EGFR Calculation: Question on egfr... - Kidney Disease

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EGFR Calculation

apopnj01 profile image
17 Replies

Question on egfr calculation.

My gfr is approx 63 which the say "normal" by quest labs. I belong to a Kidney group on Facebook that promotes clean eating (no meats of any kind etc.) Their calculator has me at egfr 78. So far all labs are within normal range. The Quest labs do not take into account height and weight. Shouldn't that play into affect as well? The Quest labs results say i have the same metabolic rate as someone 53 yrs old 6'2" and 140 lbs. Im 53 yrs old 5'9 / 185lbs. Some food for thought.

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apopnj01 profile image
apopnj01
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orangecity41 profile image
orangecity41NKF Ambassador

The Cockcroft- Gault test uses weight in GFR calculation but not height. medcalc.com/gfr.html

apopnj01 profile image
apopnj01 in reply to orangecity41

i just calculated the egfr using my lab numbers : 78

I don't know anything about Facebook or any of its groups. I do know that anyone, individual or group that espouses only one way to eat to slow down the progression is being disingenuous at best. There is evidence that going vegetarian or vegan is beneficial however there is other evidence that including protein from some seafood and poultry is also acceptable, especially in the early stages of CKD. I've had seafood and poultry in my meal plan for almost four years and since I was diagnosed with a GFR of 32, since then my GFR average is at 52. I've included an in-depth look at GFR calculations and you can look it over and make the decision for yourself.

kidney.org/sites/default/fi...

apopnj01 profile image
apopnj01 in reply to

As usual Mr K thank you for the great information. Personally, i am thinking weight and height should make a difference but that is just my opinion.As a side note: i do agree wholeheartedly with you on including some protein. I usually get it from eggs / turkey / seafood and once in a while - i live in texas so.....brisket :-)

in reply to apopnj01

Now you've really hit me hard. When I received my diagnosis and met with my renal dietitian, I had to make choices and since it was possible to obtain some protein from seafood and poultry, I jumped at the chance. The hardest part of this was finding out that I couldn't have red meat. My beloved smoker had to go. No more ribs, smoked chicken and oh my, no more brisket. When I get to resume traveling I will have to go around Texas and Kansas City to avoid the smells from the barbecue joints. I'll have to make some strange detours.

Marvin8 profile image
Marvin8 in reply to

If allowed poultry, why not smoked chicken? Too salty?

in reply to Marvin8

Excessive sodium is one reason and another is what the issues the smoking of any food has on heart issues and that puts a strain on my kidneys that I don't want to deal with. Difficult to go without but better for a healthier heart and kidneys.

Marvin8 profile image
Marvin8 in reply to

Definitely tough to give up many of the great foods we enjoy most. Ribs are my favorite, and it truly sucks not to eat them any more, although I admit that I'll have one or two ribs off a friend's plate once a year or so. As for smoked foods, I had no idea they heightened the risks for people with kidney or heart disease. I guess that I'll only cheat if it's a grilled (boiled, then grilled) rib and not a smoked one. :D

apopnj01 profile image
apopnj01 in reply to

hard to give up my smoker - for sure! Clean living is where it is but sometimes......:-)

drmind profile image
drmind in reply to

Here I am trying to get with a kidney friendly diet and you have to mention bbq and ribs. My favorite is pulled pork with coleslaw and ribs. Ahhhhh. Oh, well. meantime I cannot locate a renal dietitian in my area that does not do only vegan menus. I am looking for a dietitian who can help with a modified vegetarian diet that includes meat and/or fish once or twice a week. All my labs are within normal range even though the GFR is low. So far, three dietitians that I contacted provided me with super vegan menus that I just cannot do right now. I've been a meat and potato cook most of my life and I'm trying to edge into a vegetarian diet slowly. I currently eat a lot of veggies and fruit, but I need help with other issues. I've also watched my sodium and potassium and try to keep the levels down. If anyone has a dietitian that has been helpful along the lines that I need, I wouldn't mind doing a telehealth wherever they may be. Although I live in a very populated area, it is heavily tourist and there is a scarcity of good medical and associated providers. Its been weird for me because i came from a relatively small college town with a medical school that had marvelous medical services in every area. Have a nice day everyone.

in reply to drmind

I'd suggest you go to eatright.org and in the upper right hand corner there will be a red box labeled FIND AN EXPERT. Click on that link and then enter your zip code and you'll get a list of dietitians. Look for a renal dietitian and go from there.Best of luck.

drmind profile image
drmind in reply to

Thanks for the information. You gave me this information a few months ago and i had no success then. This time, the site gave me about seven leads with only three specializes in renal diets. I've had contact with two with no success,. They were very pleasant and informative, but they relied heavily on vegan menus. I'm hoping the third one will be a winner. Still trying to plan meals around my labs. Thanks again and enjoy the day.

in reply to drmind

If that third one doesn't provide what you need contact any dialysis center or a local hospital. Those places also have renal dietitians on hand and possibly they might be able to work with you.Best of luck.

Darlenia profile image
Darlenia

Hi Apopnj01. Your observation has a lot of merit. Recently, I ran across a thread on here which pointed out the how kidney disease (and eligibility for transplants) is ignored for the black population based on stereotypical assumptions that they're all taller and heavier than other populations and so on. This is then reflected in their lab reports so they're not treated seriously until the disease is much further along. While some research facilities and labs are now quietly making adjustments (one can research this), it's time for all of them to come together and fine tune and truly individualize lab reports. Height, weight, and age should play significant roles in that picture. It's the 21st century after all.

apopnj01 profile image
apopnj01 in reply to Darlenia

Definitely agree with you - ex. taking age / weight/ height my egfr is 78 / quest first had me at 53 and than 62 with their calculation (doesn't take into account height and weight) - all other numbers right in the middle with bp 117/75 (no meds... yet:-)) It just puzzles me how they can group everyone together and think we all have same metabolic rates

horsie63 profile image
horsie63 in reply to Darlenia

My kidney doc uses this one with the provision that it accounts for body surface area given that I'm quite small the traditional method is not accurate.

kidney.org/professionals/kd...

It's also not race based, thankfully.

Blackknight1989 profile image
Blackknight1989

while all info is true you have received the eGFR calculation was changed worldwide in August 2021 to eliminate race from the equation. However, if you look towards the top of the forum I have posted 2 separate medical research studies explaining the nearly 50% inaccuracies in eGFR calculation regards mGFR. In one of those it relates “there are over 70 calculation to determine eGFR.” Thus while ASN, NIKKD and NKF recommend the correct way to calculate and the methods all labs should use they can’t MANDATE that advice. Which is why I encourage all CKD patients to become the second smartest person in their care team in this disease so you can advocate for yourself because most doctors knowledge of CKD is 20 years old and that is unacceptable to me. What I would do is talk to the your doctor and determine why they use Quest after determining a local lab that uses the correct method, and request the doctor use the new lab. If they resist change doctors.

All agencies recommend NOT reporting eGFR as a whole number to doctors or patients. The primary reason is eGFR is jot intended to be used as a one lab result example of kidney damage rather it should be used as a series of labs drawn at 3 or 6 months to manage the trend of kidney function. It is highly inaccurate and not intended to be mGFR ever. If reported as a whole number patients AND doctors become obsessed with that lab result only and live and die by the one reading. That leads to the posts we have a plethora of currently such as “I want to share my great news of how I am cured buy changing my diet and ordering Lee Hulls probiotics.” Or “”why do they say CKD isn’t reversible I know people and there is this guy on YouTube.” In CKD if your eGFR indicates you are stage 3 with a 40% decline in function that means you have destroyed 40% of the special blood filtering cells called nephrons and unlike liver or skin cells those do not regenerate. Thus you will never restore that 40% loss. The eGFR measurement can increase and be maintained many times without ever getting to the ERSD stage lifestyle changes and new medications to treat the underlying condition causing CKD but you can never restore those nephrons. I wish your family my best!

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