MSK

I had my follow-up appointment with the nephrologist this morning to find out what's going on with my kidneys.  Here's the break-down, with additional information courtesy of the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC):

 

I have Medullary Sponge Kidney (MSK), a birth defect in the structure of my kidneys that means they have more of a cyst-like structure.  This interferes with the free-flowing of urine through the tubes inside the kidneys.  Statistically, this occurs in 1 out of every 5000-20000 people, but it's hard to know the exact numbers because people with MSK don't always present with symptoms.  Most often, the associated problems are blood in the urine, kidney stones. and urinary tract infections.  I didn't have any of these symptoms (but still may because they don't usually appear until ages 30-40, so there's still a chance!).  What was reassuring is that MSK on its own is very unlikely to lead to more serious problems like total kidney failure. 

 

People are most likely diagnosed with MSK after having repeated UTIs or kidney stones.  My MSK was diagnosed because my primary care physician was concerned about elevated creatinine levels.  She referred me to a specialist who ordered an ultrasound of my kidneys, which identified MSK.  I followed the lower protein diet of 80g/day for about 2 months to see if my creatinine levels went down.  When I redid the lab work, my creatinine levels came back at 1.07 which is within the normal range for women (upper limit of 1.1).  My 24-hour urine collection also indicated that my creatinine clearance was good (comparing creatinine levels in blood and urine).  So there were no flags and it was just determined that my kidneys have a tougher time processing higher quantities of protein because of the structural defect.

Now, there's no treatment for MSK.  It's a structural defect and it is what it is.  Instead, the focus is on treating the conditions that arise in relation to MSK (kidney stones, UTIs).  My doctor said I could take medication as a preventative measure to deter the formation of kidney stones but, given that I've never had any (yet), we all agreed that seemed like an excessive measure.

So what am I doing, now that I've got this official MSK diagnosis?  I still need to follow a lower-protein diet, but not necessarily as low as the 80g/day I've been following since early February.  The guideline is generally 1g for every kg that I weigh, which would put me in the 65g range.  The doctor encouraged me to try and stick with the 80g, but was understanding that I may eat more than that at times.  Still no 120-130g/day as I had been doing, but I can be a little less strict than I have been.  As for the medical side, I'm going to have my creatinine levels monitored every six months.  I've got a slightly higher baseline than typical, and the aim of the blood work is to make sure that I'm staying around that baseline.  

It's nice to finally know what's going on with my body.  Now I can take steps to figure out how I can take care of myself, working toward my various fitness and health goals.  I'm going to see if I can locate a sports nutritionist to help me modify my current meal plan so that there's flexibility and variety to keep me engaged and on-track.  

I must admit that I'm scarily excited about the prospect of being able to have a protein shake every now and then if I decide I want to have one!  Is that wrong?

Food Log

• Meal 1  
• 2 egg whites
• 40g oatmeal
  
• Meal 2 
• 3oz chicken
• Salad
• 2 tablespoons light salad dressing
• Meal 3
• 1oz almonds
• Light cheese
• Apple
• Meal 4
• 3oz chicken
• Green beans
• 2 tablespoons light salad dressing
• 40g oatmeal
• Generous tablespoon of peanut butter

Exercise:

• Time:  60 minutes on the elliptical
• Level:  Level 1 for 1 minute, Level 2 for 58 minutes, Level 1 for 1 minute
• Calories:  750+ 

Today's Weigh-In:  149.4 / 149.1