Nephrology appointment (for IgA nephropathy) & specific gravity test

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Two weeks ago, I had a follow up appointment with my nephrologist to monitor my IgA nephropathy. The visit was quick and included a review of my blood and urine tests from the week prior. My numbers are all stable right now with no real change since my last visit, so the watching and waiting continues. However, now that I’ve been seeing this new nephrologist for a year after moving here last fall, my next appointment will be in nine months instead of six.

I am really happy with my nephrologist here, mainly because he listens to me and takes me seriously, but also because he is always eager to explain things and go into greater detail about lab results and kidney function. One interesting thing I learned on this recent visit is what’s really behind the specific gravity urine test.

Now, I’ll preface this by saying that in the past, doctors have been quick to tell me I’m dehydrated and just need more fluids. I’ve been told this so many times from primary care and (especially) emergency room doctors that, for the past few years, I’ve been drinking as much water as I possibly can. It’s been one of the few consistent things I’ve heard over the years with no one saying anything to the contrary, and so I just accepted it.

However, as my nephrologist was going over my recent labs, he pointed out my specific gravity result that was at 1.004; the reference range is 1.001-1.035. Since my result fell within the normal range, I didn’t give it much thought. But, it caught my nephrologist’s attention and he explained that levels near the 1.035 end would be like walking through the Sahara Desert and levels near the 1.001 end, which is what I was near, was like drinking a melted igloo. So, I could go ahead and back off the fluids. (Thank goodness, because I was peeing constantly!)

Coincidentally, the day of my visit, I also had swelling in my right ankle with pitting edema that started a couple days prior. I asked my nephrologist about it, but because my numbers didn’t indicate that this was anything related to my kidneys, he recommended I follow up with my primary care doctor, which I did. But, armed with the new information that I was more than adequately hydrated, I cut back on my consumption of excess fluids and the swelling quickly went down and disappeared after just a few days.

So, long story short, my kidney function is holding steady right now. I’ll continue my current treatment of blood pressure medication to help protect my kidneys and will be seen at least once a year by my nephrologist to monitor my kidney function. Back to watching and waiting.

I have an appointment with my primary care provider next month, so that will mean a fresh set of labs for my routine annual appointment (which I’m more than happy to do because I like being able to see my lab results more frequently than once a year). Having just seen my gastroenterologist in August, I won’t follow up with him until February.

I do seem to have some quirky things occur here and there (like the random swelling in my ankle earlier this month or the emergency room visit last fall when I woke up to the room spinning and my body on fire), but the molehills never seem to turn into mountains. I often liken myself to the Energizer Bunny that just keeps going and going; and I’m glad that nothing is escalating. So I’ll just keep rolling with the punches.

With my appointment done and no real revelations (other than my hydration levels), I’ll keep doing what I’m doing: mostly fasting and trying to make sure I’m getting a variety of nutrients through diet and supplements. I’ve been taking it easy on my ankle and haven’t been doing many workouts, but I feel like I’m ready to jump back into those now, too (literally, since my workout is jumping on a trampoline!).

Until next time, be strong, be grateful, and keep going!

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