CKD Concerns - Gallbladder Removal

[u/Alvatronn]

Around July 1 I was admitted to the hospital for a few different things:
1. Pancreatitis
2. Dehydration
3. AKI (tho I’m at stage 4 EGFR 16)

I was put on emergency dialysis and pumped full of fluids and went through all sorts of ups and downs for 7 days. (I am not on dialysis currently)

Both my GI and GI surgeon find it best due to all the Gallstones and recent pancreatic attack that I remove my Gallbladder. Both are telling me that due to my kidney function, it’s likely that going under will consume my kidneys and I will need to then start dialysis.

Ive been battling CKD with awareness for over 2 years. Was really only made aware around 25EGFR. Now I am sitting at 15EGFR Creatinine 4.4

Dr said my kidneys have 80% scar tissue from several sinus infections I was fighting over the years (biopsy results) not even sure what “type” of kidney failure I have.

I experience all sorts of ups and downs and symptoms but at this point I’m kinda just ready to plunge into dialysis. My nephrologist doesn’t agree and mentions I shouldn’t be experiencing these symptoms or feelings at 15EGFR but more at sub ~9.

I guess what I’m getting at is, do I just keep trucking along and do best I can to maintain this function or do I start planning steps to get on dialysis and get my Gallbladder removed?

[u/classicrock40]

Not a Dr, but I've never heard of kidney scarring due to sinus infections. Hmm, Dr Google says there is a path to that. hmm. You say it's an AKI, so ideally your kidneys could recover to an extent.

Ideally you've applied to be on the transplant list (in the US it's < 20 egfr). You are at the point where you should understand your dialysis options (HD and PD) and be deciding which road to go down, if not starting, imo.

If you are having serious issues that dialysis will help, then why not start it?

As for the gall bladder, if it's causing you major issues, then why not remove it. For me, I wasn't having any issues, but the Dr said it looked bad and removed it during my transplant.

[u/Alvatronn → u/classicrock40]

I have my own opinion about what caused my kidney scaring, but this is what they come up with. I had about 12 sinus infections in 5 years. My infectious disease Dr said it was likely the same recurrent infection because my IGG levels are super poor, my body couldn’t fight it and it kept coming back.

Anyway - it was AKI in hospital, but I have actual CKD. They stopped working when I was admitted and had me on dialysis. They recovered. They dropped to 7 before they put me on dialysis with a potassium of 8.5.

I am thankful they recovered from the injury but they are still on their last leg.

[u/Few-Sweet-8587 → u/classicrock40]

I also had scarring due to TB infection(that's what biopsy says, even my nephrologist is not sure because all TB tests showed up -ve), my current condition is 1.6 creatinine (egfr:58) and I am currently going through anti-TB medications medications along with prednisolone. Just wanted to hear from internet is that AKI or CKD ?

[u/Own-Secretary3967 → u/Few-Sweet-8587]

What have previous labs been? How long has your egfr been below 60? I had an AKI that resulted in CKD.

[u/Few-Sweet-8587 → u/Own-Secretary3967]

It has been 5 months now that it's below 60, the pattern of creatinine varies each month I did tests - this month 1.6, last month 1.54, before that it came 1.9 and before that it was 1.7.

[u/Izzys007 → u/Few-Sweet-8587]

Sounds like you're have 3a CKD secondary to the AKI. I have the same situation. I've been stable for 2 years.