Latest labwork

So I got bloodwork done by my Dr. a little over a week ago. I immediately left his office and went to Labcorp to have the same bloodwork done there. I got my results from labcorp last week and my Dr. today. The Dr.'s lab says my Creatinine was 1.3 (egfr = 65). Labcorp says my creatinine was 1.43 (egfr = 57). So if both are to be believed, driving in your car for 15 minutes can drop your egfr 8 points. Seriously people, don't let a nephrologist stick you with a CKD diagnosis based on creatinine alone.

[WYOAnne]

One creatinine value does not CKD make! There has to be a trend over time of creatinine, eGFR, potassium, sodium, magnesium with urine results showing protein, albumin, etc. eGFR and creatinine can vary by hydration, your age, exercise and what you ate the night before, etc. This is why it has to be over time and see if there is a true decease in your kidney function. One test can be a little scary but it does not mean you have CKD.

[Hidden in reply to WYOAnne]

You are absolutely correct. The Kidney foundation says you must have 3 consecutive months of creatinine elevated to the point that your egfr stays below 60. The problem is creatinine is incredibly unreliable. If this were my third sub-60 egfr (which it is not) the Labcorp value would classify me as CKD stage 3. The Dr's value would not. This is why they really need to come up with a better way of diagnosing CKD!

[WYOAnne in reply to Hidden]

In the '90's they didn't have eGFR. My CKD stage was based on creatinine, BUN, symptoms, and other labs. When my creatinine was> 1.5 is when they did an ultrasound followed with a biopsy.

[Hidden in reply to WYOAnne]

I think your way is actually a better way to diagnose... egfr is cheap and easy, and our healthcare anymore is more about money than what is best for the patient.

[Bluejean2]

My gfr has been between 50 and 60 for last 15 years. Its absolute baloney that people under 60 gfr will keep decreasing. I think nephrologists promote this to drum up business.

[erniep15]

3 months ago my creatinine level was 1.59 and egfr 44, I was freaking out figured I'd be on a machine in a short time. Now (3 months later) levels are 1.4 and 53. Urine blood work is fine all other blood work is normal. Now just worried about the atom bomb (just a little humor).

I'm 74 years old and work out for 2 hours a day so hopefully I have a few more years. Avoid worry if Creatinine is a little high and drink lots of water a few days prior to blood tests, could reduce numbers and ease the worry.

[Blackknight1989]

No the “gold standard” is eGFR and UCAR as stated in the guidelines by NKF and ASN. Here is the link to both. These are incredibly inaccurate lab values. For example last year my eGFR was 17 in January and on July 31, after my COVID diagnosis it was 29. Think about that a 12 point fluctuation with a baseline of 17. That’s about an 80% variation. Instead the values are used to form a trend line to give a proper diagnosis. No matter how inaccurate the values if the TREND is stable the kidneys are stable.

Further, I don’t understand getting “stuck” with a diagnosis of CKD. If it was cancer wouldn’t you want a diagnosis to TREAT the disease instead of finding out 3/6/9 months later when it could be too late? I know there are bad docs out there but I don’t believe a nephrologist is going out of there way to misdiagnose patients. Quite the contrary, most of us get diagnosed or TOLD of the diagnosis too late, in stage 3 or 4. Creatinine hasn’t been used to diagnosis CKD since the new KDOQI. Please educate yourselves folks to know if a doc is up to date on their knowledge AND to be your own best advocate. If doc is wrong inform them and show the resources I’ll link. If they won’t change you change docs. The biggest issue currently with CKD is ignorance of patients AND doctor’s especially primary care docs. Several agencies in the US and Europe are trying to change the narrative but it’s a slow process.

I don’t mean to sound harsh or “know it all” like and I certainly have no wish to offend anyone, only to try to help. Take that for what you will and my apologies if I offended.

Links:

niddk.nih.gov/health-inform...

kidney.org/news/changing-fa...