Lab Test Results for eGFR

[Silkdog]

Does anyone know why lab test results do not put an alert (in red) for any eGFR which is below 90? I use Quest Diagnostic, unless your eGFR is lower than 60, they will not list it as low (which will be marked in red to alert you). My eGFR has been between 61-76 in the last two years and my doctor never did tell me or alert me so I can take some precautions to slow down the progress. I was being alerted when my one of my last lab tests showed my eGFR was 59.

It would seem that Quest will put an alert if any eGFR is below 90, which will be at Stage 2 CKD, according to the definition of kidney disease.

[orangecity41 NKF Ambassador]

Here is link to article from Lab Corp labcorp.com/help/patient-te... "A normal eGFR for adults is greater than 90 mL/min/1.73m2, according to the National Kidney Foundation. (Clinical laboratories that use the MDRD equation to calculate eGFR will only report actual values that are less than 60 mL/min/1.73m2 because MDRD works best for estimating reduced kidney function. Clinical laboratories that use CKD-EPI equations often report all numerical values.)"

Possibly some of your tests may have used the MDRD equation as per Lab Corp and others CKD-EPI

[Silkdog in reply to orangecity41]

Thank you, orangecity41,

I am not sure what equation did my lab use. However, no matter what equation they used, according to the chart in the link, anyone whose eGFR is below 90 should be alerted, even though it's only at Stage 2. Early notification is always a good idea to take precaution in order to slow down the progress of any disease before it gets worse.

[ICE187]

I too use Quest Diagnostics. My eGFR was 76 about 2 months ago. It was 98 a few months earlier. My "former doctor" didn't mention anything related to it. My new dr diagnosed me with overt hypothyroidism and said he wasn't concerned, that my eGFR should rebound with my Levothyroxine meds. That still doesn't set to well with my worries. It seems like doctors generally don't worry until you reach stage 4 or 5. If you haven't done so already, create an account with Quest "My Quest" and you will see your labs before your doctor does in most cases.

[Silkdog in reply to ICE187]

Hello ICE187,

Yes, I have an account with MyQuest, that's how I was able to look at my last few years' lab results. It's crazy that doctors won't alert their patients until their eGFR fall down below 60. Didn't they realize early warning is very important to fight diseases?

[horsie63 in reply to Silkdog]

My experience has been unless there's a treatment such as dialysis or transplant for end stage kidney disease there's not much a regular doc will do. It's up to the patient to understand what's going on, get referred to specialists (neph, dietician, etc.) Most people have been told for years to eat right, exercise, get adequate sleep, don't eat junk food, etc. yet we have an epidemic of overweight and unhealthy people. If you are having blood work for some reason you should be monitoring the results and if you see an issue, alerted or not, bring it up to the doc who issued the need for test.

[Silkdog in reply to horsie63]

Hello horsie63, I understand that. My point is that doctors should alert their patients if their eGFR falls below 90 so they can take early precautions. I did my blood test for another health issue, so I never did consider looking at those results relating to my kidney functions. Until my doctor alerted me that I have Stage 3b, that's when I started learning more and more about kidney disease and about how to read the results.

[horsie63 in reply to Silkdog]

Was the numbers on the other test results? I look at each and every value on my lab work. Initially I had blood work due to a thyroid issue and that led to having a CMP done which showed my creatinine level and the area for the eGFR. Once I saw that I asked her what it meant and researched the numbers. I also asked for a referral to a nephrologist.

[Silkdog in reply to horsie63]

Hello horsie63,

It depends on what kinds of tests do my doctor want me to do. Sometimes it included kidney, liver, etc. and sometimes only for the specific issue I have. In the past, I didn't even get a physical copy of the results, I did a follow-up doctor visit, that's when my doctor briefed me what's on the results. I realized now that I depended too much on my doctor to analyze the results. The doctor's office used Quest and I just recently realized that I can open a MyQuest account and receive physical copies myself. That's what I did and also that's when I started learning how to read the results.

I have a doctor appointment next month and will ask for a nephrologist referral as well as a dietitian. It's difficult to find one by myself as there are so many to choose from.

[horsie63 in reply to Silkdog]

I've been fortunate in both my PCP and my neph taking time to answer any question and go over options. They listen to what I have to say and I bring a list with any concerns/questions/issues I may be having. While my PCP isn't a specialist, if she sees an issue she'll refer me to a specialist. It may be too that I'm an internal auditor and that leads me to question everything.

[Hidden]

None of my doctors said a word to me until my gfr was in the 20s! It's now in the 40s but I'm still pretty ticked off about THAT!

[Silkdog in reply to Hidden]

I don't blame you. To me, that's crazy!

[Denise-80 in reply to Hidden]

Same here. Doctor never mentioned GFR. He always told me my creatinine numbers. I knew I needed a transplant, just didn’t know the GFR numbers through the years.

[daggertxtx in reply to Denise-80]

How did you get it to go up into the 40s?

[Silkdog in reply to daggertxtx]

I have no idea. The previous result was 40, so my doctor wanted me to take another test, it came back at 48. I didn't do anything differently between the two tests.

[Porter20 in reply to Silkdog]

eGFR is estimated rate so lots of things play into this number. Hydration, protein consumed, medications.So it fluctuates daily. Rarely the same day to day.

[Porter20 in reply to Denise-80]

Most go off creatine & bun because eGRF changes with age and those numbers so it never really the same each time you test. Similar hopefully but usually goes up & down based on many factors.

[Silkdog]

I just talked to my doctor and he said it depends on the age. When you get older, your eGFR will tend to go down. He said doctors normally don't alert patients unless their number is below 60, which is stage 3. I would hope that will be changed as early warning is so important to fight any diseases.

[Sarah_402 in reply to Silkdog]

Yep early detection, couldn't agree more. Even someone 70 years old, there average eGFR is 75.

[orangecity41 NKF Ambassador in reply to Sarah_402]

Here is link from National Kidney Foundation on age relation to eGFR. kidney.org/atoz/content/gfr

[Silkdog in reply to orangecity41]

Thank you, orangecity41, for the link. Another reason I should have been warned about my eGFR being so low so I can take early precautions.

[orangecity41 NKF Ambassador in reply to Silkdog]

You are welcome. This is very true on being warned early by Doctor.

[Denise-80 in reply to Silkdog]

Barbara - That is interesting. Up until about about 1 year ago, the lab my doctor used only reported the upper limit of as >59. Now they are providing actual numbers above 59.

[Sarah_402]

I wasn't told either until my eGFR was in the 40s. I had several low readings (80s, 70s, 60s, 50s), following a downward tread before the 40 result. Probably worse is I had acute kidney disease and no one caught it until it became chronic. I have also read, like others, that numbers above 60 are not as accurate and age is a factor, but honestly its not that hard to pay attention to treads, monitor labs, and figure out someones age. It has happened to so many people on this site it seems like negligence to me. When I figured out I had kidney disease and looked at the data in my medical chart...it was clear as day to me, decreasing eGFR over 4 years, blood in the urine. Seemed really accurate to me. So I agree with you...

[Ziggydoodah]

I had blood test to determine why I was so tired. I thought it was maybe my thyroid. Everytime I phoned to get my results i was told they needed to do more bloods. This went on for 3 months, no mention of kidney function. One day a locum phoned me and asked if anyone had discussed being sent to a renal specialist. He was shocked when I said no. He immediately referred me.