The medical community has done it again and labelled millions as having "disease". There are hundreds of post on here of people labelled as having kidney "disease". And there is constant discussion if those in very early stages really have any disease at all. Or if it is just this "system" of converting your creatinine level into an eGFR rating and comparing the result on a chart to some studies and decisions by the medical community on what is "normal". So how many are labelled as "diseased" when they really are not, but are just experiencing normal decline or what is normal for them. As we all are different shapes and sizes and different medical history, how can anyone define normal. I just read an article in todays newspaper how this has been done again, to millions of Americans.
The article said that is now measured that almost 1/2 of all Americans (48 or 49 percent) now are considered to have cardiovascular disease. And huge increase in the number this past year. Why the huge increase? Why call so many as diseased? Because the medical industry changed the guidelines for what is high blood pressure. For a long time you were considered to have high blood pressure (which they label as cardio vascular disease) if you maintained readings of over 140. But they now changed it to you are high blood pressure if it is higher than 130/80. There were millions of people in the range between 130 to 140 that were NOT considered to have high blood pressure, thus no cardiovascular disease. After the change they are now considered as diseased. What was "normal" was changed with the flick of a pen. In fact in my community the association of doctors now considers you to have high blood pressure if it is over 120/80. YET, all my doctors tell me to not even give my blood pressure a second thought as long as it remains below 140/80 consistently. A flare above now and then is insignificant. (mine is in the 120's, some days low 130's).
This is a great example as to how it relates to CKD and the use of eGFR to label people as diseased. One day you are living a normal healthy life. All your testing shows no serious abnormalities. But a panel of doctors develops an average as to what is normal and applies it to people of all shapes, sizes, conditions. And labels those outside "normal" as diseased. Causing undo worry, stress, and changing lives. This just shows you that you must remember we are not all the same. We are different color, weight, height, medical history, medications, activity levels, and of course age. Just be sure to follow your own doctor(s) advice as they know you better than any chart on the wall, or formula on the computer. And they have access to all your blood and urine and radiology testing.
This is NOT saying that there are not people with serious, life changing diseases as CKD or CVD in these ranges. Of course there are. And it is heart breaking. But just because you fall into this range, does NOT mean you are one of them.
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RickHow
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I think what you say is so true Rickhow . As you know I was recently diagnosed with CKD ..efg 57 .... my doctor told me in recent years it has been in the 60s ... so here is my question . CKD ... has 5 stages . Stage 1 - reading of 90 or higher - Stage 2 - 89- 60 .Stage 3 , 59- 45, Stage 2 , 29-15, Stage 1 Less than 15. So why didn’t my doctor tell me many years ago o was in Stage 1- 2 of CKD. My thinking is - going off that statistics - I’ve had CKD practically all my life! ...
If I have ... I have been totally healthy all my life and it’s only now I am suffering- with the stress of doctor telling me I have CKD!
Well ..... Those guidelines weren’t even “invented” until 2002-2003 —- so what, 15 years??? It probably took a while for information to get around.
Also, most (at least of my) blood tests used the MDRD equation (or variations) to compute GFR. The MDRD is not accurate enough to give reliable results over a GFR of 60. So most people just saw “>60” on their lab tests. Since your GFR creeps down as you age (part of the Equation), suddenly people went from “>60” to the upper 50’s. We never saw 60 coming! I certainly didn’t see it. I was “>60” for years and then jumped one year to 59 or 58.
In the last couple of years, labs have started using the CKD-EPI equation which will go over 60. The premise of creatinine and age to predict GFR is still a bit “squeaky”. But at least people will start seeing 60 and below coming.
The CKD-EPI (as you probably know) has two "versions". One is uses the "standard" (average, typical) weight and height in the equation, based on your age, sex, race. The other "version" you can remove the "standard" measurements and input your own actual height and weight (called body surface adjustments in the formula). I have found quite a difference between the two. Using the "standard" body surface (which most doctors and labs do), my eGFR is always four points lower than when I use method of input of my actual height and weight. Now the difference can sound like little, just four points. But in my case, using the standard I am stage 3b. Using the actual I am stage 3a. Insignificant I know. And I imagine there are people who in one case could be called, for example stage 3a, but then using their actual numbers could fall into stage 2. Interesting.
I am 65 years old with a creatinine of 1.32 (last reading). It's a bit higher than normal for me because I am on ARB medications to lower blood pressure. ARB's tend to add a little bit onto creatinine measurements - but it assumed that it is better to lower blood pressure than to have higher serum creatinine.
When I put int my numbers into the standard formulas for MDRD and CKD-EPI - I get a GFR of 54 for MDRD and 56 for CKD-EPI.
But when I put in my REAL height and weight into the calculation, I get 63 for MDRD and 65 (!) for CKD-EPI. The bottom line here is when I put in my real height and weight into the CKD-EPI, I get a GFR that is 9 POINTS HIGHER! I go from stage 3a to stage 2.
MDRD goes from 54 to 63! Again - Stage 3a to Stage 2!
This calculator is given in earnest by some kidney outfit, but it really shows how much of this is a joke. As someone who spent many years studying and practicing lab science (me), I would have thrown this whole thing into the trash can at first sight! Labs use the non-height and weight adjusted number when telling you your GFR, but look at the difference? Frankly this is really a bunch of garbage.
I thought exactly the same thing! Thank you, why aren’t doctors informing patients long before they hit the magic number of 59! It really infuriates me they didn’t inform me several years ago. I would have immediately changed my life style
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