Need help to understand what eGFR 63 ml/mn/l stand for

[Adams_]

Hi everyoneI am 54 years old and I was newly diagnosed with eGFR 63ml/mn/1,73 and 113umol/ créatinine.

Can anyone tell me if that means i have a kidney condition and how serious can it be?thank a lot for your advises.

[Marvin8]

You have a mild case (Stage 2 out of 5) of CKD that if taken care of thru diet, exercise, hydration, and proper sleep, shouldn't progress much. That being said, you should have it checked again in a few months to verify that the creatinine level is the same or better. If the creatinine level goes down, you might not have CKD at all.

[Adams_ in reply to Marvin8]

Hi MarvinThank you very much for your answer.Back to 2011 my creatinine was already 12mg then 13,9 mg in 2016 and today 12,8 mg.I heard that this amount can't decrease so i am a bit surprise to have less creatine in 2022 than back to 2016.

I have to admit that from 2011 and 2017 i didnt have a healfy life at all ( bad food, alcohol,....i did all the opposite than i should have done to care for my kidney!...) but in another way i have always exercise myself for years ( musculation, jogging....) .

I will follow your recommandation for sure.

Sorry for my "broken" english but it s not my mother tong.

[Marvin8 in reply to Adams_]

1.2 to 1.4 to 1.3 over 11 years is pretty stable. You'll be fine if you maintain a healthy lifestyle and avoid dehydration.

[Adams_ in reply to Marvin8]

What do you mean by dehydration?how much liter per day should i drink if i get you and what suppose to be the limit?Thank you very much

[Marvin8 in reply to Adams_]

You've just asked the $64,000 question to which is the answer is unknown. Worse yet, there's very little research on the subject on the subject. All I can say is that it's best to ask your nephrologist for their opinion, then ask if they can back up that opinion with research, which they can't. The only real "rule of thumb" answer I've heard is to drink approximately half your body weight in ounces...ie...for a 150lb person, drink around 75 oz. Of course, that doesn't take into account your exercise sweat, environment, or a host of other factors. I sure wish more money was devoted to research the subject since it's so important to the ckd population. Sorry for the vague answer.

[Adams_ in reply to Marvin8]

Thank you very much but as far as i can see nothing is about certainty when it comes to this disease. It looks like that the individual genetic as a lot to say even we respect a healthy way of life.

[horsie63 in reply to Adams_]

go by urine color…it should be a light yellow … if it’s clear you may be over hydrating… if it’s dark you could be dehydrated. Too much is as bad as too little.

[Adams_ in reply to horsie63]

I do agree with you i will drink as much as my body will ask for it except if i have contre indicat

[Marvin8 in reply to Adams_]

You are absolutely correct.

[Adams_ in reply to Marvin8]

Correct me if i am wrong but from what i read so far it looks like that the logic of this sickness is to worsen with the time ( 5,10,20 years depend on everybody else constitution ) and whatever you do you will reach a point where transfusion or kidney donors will be needed!Is that thrue from your point of view?

[Marvin8 in reply to Adams_]

Not necessarily true. Too many variables to take into consideration. CKD patients tend to lose around 1 gfr pt. per year and with so many variables to take into consideration, it's really hard to say. Unfortunately, the sad truth is that the vast overwhelming majority of CKD patients never make it dialysis or transplant stages. Why? They die from cardiovascular disease/events first. This is because having ckd raises the risk of CVD by nearly 20 fold. Just try to take care of yourself the best you can. I was diagnosed six years ago with an eGFR of 59. At worst, my eGFR was 52 last fall. A month ago it was 56. It appears to be fairly stable and I'm not yet leaking protein. I simply try to take good care of myself.

Oh, and to make matters even more confusing, my eGFR calculated from Cystatin-C puts me at 103! I no longer put a lot of faith in the Cystatin-C calculation because it is so easily affected by thyroid issues, even small ones. Subclinical hypothyroidism (which I may or may not have) will lower Cystatin-C levels, which in turn will raise eGFR. The opposite occurs with hyperthyroidism. On the flip side, muscle mass can easily throw off the creatinine eGFR calculation. Remember, the calculator formulas are based on population AVERAGES, not YOU.

[Adams_ in reply to Marvin8]

I really appreciate your point of view.Are you scientist or have you done your own personnal research regarding your own case?Too much parameters has to be taken in account to be able to have a correct reading of eGFR which can change from one day to another one ( like the weather,isn't ).Look at yourself with cystatine.-C ( by the way and if you can let me know how to calculate mine )

It might be important to focus my attention as much possible as i can on the other's blood parameters ( potassium,sodium,proteïn) to avoid cardiovascular problems ).

As well our own personnal genetic plays or not for us.

The most difficult with this situation is to know what to allow to yourself in term of food,drink... and keep away from your mind that eGfr drive your life for ever.

[Marvin8 in reply to Adams_]

Cystatin C is a blood protein and is not nearly as correlated with muscle mass as creatinine is. Creatinine is byproduct of protein breakdown. I was in the exact same boat as you are now, and I've spent tons and tons of time researching....probably too much. You are right when you say that it's probably best to focus your attention on the other issues than creatinine level eGFR. And yes, genetics probably plays a large part. Your last sentence about the most difficult thing being what to allow yourself in terms of food, drink, and not focusing your mind on eGFR is spot on. Best of luck and kidney health to you.

[Adams_ in reply to Marvin8]

Thank you very much for sharing with us your experience.I can see you went deeply inside the topic to find out the best answer possible if there is.You have a global approach without exclusive which is very interesting. I will keep you updated time by time if you don't mind.

[Adams_ in reply to Marvin8]

I forgot to ask you what cystatine-C stand for exactly?should i look for it even if i can see you have doubt.You said patient with CDK have tendancy to loose almost 1gfr pt per year but if i look at myself i went from 123 in 2016 to 113 in 2022 ,it's a "gain" much more than à loss, isn't?same to you with another number.

How in this condition based our full trust on eGFR?

[Marvin8 in reply to Adams_]

Fyi, here's a kidney function calculator for you. You can use the creatinine, cycstatin c, or the combination formula;

kidney.org/professionals/kd...

[Adams_ in reply to Marvin8]

I have tried to calculate my eGFR from the calculator.I have got to different results.

- the first one ( with adjust for body surface ) gave me an estimated CKD-EPI of 75 eGFR

- The second one ( Standardized assays ) gave an estimated CDK-EPI of 67 eGFR ( not too far from my actually 63 eGFR, even there there is a difference ).

The gap beetween both of them surprise me a lot.Which one should be more acurate? or it doesn't matter?does the method of calculation is based on international standard?

[Marvin8 in reply to Adams_]

I really can't give a good answer to this one. All I can say is that most nephrologists are suspicious of eGFR calculations and prefer to view trends in creatinine levels instead. Perhaps they just don't want to keep up with the latest research on eGFR calculators. As I said, I really don't know. From what I've read, the most accurate estimation formula is the ckd-epi formula that uses both creatinine and cystatin c, but again, they're not perfect. My hunch is that the more information you can feed into a calculator, the more accurate the estimation, but none of these calculators take muscle mass into consideration, hydration levels, true bmi, etc. And talk about gaps, re-read above; my creatinine vs. cystatin c eGFR gap is nearly 50 pts!

[Adams_ in reply to Marvin8]

Too much parameters to be taken in account to have a perfect reading of eGFR calculation.It can give a good indication ( mostly ) but the margin of error is still there ( i would say plus or less 10%).Better to view trends in creatinine levels instead.

[Marvin8 in reply to Adams_]

Whether you have Type-2 diabetes or not, this article should prove edifying if not downright anger-provoking.

karger.com/Article/Fulltext...

[Adams_ in reply to Marvin8]

This is absolutely incredible.The margin of error is too important to ignore those contradictions.Science is not a postulate but at this level of blindness it is.Thanks for sharing those kind of informations.

[Tempest1]

Hi,

I was similar to you a few months I'm ,54, female. I had 123 creatinine and egfr of 48. I was told I was dehydrated. After a couple of weeks of increasing my water intake ( I did not drink enough) I got retested and my creatinine dropped to 80 and egfr is 72. Anything over 60 in UK is classed as normal . My other bloods like urea, potassium, all normal as was urine sample. Ultrasound normal . My GP said that such a good turn around on my bloods in a short time would not have happened if I had CKD . I would get retested. I am changing my eating habits as my egfr is not ideal and shows some loss of kidney function which I'm hoping is age related . Hope this helps. I have put a few posts on here as like you I was concerned. I have had some really good feedback from people on here who are brilliant with given advice and reassurance.

[Adams_ in reply to Tempest1]

Thank you very much for your answer.I learn from everybody else experience and it is important to understand what's going on with our kidneys to make sure to take the best action to préservé our health.But i don t know if egc above 6o is as well good for man?

[Tempest1 in reply to Adams_]

Hi,yeah in UK egfr anything over 60 is standard normal for male and female. Remember it's a estimate reading using a formula. There can be variations on these readings. If everything else is within normal range in your bloods and your urine is ok, protein then I would think things are ok. Get another check in a few months to see is things change or have stayed the same. . Stay well hydrated and eat a healthy diet. As I said I was dehydrated and dramatically got my numbers back to a normal level in a week.

[Adams_ in reply to Tempest1]

Thank you again your words give me hope.As soon as i knew about my kidney problem i starter to drink much less water brmecause i read that the more you drink the less your kidney works and better you care for them.I was absolutely wrong as i can see!

[Tempest1 in reply to Adams_]

Hi,

The thing to check again is your creatinine if this gives down it's probably dehydration . I aim for two litres of water aday. Or 8 cups or water, mugs of water, whatever you have a cup of tea or coffee in. If you look online at what you should drink for healthy lifestyle that's the normal unless you have been told not to drink too much fluid. I would talk to your doctor about your results and what they mean for you as everybody has different health issues and medications that can affect blood results.

[Adams_ in reply to Tempest1]

My creatinine lebel went to 106 (2011 ) to 113 in 2022 ( last check) with a hight at 123 in 2016.Everybody is talking about healfy life and diet to keep good care of the situation and i do agree with that because it make sens.But to be really honest from 2011 till 2021 i did all wrong to care for my kidneys ( alcool,salt ,junk food....) so how and why my lebel did not went total ly down after almost 10 years of " bad" life?

Don't confuse me i do not say this is the way to follow ( this is madness) i am just trying to know why and how it happens?

To make it clear i knew my condition recently (2022 ) even my creatine lebel was already low in 2011 no one told me about MRC i am the only one to answer myself regarding my blood test then my New doctor talked to me about it!

[Tempest1 in reply to Adams_]

Hi,

I'm afraid you'll have to ask a expert why your levels have not dropped dramatically after not living a healthy lifestyle for a few years. Not everyone will follow a text book scinario where living a unhealthy lifestyle messes your results up. Everyone's body acts differently . Be thankful that you can maintain some kind of stable readings with your lifestyle now.

[Adams_ in reply to Tempest1]

Far from me to recommand to anyone to live the life i had the last few years with an MRC.But as i said i wasn't aware from this sickness before recently where the doctor hihglithed the thing.From now, of course, i will do what it Takes to recover or to stabilise this one.thank you for your advises.