Here is a message from a patient with Renal Failure, in which she expressed the confusion about her medical conditions.
Hi doctor, my creatinine clearance was 17.26ml/mins, my 24 hour urinary protein was 342 and the machine value was 21.6, but I have no symptoms of a kidney failure person, like blood in urine, swelling of feet and shortness of breathe. I want to know why and I wonder where I stand.
From what she said, we can feel that she is very surprised about the severity of her disease and confused why she did not present some symptoms of Renal Failure. Actually, many patients have the similar experience that no obvious symptoms attract their attention, but it has been at the late stages of Renal Failure when it is diagnosed.
Renal compensation
The kidneys in the body boast a great compensation. Even if we lost one kidney, we still can feel normally. Only when more than half function of kidney fails emerge the obvious symptoms. The common urine test includes creatinine, protein and blood in urine. The patients usually never know about creatinine clearance test or GFR (glomeruli filtration rate). GFR is the best one reflecting the function of kidney and even more precise than the value of clearance creatinine test.
Late symptoms
Symptoms do not go hand in hand with pathological damages. They usually happen behind pathological damages. Even creatinine is dull to the damage of glomeruli. The normal values of test in proteinura or blood urine dose not mean that the kidneys are intact, because those tests can not give us the real degree of pathological damage. Although GFR is the most precise, most doctors tend to avoid efforts to get it. Traditionally, they just try to control the symptom at the beginning. Then they seem to wait for the creatinine exceeding 450 umol/L and make the patients receive dialysis, which just can remove creatinine and can not stop the more creatinine increasing. The point of 450 umol/L usually is a watershed, because at this time GFR is usually less than 30 ml/min. If the doctors take effective measures to control creatinine, it is possible to heighten GFR and stop the development of Renal Failure. However, the traditional treatments like hormone and immunosuppressant do not have this therapeutic effect.
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