and other relevant markers. Additionally, monitoring for symptoms such as fatigue, swelling, or changes in urination can provide valuable information about your kidney health.

In summary, it is advisable to consider reducing your protein intake, maintain a balanced diet, stay hydrated, and adjust your exercise routine as needed. Consulting with healthcare professionals who specialize in kidney health will provide you with the best guidance tailored to your specific situation. Remember, early intervention and lifestyle adjustments can significantly impact the progression of kidney disease and overall health. Thank you for your inquiry, and I wish you the best in managing your kidney health!

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