GFR near 60 for 2.5 years

[AlwaysForward]

2.5 years ago I went to my doctor for a regular physical. He took blood and I was told I had a GFR of 59, two weeks later it was 54. Two weeks after that it was over 60. In the 2.5 years since it has been just over 60 every time. I am 48, not diabetic, no high blood pressure. I had a scan of my kidneys and there were not masses to worry about. I workout 5 times a week. I am hoping someone can tell me if dialysis is most likely inevitable. My doctor has not acted concerned at all but every 12 months I have blood work and all my kidney numbers are barely OK or just outside of normal range. I am just worried and hoping to get some guidance. Thanks

[MarBea]

Hello, I am newly diagnosed, so I can't offer any sage advice.

The fact that your physician does not act concerned is extremely troubling to me! I am concerned and I am not your physician! I am irritated that my new PCP did not mention my GFR a few months ago, when it had dropped from 99 a few years ago to 68. At least MENTION it went down 30 points, so I can start living differently! Did your PCP ask about supplements, diet, and water intake? I took a bag of supplements to my PCP today, and she said STOP everything except a low dose of Iron and Melatonin, so that we can at least rule out supplements. I have been reading on this topic like someone possessed, and I have read about GFR going up, after stopping all supplements. My PCP said, once my GFR goes up, I can introduce one or two supplements like Vitamin C and B complex, and then wait and check the levels again in a few weeks. She said I can do this, until I have introduced supplements, she feels I need. I wish you all the best, please keep us posted.

[Ladybug_05]

Hello! I was born with a solitary kidney with CKD, and I've done dialysis (both kinds) and was recently transplanted earlier this year. Just because your gfr is bouncing around, does not necessarily mean that you will need dialysis. Having a fluctuating gfr with those numbers could mean that you are dehydrated, have too much potassium, phosphorus and/or sodium in your diet which can be giving your kidneys a hard time, or something else entirely. I would definitely go and see about getting a second opinion and have some other tests done (creatine, phos, potassium, sodium, complete renal panel basically) and ask to be referred to a nephrologist and a renal dietitian.

In the mean time, doing a food and liquid diary can help you see what you consume and how much you are consuming daily. Some red flags to look for would include if you are frequently drinking soda, coffee or other caffeinated beverages and alcohol, frequently eating red meats, beans, nuts and/or dairy, and canned/boxed/processed foods. Generally, a good rule of thumb is to practice "clean eating." Which eliminates many of the above groups!

I would not recommend switching to a renal friendly diet before seeing a dietitian, as renal diets are based off of lab work, are highly individualized and have the potential to cause nutritional deficiencies due to the restrictive nature of the diet. I gave you are some things to look at when analyzing your diet habits and to have some insight that your PCP might not have. However, eating clean never hurts! It is also quite possible that your kidney function was damaged somehow and that would be your "normal"- also something that you would see a nephrologist about! Good luck!

[flanderscycling]

A lot of things factor in to the serum creatinine test used to determine your GFR. If you work out a lot (have more muscle mass than the average person) your serum creatinine and thus your GFR will be lower. Bodybuilders and even professional athletes in their 20s and 30s have GFR's in the low 30's with no kidney damage. GFR can also be affected by hydration, caffeine, stress, a diet high in protein, especially red meat and several other things. If you're taking protein supplements or any creatine supplements this will also lower your GFR. I would stop taking anything supplements or daily vitamins not specifically recommended by your doctor for the time being. If your urine is foamy that could be a sign of kidney damage and proteinuria (protein in urine). If you're concerned I would have the doctor perform the following tests in addition to the serum creatinine test:

BUN

Albumin

Urinalysis (will test multiple things and also determine if there is protein above the normal limit in your urine which is a sign your kidneys aren't functioning properly)

Urine Microalbumin

Electrolyte Panel (Sodium, , Potassium, Chloride, CO2)

Additional electrolyte tests (Calcium, Magnesium and Zinc and Phosphorus)

Vitamin D test

CBC test (Complete Blood Count)

At Age 30 my GFR was at 72, but I was working out an hour and half per day, sometimes more. I may have had kidney disease back then but telling my doctor this may have caused him to not run additional tests due to an assumption it was related to my diet and exercise routine/muscle mass. Four years later my GFR was down to 52 and I felt almost all the symptoms of kidney disease. It doesn't hurt to have a few extra tests done as a precaution and you'll have the results within a week. Good luck and I hope the results show your kidneys are functioning perfectly.

[WYOAnne NKF Ambassador]

GFR is just part of the picture in diagnosing CKD. You also have to realize that eGFR is but an estimate of how well your kidneys' filtration system is working. Your GFR level can be effected by being dehydrated and by stress. You said you work out 5 times a week, which can cause stress for your kidneys.

Has your doctor ordered other blood and urine tests? What is your creatinine, BUN? Is there protein or red blood cells, white blood cells in your urine? These can also be influenced by workouts in the gym and by your diet.

You need to talk to your doctor about all of this. Fluctuating GFR numbers can be the result of your exercise routine, diet and not drinking enough water.

[AlwaysForward]

I appreciate all the comments. To clarify, all of my kidney numbers are either out of normal range by a little bit or just inside of normal range. Also, I do work out 5 times a week but I am not a marathon runner or a power lifter. I jog a couple miles or do some light lifting for maybe 30 min on my lunch break. As for the crux of my post, I am just really scared. I am fearing I am going to either not live that long or be tied to a dialysis machine and feeling terrible. My doctor has given me no guidance. I sent him a note today but as of yet not heard back. Thanks

[Hidden]

Be VERY Thankful. Mine is 21.