UPDATE: Should I be concerned about a 23 (or 10 ) point drop in gfr in a year?

[jrex]

Hello. New to all of this and feeling overwhelmed. I'm a 72 year old female. I have almost controlled high blood pressure. I looked at my recent blood work and saw that my gfr was 54. So far my Dr. hasn't talked to me. Last year at this time I was at gfr of 75. That seems like a fast drop from what I've been reading. Does anyone else have a similar experience? Is that out of norm?

Thanks for any replies.

UPDATE: I finally got my blood work and thought I would share some numbers. First off now that I know a bit more I saw that I did not go up 23 points in a year but more like 10 points. I think the following numbers are the ones people focus on the most so here goes. EGFR 54.50, BUN 15, CREA 1.000, ALB 4.0. Blood work is tough when they only use LETTERS!

I am very pleased with these numbers. But I will also say I've learned enough this past week not to take it for granted. With help of fine people like yourselves and all the info that's available you can be sure I'll be giving my kidneys a lot of TLC!

[Hidden]

I would say it depends on several factors.

GFR can bounce around based on fluctuating creatinine levels. If you we’re dehydrated, for example, you creatinine may have been elevated. eGFRs seem to be fairly sensitive to even small fluctuations — that according to your GFR could look monumental.

My wife, who donated a kidney for me and has only a single kidney, has a 1.01 creatinine and her gfr resides in the 60s. Her creatinine, in my opinion, is good. Her gfr doesn’t appear wonderful. Yet, the one is based on another.

Do you have Chronic Kidney Disease?

In any case, I would just repeat labs and look for patterns.

I’ll send positive vibes your way 😀

[jrex in reply to Hidden]

Thanks! They had an awful time drawing the blood work that and asked if I was dehydrated. Maybe my follow up will show that was the problem. Time will tell. Thanks for the vibes!

[Hidden in reply to jrex]

😀

[Sophiebun11 in reply to jrex]

It's always a good idea to drink a full glass of water before a blood drawn, it makes it much easier for the phlebotomist.

[Milli77 in reply to jrex]

Drinking water before your blood test is always a good idea. Dehydration does cause a lower reading. If you drink a lot of water you reading maybe lower but does not necessarily mean your kidneys are working better. So everything in moderation.

[userotc in reply to Hidden]

Can I ask what the urinary protein and serum urea results are for your wife? I've been trying to understand why my mum's u/p has steadily increased and urea stayed high since her nephrectomy 4.5y ago. The only explanation I can find appears to be that she only has 1 kidney.

Her eGFR and serum creatinine have steadily improved over the same period

[Skeptix]

Definitely folk around here constantly talk of hydration and it's effect on eGFR. For info, the only blood metric used to calculate a typical eGFR is creatinine. Age and race are added to that.

Bassetmommer, a regular and informed poster here spoke of good hydration helping with the blood draw. Dunno how exactly but I know if I water my plants, everything plumps up - so perhaps veins too.

Don't pile into 16oz steaks in the days leading up to your blood draw. Cooked meat contains creatinine which would boost your blood levels and lower your eGFR.

Beat of luck with the next draw

[Sophiebun11]

Like everyone is saying, I wouldn't worry since it's only one time. You should probably get it repeated in 1 - 3 months and see how it looks then. If it's back up no worries. If it's the same or dropped a couple points ask to see a Nephrologist. Your Dr. can tell by other blood values if you were dehydrated, like your BUN level.

[jodaer]

I agree about drinking water before a blood draw. I'm in the Moderna study and they drew 6 vials of blood each time I went in. They told me to be sure and hydrate before coming.

[jrex]

Thanks everyone. I'll post back when I finally get the rest of the results on the blood draw. The test they do on the urine in the office was not normal either. So I'll just have to wait and see what happens.

[PecanSandie in reply to jrex]

The same exact thing happened to me. I am 73. I was at GFR 60; next year it went to 47; then the following year it went to 33. Now it's back up to 37. I thought the drop was caused by my blood pressure medication (so my doctor changed it) but when they did a scan they discovered my right kidney is smaller than the left kidney and it's filtering at less than 60%. Weird, right? No one knows if I was born with the small kidney or if it just shriveled on its own from being dehydrated - this is possible since I hate drinking water!

Have you ever had a DEXA scan to discover whether you have osteopoenia or osteoporosis? Along with my worsening kidneys my osteopoenia turned into osteoporosis.

Have you had your parathyroid levels checked? Mine is high because of the CKD and so the nephrologist prescribed a form of Vitamin D which is actually helping.

My takeaway is that every system and organ in your body depends on another organ or system and sometimes one of them will be "off" and it affects everything else.

[Skeptix in reply to PecanSandie]

Which form of vit D, if you don't mind me asking?

[PecanSandie in reply to Skeptix]

I take Calcitriol 3x a week.

[orangecity41 NKF Ambassador in reply to PecanSandie]

I take Vitamin D pills , 2000 iu. So far has helped the Vitamin D level.

[PecanSandie in reply to orangecity41]

I am not supposed to take regular Vit. D with Calcitriol. I think the reason is that it interferes with the testing. I noticed my Calcium pills had Vitamin D in them and I stopped taking them. My nephrologist says I don't need Calcium pills but my GP wants me to take 600 mg a day of Calcium (+ 600 mg from food). Ay ay ay.

[orangecity41 NKF Ambassador in reply to PecanSandie]

Yes it can be confusing when PD wants you to not take something but a specialist wants you to.

[jrex]

Honestly I haven't had anything checked. I've had a couple of major medical issues that seemed to have shadowed everything else.

[PecanSandie in reply to jrex]

I notice that you said that your bp was almost controlled. The same thing was happening to me. I was on a few BP medications and they seemed to work when I took my BP at home. However, anytime I went into the dr's office, it was high-ish. Then I went in for a procedure and my bp was so high that they sent me home. I called my GP about it and she added more medication. Finally, I feel my BP is under control. I always had the idea that the less medication a person took, the better but I no longer feel that way.

[jrex in reply to PecanSandie]

My gosh, this sound like me. Always fighting against more medication. I would have extremely high numbers in at Dr's office but could always get reasonable readings at home. It was put off as "white coat syndrome" but even at home it was higher than it should have been. I have to wait a few weeks for my next appointment but will be asking to get this bp under more control.

[Skeptix in reply to jrex]

Consider a 24 hour ambulatory. Its the gold standard and gives more accurate picture than office or home. I was taking mine, doing it right, averaging multie results etc. An ambulatory knocked about 10 points off my systolic!

It also has a look at your nighttime BP. It's important your BP dips at night and the 24 hr picks this up.

If getting BP meds, ask about taking them at night rather than morning. Indications are this is far better (a lot of heart attacks come upon waking)

[PecanSandie in reply to Skeptix]

I agree with you. The game changer for me was taking one of the medications before going to bed and taking the other in the morning. So the medications were spread out during the day and that seemed to help quite a bit.

[nellie237 in reply to Skeptix]

Hi Skeptix,

Did you use an Aktiia, or a cuff for the 24hr ambulatory?

[Skeptix in reply to nellie237]

A rented, calibrated unit from a chain pharmacy. I checked out the Akiita, the concept is great. But its nothing short of a scam - if you actually read their own site for scientific 'literature' it says that the unit cN't measure accurately. For example, standing measurements (where the wrist mounted unit is lowest wrt the heart produces accurate readings 25% of the time.

You're having a laugh, right??!

I was thinking of investing in a medical grade unit, given the role of BP. But your talking 1500-2000 $/€/£

[nellie237 in reply to Skeptix]

Thanks for doing the research .........I thought they might be too good to be true.

Did you manage to sleep with it on? Sore Arm?

I really need to do this, but have been putting it off because I'm a bit scared of adding back more BP meds after the AKI.

I don't think we can rent them in England, but GP's have them, so I'll get myself on the waiting list.

[Skeptix in reply to nellie237]

England? I got my from Boots in Ireland so likely u2. €50 and you get a printed report, some graphs. It was a bit of awkward alright when sleeping but not terminally so.

It gives you a 30 sec or so warning of impending measurement. Enough to 'assum the position' and aid accurate measurement. It's quiet and unobtrusive, not clattering away.like my Omron.

I took a BP drop compared to the Omron (which I calibrate off the doctors unit) so worth doing perhaps.

You also get a view into overnight BP which is, apparently, more important than daytime readings

[nellie237 in reply to Skeptix]

Thanks again, I'll have a look at Boots here....hopefully better than what will be the GP's undoubtedly out-dated kit.

[PecanSandie]

Finding the correct balance of BP medication is kind of experimental....a doctor will adjust the doses until your pressure is under control. It might take a while to get the right balance and the right drugs. And the doctor has to keep your gfr stable in the process. It's really a balancing act.. The most important thing is that you and your doctor work together to make sure you get it right.

[Milli77 in reply to PecanSandie]

So true, blood pressure meds can be very dangerous if you blood pressure goes either too high or low, both cause kidney damage.