What can cause a 35 point drop in egfr?

[Laaandstuff]

Hi, I'm new here. 48 years old, newly diagnosed with stage 3a. I have had controlled high blood pressure for 15 years, likely genetic. Last October, it started going all over the place and we haven't been able to manage it with change in meds. At the same time, my egfr came back at 59. We tested again in January and it was 54. My doctor has sent me to a neph but I won't see them until March 1.

We went back to look at previous labs and it had been 62 in Jan 2021 (no one caught it). The labs I had before were from 2019 and my egfr was 95. Two labs in 2018 were also 95. So it seems I had almost a 35 point drop over 2020. I didn't have any labs that year because of the pandemic, but I was actually very healthy during lockdown. Ate better because we never went out and exercised 5 days a week. I know I'll discuss this all with the neph, but I'm so curious - any ideas what can cause a sudden drop? I did take a new medication for 2 months (a female viagra thing that doesn't seem to have any instances of kidney issues), and it's possible I had a mild case of Covid (I was exposed, but tests weren't available and all I had was a terrible headache for a week). Did my body just suddenly tire out from my hbp diuretics? But then why has the decline slowed down?

While I wait for my appointment, I've put myself on a renal diet. The lower salt seems to be helping regulate my blood pressure somewhat, thankfully. If I had a better idea of what happened, I would feel better about how to approach getting well.

Any thoughts would be appreciated. The mystery is killing me.

[S_dillow]

3b here covid will definitely mess with your kidneys and so will uncontrolled bp.its great youre on aa renal diet ansd exercising.your nephro can give you a better idea of whats going on though .i can only speak from my experience and you may have other stuff going on

[Bassetmommer NKF Ambassador]

We cannot and should not try to diagnose your situation. Waiting is difficult but there are many factors going on with you which may have caused the drop. You are wise to change up the diet. Have your doctor review all the medications you are taking. If they are not renoprotective, or good for the kidneys, find something else to take. There are many safe BP medications out there.

[Laaandstuff in reply to Bassetmommer]

I'm not looking for a diagnosis so much as things that can cause that sort of decline. Of course I'll let the neph be the expert. I'm just interested in whether that decline happens out of the blue and what sorts of things cause it.

[S_dillow in reply to Bassetmommer]

i consider myself spanked if i accidentally did that.sorry

[Laaandstuff in reply to S_dillow]

😂 no you're good!

[Bassetmommer NKF Ambassador in reply to S_dillow]

S_dillow. you did not...but someone might have...

[S_dillow in reply to Bassetmommer]

woohoo..darn i missed it

[userotc]

My mum had a similar eGFR drop mid-2022 (76-46) after it had constantly risen for >5y following a nephrectomy. We speculated on possible reasons eg an OTC medication, less hydration etc and cant be sure what caused it....but it is now back to a fairly stable ~60 so we are content.

In your case it could be one/more various things including covid, medication, covid vaccine (if you took it) etc etc. The key thing is where you go from here.

PS Mum's neph never even commented on the drop!

[Laaandstuff in reply to userotc]

Thank you for weighing in. Glad to know it can change directions.

[nonna70]

When I was first diagnosed, I too worried about my EGFR. My neph told me that it was normal for it to go up and down. As long as it didn't continue to go down with no upward swings, he was not concerned.

[Laaandstuff in reply to nonna70]

Thank you, that's reassuring.

[Blackknight1989]

Nonnna nailed it and I know for newly diagnosed it can be confusing but I’m sure most have had blood test before with other level that do t stay constant in the body. EGFR is perhaps more subject to flux because of the use of creatinine in the equation. Thus the “E”in the eGFR name. It is only estimated and the key for us is long-term trend. If like most (I’m stage 4 so I am on the every 3 month plan) you have blood work done at those intervals and the trend is stable MOST LIKELY your kidneys are stable. That is the best we can do currently and I’d challenge most of you to work towards a level of knowledge that you can eventually answer most of these questions.

BECAUSE I can almost guarantee that any random encountered doctor won’t know as much and THEREFORE it is on us to be the BEST FIRST ADVOCATE for our health because No One else cares as much as we do about our own health and unfortunately the recent emphasis on CKD is just that recent and the average doctor treating (if not your primary nephrologist) is woefully lacking in knowledge at least about the specifics. Just my opinion after being stage 4 since 1996.