Need clarity with egfr

[ray777]

I recently did a routine blood work and my egfr values returned 74 with comment as normal , i have had and have a normal blood pressure . but on the global ckd the chart this is classiclassified as stage 2 ckd , why would the lab result comment it as normal?

[whooodaman]

It maybe normal for your age bracket

[userotc]

Essentially because medics can do little or nothing until it advances, with limited medical resources! It's a common comment on here at stage 3 or later/never eg my mum.

It's wrong because others eg Nutritional Therapists or we, can do something about ckd. My mum adopts a NT protocol and has doubled her eGFR in 6y.

[Sno125patrol in reply to userotc]

What’s an NT protocol ?

[userotc in reply to Sno125patrol]

A protocol using Nutritional Therapy. Heres a definition of NT which is widely adopted theanp.co.uk/therapies/nutr...

[BettysMom]

Most labs report every eGFR that is 60 or above as normal. It's just an estimated lab value. Following your creatinine level is much more useful.

[tas1kubra]

This relies on the definition of the disease, and stages. You might have gfr 80, but still have a chronical kidney disease. So lets differ them from each other.

Normally, your gfr shows your kidney performance, right? And lets keep in mind that, its just an estimation-not the measurement (meaning that 24h urine sample will provide the actual status of your kidney performance, but gfr just gives momentarily info which can alter any time of the day). By age, your gfr naturally decreases, but it does not necessarily because of a kidney disease. Its the nature, our organs get old and lose performance over time. But we dont define this situation as a chronical kidney disease.

On the other hand, when you have a kidney disease, if you are lucky it is spotted early. You still have kidney performance more than 60. This means you have the disease, but its still very early. So you are classified according to your gfr value, and if you have 74, you are in stage-2. Which is great compared to many CKD patients, because with control, you can definitely avoid kidney failure. But you still have the disease, right?

I guess you have a diagnosed kidney disease? If not, I dont know why your gfr is around 74, maybe you have an explanation for that, I am not sure. But if you have a kidney disease, you are in early stage of it, and you are under track. Also honestly don't focus on gfr. I was so obsessed with it, until I found out I can actually affect it. When I bike to my doctor appointment, it is high. When I take my last calm 1 day before my appointment, its low. But its never really giving the exact situation, because its an estimation. We know more for sure, by measuring our 24h urine, and then get a blood sample, and compare the values. Its called as creatinine clearance. Its a ratio of protein in your urine vs blood, because our kidneys are supposed to filter the protein and give it back to our blood. But when you leak protein, aka have CKD, this ratio drops. And you measure it to find out how much your kidneys are working in a day.

It has been 1.5 year since I know my disease; my creatinine varied between 1.6-1.9. When you convert it to gfr results change drastically (because its estimated as log function). But my creatinine clearance are more or less the same, it varies around 42-45. Which is quite normal fluctuation.

Sorry for this long explanation But for me, it was very painful, and I was sleep deprived because of these questions. I just wanted to provide a general aspect to this situation, because there are every kind of information on the internet that makes you easily very stressed. I hope it helps

[Cobalt2sister in reply to tas1kubra]

Wow that was so very helpful. Thank you so much!!

[tas1kubra in reply to Cobalt2sister]

thank you I would be very happy if I could clarify somethings, because they were very confusing and painful for me. When doctors diagnosed me, their approach was "There is nothing we can do for you, you will get ESRD in maximum 5 years, you should register for transplantation". Well... Their diagnose was wrong. I am curious to find out, how it will be in 5 years, but I feel like they were completely wrong. Even if they were right, the stress they caused was way too much. I was crying saying that I dont wanna die.

But then I found this platform. Talked to amazing people, and saw that you can actually live with kidney disease. Yes it has its challenges, but what was easy in my life already? Nothing! So I started reading lots of medical papers, talked with many people, moved from Turkey to Denmark; and my life changed completely. Now I know what to expect, what to worry, what not to worry. Personally I hate ambiguity, and not knowing what is going on with me. But I clarified every question in my mind one by one. And that helped me so much.

So I am trying to give back to the community, because they were with me in my darkest times

[vinadhun2 in reply to tas1kubra]

I have studied your reply carefully.

Kindly give your views on my case:

I am 75 years old.I have no other health issues means BP is normal, no diabetes, cholesterol is normal, all electrolytes are normal. No protein in Urine. BUN, Urea, uric acid are normal. Only creatinine is elevated at around 1.90.

As per your explanation above, Can I conclude that my creatinine has been elevated only due to age and I do not have CKD

[tas1kubra in reply to vinadhun2]

its best that if your doctor does the diagnosis; but many things actually affect creatinine level. For example once I had food poisoning and throwing up, and my creatinine was elevated to 1.5.

If you were dehydrated, you had physical activity a lot, etc... List is long to say that can affect your creatinine. What do your doctor says? Are you planing another blood measurement? It might be your age, your genetic factors, everything! Also 60 is the critical limit, that doctors take as a signal, so its understandable if your doctor is not worrying about this. And protein leakage is the marker for kidney disease, its by product of scars on your kidneys, so if you dont have protein in your urine, thats very relieving!

In kidney disease, long-term measurements play important role. Your doctor might ask a follow-up on your lab results. Did you talked about this? Did your doctor discussed any possibility with you?

To sum up; just take a deep breath. I am not a doctor, but I would be really surprised if your situation turns out something challenging. As I said, a decrease is expected on your kidneys after you are 50 years old, as far as I remember.

[vinadhun2 in reply to tas1kubra]

This has been there since last 5 years. and in my life, I have done blood work for the first time when I was 70. when I did blood work 5 years back and I found this out, I did everything possible and I did all the research so much that may be now I can earn PhD on this.

Anyway, I had met Nephro and he had said that it is due age and just keep on monitoring, which I have been doing. It is fluctuating between 1.75 and 2.

Just to add, I am not taking any medicine or tablet regularly for any issue

[ray777 in reply to tas1kubra]

Thank you so much for the detailed reply . i will provide more context

Earlier this year i met with my primary care provider and complained of reflux acid , and he prescribed pantoprazole 40 mg , i took it for 1 week and realized that my foot got swollen i alerted him and quit the meds , as at that march my egfr was 78 , and was commented normal on my blood work with creatinine of 1.2 . fast forward to July 4th for i visited the ER because i was having brain fog ( i was practicing intermittent fasting for 3 years the wrong way , my fasting was dry and i eat/drink from after 16hours and above ) they ran my vitals and said i was dehydrated and as such my kid function was a bit compromised with a creatinine of 1.5 and (2021 egfr of 58 ) this was how it was mentioned in the test and wi wouldnt know if that was current , because in my discharge documents they mentioned that i vape , which is error i dont smoke and i dont vape.

Two weeks ago , i ordered a personal test with a diagnostic center for another blood work and the egfr stood at 74 and creatinine of 1.22 , proteine in urine stood at negative .

Then same week , things took a different turn, i ran into an old chiropractor , he ran an xray on me and told me all my symtoms and he was 100% right , he said i have what is called SUBLUXATION which a condition where my nerves are compressed and inhibited communication between my brain and my organs , they started of on an 8 weeks decompression programme and behold after the first two visits my tingling on my feet went away and my edema disappeared, brain fog is gone too and try to stay hydrated .

at this point i am still circumspect in understanding the direct test for diagnosing ckd , what will be your most strategic advise?

[tas1kubra in reply to ray777]

Hmmm you have a different condition than me, because I have no other disease, just kidney disease. But in your situation as I understand you are asking if it might be secondary kidney disease?

I am really curious what your doctor is saying about this, do they see it as alarming? Because your creatinine levels might be totally because of what you have described, have you ever collected 24h urine?

[ray777 in reply to tas1kubra]

No I have never done that

[ray777 in reply to tas1kubra]

yes i am asking if it is a stage 2 , because my doctor did not flag it , the lab result comment ,was normal , but will do further digging , will also retest soon

[vinadhun2 in reply to tas1kubra]

As you have rightly mentioned creatinine goes up with age. In my case I am 75 and since last 4 years my creatinine is between 1.8 to 1.9. Rest all parameters are perfectly normal.

No B.P, no sugar, all electrolytes normal, BUN, Urea, Uric acid normal. No protein in urine.

So all is OK. My Nephro has asked to me to monitor.

I guess that I do not have CKD although simply based on Creatinine and my age Egfr is around 35.

It is hard to understand

[tas1kubra in reply to vinadhun2]

yeah, and I am 30 years old with same creatinine levels think about it It doesnt necessarily mean that you have CKD. But still, you should pay attention to your nutrition. Because even though you dont have active disease in your kidneys, still what you eat will be a load on your kidneys.

[Nagswoman]

Maybe your creatinine was normal.

[kwikc]

CKD stages start when you eGFR is less than around 90. Healthy young people often have eGFR well over 100. My nephrologist once claimed that readings in the area of 60 are not so accurate, but docs like to see ranges over 60, and if the reading is greater than 60, often times the lab won't even say what the exact number is. However, 60-89 indicates early stages of kidney disease, but that reading has more than one formula behind it, and several factors influence that reading which fluctuates a lot, because it is based on creatinine which fluctuates a lot. There are ways to get a better reading and more accurate, but that requires a mGFR or measured GFR which is much more expensive and time consuming. There is also a calculated measurement using Cystatin C which will give an even different result, probably lower. An there is one formula for calculating eGFR60. All very complex. And...never forget that there is a "normal" range for different age groups, because eGFR will usually--but not always--decline with age even without any disease being present.