In the meantime, my healthcare team ordered additional tests to see exactly how well my kidneys are (or more precisely are not) functioning. First a little background.
The "Gold Standard" for measuring kidney function is called the EGFR - medical jargon for Estimated Glomerular Filtration Rate. One healthcare provider explained it pretty simply: think of it as the percentage of kidney function that you have. In this test, bigger numbers mean you have more kidney function than lower numbers. Kidney disease has stages (like cancer) numbered 1 through 5 with 1 being normal and 5 being on dialysis or needing a transplant, I'd been at the bottom end of Stage 3 for a few years. As recently as July I was up to 33. Last month it dropped 19% to 26.7, which put me in Stage 4.
Normally an EGFR is a simple blood test. It is accurate enough, however some factors can skew the results. To see what my true kidney function was, a different GFR test was ordered. A a radioactive isotope was injected into my bloodstream and blood was drawn. Two hours later another blood sample was taken. The radioactivity was quatified as a way to determine exactly how well my kidneys were working. The actual GFR was 23.8 - down another 11% since September. Bad news.
You'd think that is pretty bad news, but what can I do about it? Actually, not much. Drink water, take your medicine, etc. But in real, concrete terms the best you can do is roll with it.
But out of this bad news, there might be a silver lining, maybe. Ideally, I wouldn't be sick, but that horse left the barn 23 years ago. Next best case is to make the best of things. I try to do that. Realistically, my kidneys will never get better. They're as good now as they will ever be in the future - with one exception. That exception is getting a new one. The point at which someone can be put on a transplant list is an EGFR of 20. While I'd prefer not to have to go through this process and life a relatively normal life without dealing with this, chances are that isn't in the cards. The next best option is a new kidney, and this test result puts me one step closer. For now, my team is starting to schedule some of the tests and evaluations that will be necessary to get me on the transplant list since I am much closer to needing one.