Confused: GFR 63 but perfect ultrasound

[Sarahdottir]

Hi there, totally new to this. Hadn't heard of a GFR or CKD before I did a general blood test as part of a check-up. I'm 37 and my GFR was at 63, which led my doctor to schedule an ultrasound. Nothing was detected, everything looks fine. How is my GFR this low then? I don't understand. Does CKD not show up on ultrasound? Can the blood test be influenced by factors by not drinking a lot of liquids for a few days for example? Thanks for your answers! (Edit: I have no other symptoms whatsoever, this came totally out of the blue)

[Julesboz]

Hi there, well I’m pleasantly surprised the doctor arranged an ultrasound as the vast majority of the medical profession think anything over GFR 60 is considered normal and you won’t be diagnosed with CKD until you get to under 60 (I’m in the UK so it may be different where you are).GFR can be affected by many things and it really does fluctuate. Being dehydrated is definitely a factor, as well as other things. I have very mild CKD with a perfect ultrasound. I’m 52 and my GFR is currently 59 and it’s been like that for at least 10 years (in fact it’s fluctuated between 49 and 60 in that time). I’d talk to your doctor but it sounds like you shouldn’t be worrying. To help your kidneys maintain good function, reduce salt, processed foods, fizzy drinks and eat plenty of whole natural foods. Try and limit red meat, and for some people dairy is an issue. Moderate alcohol and relax and take regular exercise. Drink lots of water and avoid NSAIDs. Good luck!

[Sarahdottir in reply to Julesboz]

Thanks for the answer & advice! What worries me a bit is that none of the risk factors apply to me. No high blood pressure, no diabetes. I haven't eaten any meat for 6 years, I drink rarely, I don't smoke, I exercise, I don't drink soda, I don't eat much salt...so I can't really change anything to make it better... I'm paying attention now to taking in more fluids, but I can't imagine that's the sole reason for such a bad GFR. It seems really strange. Would a CKD show up on an ultrasound? Maybe I should do a renal scan? Glad to hear you were able to keep yours so stable!

[Julesboz in reply to Sarahdottir]

Hi there, I’m the same. I’ve got low blood pressure, no diabetes, low BMI, I eat healthily, don’t drink, have never smoked and exercise regularly. It’s just one of those things and my doctor has told me that some people just get CKD with no apparent cause. I’m not an expert at scans but I do know that filtration rate (GFR) is determined by blood test not scan and a scan wouldn’t show that. If you’ve had an ultrasound I would guess that would have shown up kidney stones and anything of concern so if that’s clear it’s a good sign. If you are concerned you should have a chat with your doctor and get some reassurance or further tests if they will do them.

[Sarahdottir in reply to Julesboz]

Thanks for your answer. That's so odd! How can there not be a cause. But happy to hear it's possible to keep the GFR stable

[Bet117 in reply to Julesboz]

Agreed. Like you, I have low to low normal BP, no edema, no diabetes etc. I was diagnosed with Membraneous Nephropathy in 2017..out of the blue.

The key is to continue to eat healthily, exercise, drink water and support each other.

[Sarahdottir in reply to Bet117]

I will definitely do that. Very happy about the support here, because talking to friends / family they just think I'm paranoid. But I think a GFR of 63 is something quite real!

[Bet117 in reply to Sarahdottir]

You are definately NOT paranoid! Something was found and you are being pro-active to get to the bottom of it.

If you have had an ultrasound which was negative, more than likely you won't need further high tech tests.

Relax as your GFR isn't terrible. I would take a look at your renal blood work as well as urine tests and discuss them with your doctor.

I believe those labs will give you a better idea as to your kidney function and possible kidney disorder.

I agree with Jules...great advice.

Feel free to continue to reach out to one of us as we will always reach back.

B..😊

[itzmich in reply to Bet117]

How was yours diagnosed? Biopsy?

[Bet117 in reply to itzmich]

Yes.

[Bet117 in reply to Sarahdottir]

Mr._Kidney or Orange City any wisdom on GFR, CKD and it's identification for Sarah based on your experience?

[Sarahdottir in reply to Bet117]

I just got back from the doctor and I now also did a urine test to check the protein levels and I'll have to see a nephrologist (unfortunately it's about a 3 months waiting time for an appointment). But so everything's on track and I'll find out eventually what's going on. My GP thinks it's most probably CKD. I'll update when I know more & thanks again!

[RickHow in reply to Sarahdottir]

lol. sorry . I meant to answer Jules original post, not yours

[orangecity41 in reply to Bet117]

I too was diagnosed out of the blue, and at stage 3b, and it was shocking. My blood pressure was good and am an active senior. I was given a renal diet to follow. It is good your Doctor is watching it. That is big plus. I suspect that when and if you reach the level that requires a diet, your doctor will advise, and you will be referred to a dietitian. It is always best to be proactive also and watch your levels on future bloodwork. You have come to a good forum to get support and information.

[Bet117 in reply to orangecity41]

Agreed and well stated!

Reach out and one of us will always reach back!

[LorrieC in reply to Sarahdottir]

I also thought I wasn't eating "much salt" until I began reading sodium content on each and every thing I put into my mouth. I was totally shocked as to how much sodium I was consuming. Now, I limit my sodium to 2,000 mg a day or less. My ankle swelling has decreased 90%, I've lost about 15 lbs and my b/p is much lower than average. My advice to you is to read labels. Good luck.

[mattjoachim in reply to Julesboz]

I am in UK also My gfr was 49 last time i had blood tests. i had kidney scans and after scans a kidney biopsy. Do you know if creatinine levels is looked at more than GFR lLast time doctor told me my creatinine was high, i have another appointment again in Nov. with doctor was wondering if i should ask him should i start on a certain diet as this was never suggested to me as i thought it was one of the first things doctor would look into

[Julesboz in reply to mattjoachim]

Hi Mattjoachim, I’m sorry I don’t know if doctors take more notice of creatine. In my experience all doctors will tell you to do is to cut down on salt and drink water. You would think it was the first thing they would suggest but it generally isn’t. I had to insist that I saw an NHS dietician because I have food intolerances and wanted to make sure my limited diet wasn’t contributing to the CKD. Normally you won’t be referred until you are at stage 4-5. I talked to the NHS dietician then did my own research on kidney friendly diets. I don’t restrict and monitor things like potassium and protein (which the dietician told me was unecessary at stage 3, unless blood tests indicated they should be). However I do try and avoid things that are generally bad for the kidneys - salt, processed foods, fizzy drinks, too much red meat, moderate alcohol, too much dairy, NDAIDs. I also drink water and eat lots of fresh whole foods, with lots of veg and fruit. My GFR has remained stable since taking this approach.

[Bet117]

Hi Sarah..

GFR can go up and down. You are in a low risk place.

Your doctor was on top of things by sending you for an ultrasound to check. Delighted it all looked good!

Keep an eye on your creatinine levels which indicate your kidney function. Did the doctor discuss that with you or if protein is spilling into the urine?

I had no outward symptoms and by sheer blink of the moment, my doctor ran a protein/ albumin level and found protein in the urine.

Until he gives you reasons to worry, sit tight.

Watch your salt intake and red meat consumption.

All will be good! 😊

[Sarahdottir in reply to Bet117]

Thanks for your answer and positive attitude I'm going back tomorrow because I want to request a urine test to check this. I don't eat any meat and not much salt and really live quite healthily, which is why this doesn't make sense to me and I'd really like to get to the bottom of this...There has to be a reason why it's at 63 and not around 100 as apparently it's supposed to be at my age

[RickHow]

Yours is a perfect example of what my doctors keep telling me. That this GFR "thing" is the best we have right now but is NOT anywhere near perfect. My 5 doctors (oncologist, kidney, gp, heart, urologist) all tell me the faults of GFR. That it reports "normal" based upon age, race, creatinine levels. But that is all it is. It really is NOT a reflection if the kidney is diseased (CKD) or not. For example, I have just one kidney as a result of cancer. I can not expect, for my age, my GFR to be "normal". That does not necessarily mean that the remaining kidney is diseased or failing. It simply can't do the work of two and produce normal results. There are just too many influencing factors inside and outside the body (food, fluid, exercise, medications, etc) that change the GFR from what a chart says would be normal. That is why it is generally just reported that if it is over 60 you are "normal". Because that "normal" can be a huge range from 60, to much higher. They all say that what is important in CKD or no CKD is testing. Blood, urine, ultrasounds. If these return results that show no irregularities then GFR anywhere over 60 is fine. Your doctor seems to be doing the same as mine. He saw GFR on the lower side of normal. Tested blood and an ultrasound. You are fine. Also remember also, that everyone's GFR, no matter who you are, declines with age. You will have a lower GFR at 63 than you did at 30, or 40, or 50.

It is NORMAL for a man in his 60's to have a GFR in the 60 to 70 range. For a man in his 20's or 30's this would be a problem.

[Sarahdottir in reply to RickHow]

Hi Rick, thanks for your answer. My doctor was alerted because I'm only 37 years old. But she sent me to a nephrologist now to make sure everything gets properly tested and stay on top of it. So I'm not too worried anymore, I feel like I'll be in good hands and there's not really anything else I can do right now. Hope you're doing ok!

[Bet117 in reply to Sarahdottir]

I am happy to see that your doctor is competent and on top of things.

I feel that sending you to a nephrologist is getting a second pair of eyes with some expertise.

The important thing is that they identify this as early as possible and you follow up with a good diet and some exercise.

Please let me know the outcome.

[CatOnACloud in reply to RickHow]

Hey Rick... I too had a kidney removed. Does your remaining show as double the normal size due to compensatory kidney function? It was all fine until I had a massive pulmonary embolism last year, now the 60+ is 45-55. I’m 47 with 30 years of single erm kidney-ness, so was wondering...

[RickHow in reply to CatOnACloud]

My remaining kidney did not increase in size to compensate. It was anticipated that is would, but it did not. They say that this usually does not happen in people over early 60's in age. They anticipated it would take about 12 to 18 months for the kidney to compensate. After months of just holding steady in all my tests, gfr levels, etc., just about 2 months ago things did start to change for me. My creatinine was always in the 1.8 or 1.9 range. Then I had a test and it went to 1.7. A couple of months later dropped to 1.44. Now about 3 months later is has achieved 1.22. There has been no measurement of the kidney lately. The kidney doctor says why bother as right now things are progressing nicely and in fact this may finally be the compensation they anticipated. Ironically I have a cyst on the kidney. It was quite large at time the other kidney was removed. It now practically covers the entire kidney. So it certainly is growing, yet the kidney is doing better than ever.

[vinadhun2 in reply to RickHow]

Glad to note good improvement in creatinine. How could you manage that.If you can elaborate, it would be of great help.

I am 72 year male with all parameters perfect. Literally everything including Diabetes, thyroid, cholesterol, no protein in urine , no swelling. All is normal. Except creatinine which is 1.90. Hence I am particularly interested.

[lowraind]

I was going to suggest a 24 hour urine test. It may provide more information and a nephrologist should have more information for you.

[Bet117 in reply to lowraind]

The nephrologist may do a 24 hour urine. It is their gold seal test as I have had several after a diversity of protein spilling was found in the spot urine test done in the lab and also the office and the 24 hour catch.

[curleytop1]

Hello Sarahdottir, I have just been reading your post re your bewilderment about your GFR reading of 63. By now you may have got more answers from your doctor about this, but no-one on here has mentioned that genetic factors could account for your situation, and no-one can really challenge them. This is my situation, both my brother and myself have diagnoses of CKD, he at 71 years old and me at 74 years old. As we are ageing so are our kidneys, and we have been told it is most probably inherited from our late mother.

Please try not to worry too much, just try to adopt a sensible kidney-friendly diet and enjoy all the years ahead of you. I think it is wonderful that your doctor is being so diligent and caring - you are very lucky in this respect. Good luck and please let us know how you get on - Curleytop1.

[My_Kidneys]

Maybe this website may help you with your confusion.

kidney.org/sites/default/fi...