LATEST eGFR Measurement Study News....MU... - Early CKD Support

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LATEST eGFR Measurement Study News....MUST READ!!!

Marvin8 profile image
20 Replies

Wanna drive yourself nuts? Enjoy! :D

medpagetoday.com/nephrology...

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Marvin8 profile image
Marvin8
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20 Replies
oceansplash profile image
oceansplash

That's a wide margin!

Marvin8 profile image
Marvin8 in reply tooceansplash

Absolutely unreal. Almost makes eGFR worthless.

oceansplash profile image
oceansplash in reply toMarvin8

By the way I'm already nuts!

That is huge!!

Marvin8 profile image
Marvin8 in reply to

Crazy, right? Almost makes eGFR worthless.

in reply toMarvin8

I know, makes you think huh?

FThomp profile image
FThomp

Does this just make the case for cystatin c that much stronger?! Maybe the medical community will get on board with something else than egfr?

Marvin8 profile image
Marvin8 in reply toFThomp

From what I've read over the past few years, the combined creatinine + cystatin c formula (CKD-EPI) was supposed to be so accurate (compared to creatinine alone) as to obviate the need for a true measured GFR. After reading this article, who the hell knows what to think any more? Nobody in the ckd community would have ever guessed that the margins for error could be so big. Maybe there's a reason most nephs just look at your creatinine levels? All I know is that this is rocking my world. To think that a person with an eGFR of 60 could actually be either 36 or 87 is absolutely mind-boggling.

tas1kubra profile image
tas1kubra

Honestly I am not that surprised. I was taken a cyntography. According to the results my left kidney is participating to its function around 38% and the right kidney is participating 62%. Maybe it sounds stupid but to me I expect my eGFR to be around 50%. However it barely goes higher than 40. By the way my creatinine clearance is around 42%, which has way higher reliable than eGFR.

userotc profile image
userotc

Presumably still OK for trending eg to indicate increases or decreases?

Marvin8 profile image
Marvin8 in reply touserotc

Sure, but due to the much larger margin of error, you'd need many more tests to compensate.

RickHow profile image
RickHow

As I have said in many other posts, my different care providers, of different specialties, all tell me to ignore Egfr and simply monitor my Creatinine levels. And that this too is not completely accurate of overall health of the kidney it is a good way to monitor if things go up or down over time. As this study points out the inaccuracies of eGFR there are a lot of reasons why it is not the best. Think of what it does. It is really simple. It takes your Creatinine level at the moment of the test and then basically (simplified) says is the patient male or female. Then it goes to that "chart" and finds your Egfr based upon your Creatinine level. Now Naturally this cannot be very accurate. I mean look around you. See all the different sized and shaped people in this world. See how some are muscular, some or not, some are overweight by hundreds of pounds, others are so thin the wind blows them away. Some are healthy some have diseases (diabetes, cancer, etc.). Some have one kidney, some have two. Some take medications which affect how much Creatinine is eliminated from their body, others do not. So just knowing someone's age, sex, creatinine level is simply not enough to say this is your GFR level with a great deal of accuracy. It is as it is named, an estimate. It is NOT useless as it can be used to track trends over time. But then again so can just tracking Creatinine levels. Another "bad" thing about it is the stage definitions. Think of it. Your egfr changes too based upon hydrations, what you recently ate, exercise, etc., etc. So you go one time, get tested, drop the eGFR by a single digit, and suddenly you are classified Stage 4, not 3b, for example. The fear of God comes over you, that you are now Stage 4, and ruins you. Yet the next test you go up 1 point of 2 and you are no longer Stage 4 but have spent 2 or 3 months worried sick that you are. This is a good approach for the patient??? I think not. Stages, estimations, chart lookups based on what is typically normal for your age and sex?

Marvin8 profile image
Marvin8 in reply toRickHow

Yes, yes, yes, and yes. I guess I didn't see a good deal of your posts. Thanks!

vinadhun2 profile image
vinadhun2 in reply toMarvin8

What I have read in some of the books is that Creatinine comes only from muscles and thus basing GFR on creatinine could lead to incorrect reesults.More accurate test is through Cystatin C measurement specially for older population

Marvin8 profile image
Marvin8 in reply tovinadhun2

Cystatin C is only good if you have no hypo or subclinical hypothyroidism or hyper/subclinical hyperthyroidism.

HisLittleOne profile image
HisLittleOne

This is precisely why my nephrologist says he doesn’t pay much attention to the eGFR but focuses his attention on my creatinine level and urine protein — albumin ratio. He tells me not to worry about the eGFR levels.

Bee28 profile image
Bee28

I have CKD3b with a single kidney. Aged 73yrs.My last GFR was 36 down from 41 and Creatanine 127 up from 113.

I am now back on veggies, drinking 2L plus per day water.

Not sure what has caused this change but after having an appointment on the phone with my doctor he said it could be muscle cells breaking down from working out in the gym?

itzmich profile image
itzmich

My nephrologist uses gfr as a guideline and advises me not to pay attention to the number. He looks at all the numbers to determine kidney functions.

Blackknight1989 profile image
Blackknight1989

That’ll do it Marvin. Actually the NIDDK info show that eGFR is accurate to within 30% of 80% of actual GFR. The kicker, UACR is just about as inaccurate!

Trends, baby, it’s all about trends in the data!

Adams_ profile image
Adams_

This drive me creasy.Just when i thought i started to understand how eGFR works.

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