First time out in the boat this yr and the weather was perfect, about 80º for the climb and about 60º at night. I met Bill M. on the river and we did the ~1500' climb up the mtn, 13 miles round trip.
I didn't really push hard, wanted to keep my HR under 170 as much as possible. It wasn't fast. My PR for the initial climb to the overlook is just under 32 min. This was only about 41 min. HR 160-170 for about 30m.
Latest test results.
Weird that there was so much change from my previous results only a couple weeks ago. Everything in these latest results were relatively normal.
Here's a comparison of these tests:
Lipids and glucose - 4/11 vs 5/7:
Cholesterol: 229, 190
LDL: 160, 123
HDL: 49, 42
Ratio: 4.7, 4.52
Triglycerides: 92, 141
Glucose: 89, 100
Kidney function (blood test)- 4/9 vs 4/24 vs 5/7
eGFR (blood - calc): 68, 57.82, 68.13
Creatinine: 1.17, 1.25, 1.20
Cystatin-C: 1.00
Kidney function (Urine Test) 5/7:
eGFR: 76
Urine Creatinine: 46.2 mg/dl
Micro-Albumin: 0.7 mg/dl
Albumin/Creatinine ratio: 15.1
Everything else including liver enzymes, etc... all normal. So I guess I'm ok. I will press Dr for an angiography when I see him on Wed, in light of my brother's issues and the higher LDL and ratio.
Cystatin c is the more accurate marker. Your creatinine is biased by high muscle mass, predicting worse than actual GFR. Do not be fooled by lower creatinine as you age as loss in muscle mass will lower creatinine. Many old people have declining kidney function with stable or falling creatinine due to sarcopenia.
ReplyDeleteHold on - you list cystatin c under urine test - that’s serum cystatin c, right?
ReplyDeleteI really don't know, maybe it was blood. I'll ask.
DeleteI have updated, results fall into the blood test range for cystatin-c, not urine test range. 1.00 is high normal.
DeleteOf course there is a urine cystatin c test but it doesn’t have clinical application other than for specific diseases. If your Dr had ordered urine cystatin c you should get a new Dr.. Once again cystatin is a superior endogenous marker as kidneys eliminate creatinine through glomerular filtration and also through tubular secretion. As GFR declines, tubular secretion increases to compensate, which masks early kidney disease. Cystatin c is filtered by the glomerulus, then entirely reabsorbed and catabolized by proximal tubular cells. It does not return to the bloodstream or undergo secretion, reflecting true glomerul filtration. (The “G” in eGFR) This is a critical distinction. Also cystatin c is insensitive to muscle mass, diet and exercise. Creatinine is more variable as hard exercise or eating a lot of protein can temporarily spike it, and it fluctuates with your circadian rhythm. Amazingly many doctors don’t even know of this significantly superior test for kidney function.
DeleteYour value of 1 for cystatin c is much closer to the middle of the range than 1.2 is for creatinine. This is good news and confirms that your creatinine value is under predicting kidney function due to muscle mass. So the atrophy and small stones identified on imaging are not (yet) having a significant effect. If you keep protein intake reasonable (more balanced, meaning replace some protein calories with calories from whole grains, legumes, and healthy fats) and stop obsessing about body weight (to avoid chronic dehydration ) you should be fine.
Very important point: kidney health and ability to filter out waste products is crucial to preventing coronary artery disease. If your kidneys are seriously declining it doesn’t matter what your cholesterol levels are, you will plug up your arteries. CKD patients almost always die from CVD.
Another little know fact: If you drink your morning liter of water quickly it doesn’t really help with dehydration. The rapid absorption dilutes your blood plasma, triggering hormonal suppression (Shutting Down ADH). Without ADH to signal your kidney tubules to pull water back into circulation, the kidneys open their floodgates. They rapidly excrete the newly introduced water as clear, dilute urine before it can reach your dehydrated tissues.Conversely, drinking slowly (e.g., over 45-60 minutes) introduces water in small increments. This allows your blood plasma concentration to stay relatively stable, keeping baseline ADH levels active so your tissues can actually capture and retain the hydration. Adding some sodium also helps as it maintains plasma osmolality (your brain doesn’t sense any dilution) so your kidneys do not dump the fluid.Try 250 mg to 500 mg of sodium per 1 liter of water.
In short sipping over a long period is significantly more hydrating and better for kidney health than drinking the same amount of water rapidly.
Drinking a large volume rapidly has application when you want to flush your kidneys, say after a contrast CT scans. But for daily rehydration and kidney health the same volume spread out over time is vastly superior.
Too much emphasis on medical science, testing and studies can be hazardous to your health. I love the guys that think they can extend their lives by studying, testing and learning new information. Same guys that were first to get the covid vaccine including all the boosters. Back to statins, if there's not a plaque problem, you don't need statins, regardless of your cholesterol levels. Period.
DeleteAgree with your first sentence. The remaining sentences show your scientific knowledge, or lack thereof.
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