Sudden Decline in Kidney Function: Causes and Solutions

What could cause a sudden decline in kidney function?

In mid-December last year, my health check revealed a blood urea nitrogen level of 13, creatinine level of 1.7, uric acid level of 6.9, pH of 6, urine protein negative, specific gravity of 1.030, and blood pressure of 126/71.
In my last check in mid-January, the blood urea nitrogen was still 13, creatinine was 1.0, uric acid was 6.9, pH was 5, urine protein negative, specific gravity was 1.015, and blood pressure was 128/75.
I was born with only one kidney on the left side (the recent ultrasound showed a size of 12*6.5).
Recently, my blood pressure has been around 142/83.
I only received the report recently and have seen a nephrologist who has arranged for a follow-up test.
He mentioned that the creatinine levels might normalize, but the time has not yet come.
I am feeling a bit stressed.
I recall that around November, I experienced frequent diarrhea for almost a month, and even in the one or two weeks before the check, I had diarrhea with a mucus-like consistency.
I would like to ask the doctor: 1.
I always notice a few small bubbles in my urine that do not dissipate; could this indicate proteinuria? 2.
What could cause a rapid decline in kidney function to below normal levels in a short period? 3.
I usually drink a lot of tea, and I brew it at home, but sometimes I drink bottled tea when I'm out.
Could this be a major factor in the rapid decline of my kidney function? 4.
Should I start a low-protein diet now? 5.
My recent blood pressure readings are around 142/83, but I have been eating less and my diet has become lighter (mostly whole foods, without sauces), yet my blood pressure remains high.
Should I consider taking antihypertensive medication?

He S, 30~39 year old female. Ask Date: 2022/01/23

Dr. Wu Jiyu reply Internal Medicine

1.
The presence or absence of proteinuria is determined by testing, and your urine protein result is negative (-).
If you are still concerned, you can ask your physician to check the urine protein to creatinine ratio next time.

2.
In mid-December, your creatinine level was 1.7, and later in mid-January, it was 1.0.
There are many possible causes for this acute kidney injury, which may be related to your frequent diarrhea and dehydration in November.

3.
Generally, please drink plain water; tea should not cause acute kidney injury.

4.
Please discuss a low-protein diet with your physician.

5.
Please monitor your blood pressure over a period of time and record it.
You can bring this information to your next appointment for your physician's reference (if it frequently exceeds 130/80 mmHg, please manage it through diet and exercise).
Thank you for your inquiry; the Nephrology Department of Changhua Hospital cares about you.

Reply Date: 2022/01/23

More Info

Understanding a sudden decline in kidney function can be a complex issue, especially for individuals with pre-existing conditions or anatomical differences, such as having only one kidney. Based on the information provided, there are several factors to consider regarding your kidney health and overall well-being.

1. Presence of Bubbles in Urine: The small bubbles you observe in your urine may not necessarily indicate proteinuria, especially since your urine protein test came back negative. Bubbles can be caused by various factors, including the speed of urination, the concentration of urine, or even the presence of certain substances in the urine. However, if you are concerned about proteinuria, it would be prudent to discuss this with your nephrologist, who may recommend further testing, such as a urine protein-to-creatinine ratio.

2. Causes of Sudden Decline in Kidney Function: The acute rise in creatinine levels from 1.0 to 1.7 mg/dL suggests a possible acute kidney injury (AKI). This can be caused by several factors, including dehydration, which may have been exacerbated by your episodes of diarrhea in November. Dehydration can lead to reduced blood flow to the kidneys, causing them to function poorly. Other potential causes of AKI include medication effects, infections, or obstruction in the urinary tract. It is essential to identify and address the underlying cause to prevent further kidney damage.

3. Impact of Tea Consumption: While drinking tea in moderation is generally considered safe for kidney health, excessive consumption of certain types of tea, particularly those high in oxalates (like black tea), can contribute to kidney stone formation or other issues in susceptible individuals. However, it is unlikely that your tea consumption alone is the primary cause of a rapid decline in kidney function. It is advisable to maintain hydration with water and limit high-oxalate beverages if you have a history of kidney stones.

4. Dietary Considerations: The decision to start a low-protein diet should be made in consultation with your nephrologist. While a low-protein diet can be beneficial for individuals with chronic kidney disease to slow progression, it may not be necessary or appropriate for everyone, especially if your kidney function is still relatively stable. Your doctor can help tailor a diet that meets your nutritional needs while considering your kidney health.

5. Blood Pressure Management: Your blood pressure readings of 142/83 mmHg indicate that you are in the stage of elevated blood pressure. Lifestyle modifications, including dietary changes and increased physical activity, are essential first steps. However, if your blood pressure remains consistently high despite these changes, your healthcare provider may recommend antihypertensive medications. High blood pressure can further damage kidney function, so it is crucial to manage it effectively.

In summary, it is vital to maintain open communication with your healthcare provider regarding your kidney health, dietary choices, and blood pressure management. Regular monitoring and follow-up appointments will help ensure that any changes in your condition are addressed promptly. Additionally, staying hydrated, managing stress, and adhering to a balanced diet can contribute positively to your overall health and kidney function.

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