Normal GFR Decline?

[Snicole72]

Hello,

I’m a 52 y/o female who was healthy until a year ago. Never smoked and I had maybe 1 drink per month. I was diagnosed with HBP in January’23. At that time my GFR was 89. Since then, I’ve had bloodwork done for other reasons but have kept an eye on this. I’ve gone from 89 in Jan ‘23 to 83 in Jan ‘24 to 78 in mar ‘24 and just 2 weeks later to ‘60. I’m new to this but does that seem accurate? I am currently under a rheumatologist care due to increased antibodies and a subsequent auto immune disease that has not yet been diagnosed but doesn’t an 18 point drop seem significant in 2 weeks?

[Bassetmommer NKF Ambassador]

Yes, it is significant and you have been showing a steady decline. Two things are going on that can impact your kidneys. HBP....high blood pressure will definitely affect your kidneys. Having an autoimmune disease can also. Keep an eye on your labs. The drop maybe more significant if you were dehydrated at the time of the lab. Make sure the day before you are well hydrated and have some, not a lot of water before your test.

[caringkriket in reply to Bassetmommer]

I also have an autoimmune disease Rheumatoid arthritis and mine fluctuates between 38 and 39. All these years NOT 1 DOCTOR has said anything about EFGR! And going back through my labs I can see the decline! I am very angry that this wasn't caught earlier and then you give me 1600 mg of motrin a day for about 15 plus years! So I am playing catch up! My new RA doctor started the process and the PA Nurse I had for surgery took me off NSAIDS! I miss them because my inflammation is off the chain and pain pills only help so much and TYLENOL DOES NOTHING!

[Bassetmommer NKF Ambassador in reply to caringkriket]

I am so sorry. I was in the same boat. I knew something was wrong with all the joint pain I was having. But for three years, my doctor refused to test me. I had EVERY symptom of Psoriatic Arthritis and it was destroying my joints. But in the meantime, I was PRESCRIBED 1800 of ibuprofen, daily. And it destroyed my kidneys. I am waiting to hear someday they will do a Legal Tort and sue the living hell out of the manufacturers..... but for me, it is too late. I am on dialysis.

NO Tylenol does not stop inflammation. Hopefully, you will find a biologic that will help with the pain. Get yourself educated on renal diets and care of your kidneys. I was told in 2018 I would be on dialysis in 6months, but I stayed away from it until 6 years later. All do to diet and lifestyle changes.

Best to you and ask questions of this group.

[Tolmezzo]

HBP can damage kidney if not treated over decades. Is not one day to the other. Do you have protein in urine? What about other kidney values: potassium, phosphorus, bun, etc? Rgs

[Snicole72 in reply to Tolmezzo]

no protein in urine. But there were crystals in early March and yesterday they were gone but the creatinine was 1.11

[Tolmezzo in reply to Snicole72]

As I said many times on this forum there's too much focus on creatinine and egfr. Let's put in this way: egfr is a warning sign you need to go in deep. Being you, knowing that no protein in your urine, I would relax a bit. Proteinuria is much more worse than creatinine. Especially when we talk of 24h urine. Trust your doctor and if your full kidney panel is ok most likely there's nothing you have to be concerned about. Rgs

[Darlenia in reply to Tolmezzo]

Yes, protein in urine is an important signal that protein that should be staying in your body is escaping from the kidneys and leaving via urine. (There are some autoimmune conditions that may not show proteinuria initially - nephrosclerosis for example.) However, creatinine is also a very informative signal indicating whether or not waste material that should be processed and removed by your kidneys is instead remaining in one's blood. If so, that's not good. So one is a urine test to see what's escaping and the other is a blood test to see what toxins are remaining in the body - together, they tell a story. Sure, diet can manipulate figures for both a bit. However, it's the trends that both tests present that are very informative. As my husband's kidneys failed, no one paid any attention to eGFR. Only the hard data interested them. It's stayed that post transplant.

[Tolmezzo in reply to Darlenia]

Sorry but I've to disagree. There are 2 way to have clean picture about your kidney function: 1) is gfr test (not egfr) which is time consuming and expensive 2) 24h clearance. Creatinine is a conventional and cheap method to have rough indication about your filtration rate. Taken alone can be misleading. Kidney function must always be assessed looking to entire serum renal panel together with 24h urine. RGS

[Helloyall in reply to Snicole72]

The creatine is a bit high. Besides hbp what medications and suppliments are you on. Your condition or meds could account for the urinary crystals. Do you know which type?

[Snicole72 in reply to Helloyall]

I was taking pantaprazole until a few days ago. The crystals were calcium oxalate. The ER doc said there was a small chance I have a uti so maybe that’s why

[Chris2023]

1. Wwre you latter two tests done after fasting for 8 to 12 hours?

2. Within 24 to 48 hours before the labs did you exercise, have a large protein intake or take a creatine supplement?

[Snicole72 in reply to Chris2023]

Yes, I had been fasting the last test because of feeling so ill

[Snicole72 in reply to Chris2023]

and no, no exercise or protein or supplements.

[Pops12345 in reply to Chris2023]

hi Chris, I’m curious to know if fasting would lower a gfr?

[Chris2023 in reply to Pops12345]

I am unsure about fasting, but dehydration can definitely impact results.

[Triathlon]

I had a 12 point drop in my GFR over a 3 month period. My nephrologist was concerned. So we did all kinds of bloodwork to rule out autoimmune issues- lupus etc. He also had me repeat the kidney ultrasound. All that checked out okay. I repeated my kidney panel 3 weeks later and my GFR was back up! It was so weird. Couldn't find a reason for the drop. Based on what my neph has communicated to me the auto immune disease you are speaking of could be your culprit. I am very fortunate I have a nephrologist that is very proactive. Hopefully, you have a good one too!

[JWahoo]

Although that is a rapid decline, it still is a good number. Your kidney function decline could be related to your diet, or something else going on with your body. Ask your physician or see a nephrologist if it is really bothering you to monitor it. What other changes have you experienced in your daily life that can likely explain the drop in GFR? Self reflection and monitoring by your physician can be of great assistance.

[Snicole72 in reply to JWahoo]

Thank you. Yes, there is a lot going on. I’ve been very ill since January, hence all of the appointments. I seem to have an undifferentiated connective tissue disease and have experienced debilitating weakness and lightheadedness for 3 months. To the point that I don’t leave the house and can barely walk at times. I can’t seem to get anyone very concerned about it and have been watching the eGFR by myself. It just seemed odd that I went from 78 in the rheumatologist blood draw to 60, 2 weeks later in the ER.

[caringkriket in reply to Snicole72]

Have they checked you for MS?

[Helloyall]

Keep monitoring and get referral to a experienced nephologist. ASAP. Possible kidney imaging. Between the 2 docs they might figure out what this autoimmune issue is.

[WildIris]

I was being treated for lupus and autoimmune hemolytic anemia with prednisone and erythropoietin and infusions and transfusions and blood tests every 3 months when my eGFR rather suddenly plunged into the 20s. Could have been high blood pressure from the high doses of prednisone or all the ibuprofen I would take for various pains. That got doctor's attention. I immediately went on a kidney diet, drank more water, and my eGFR gradually came up, after a couple of years it has been in the 60s most times. My other health problems, including aFib, another condition that doesn't often improve, are much better too, and the lupus is in remission, also I am a normal weight again (I was overweight). So that's my story. I never had protein in the urine either. Good luck. Oh yeah, I was born in '52. Lupus does tend to get better with age, one of the few diseases that do, so there's that too. My diet is quite boring but I relish the foods I do eat. Again, I'm wishing you the best.

[Hidden]

Has your Rheumatologist ordered the Anca blood tests yet. If not, I would ask for it specifically. My kidneys failed due to the Wegener’s autoimmune disease. It’s important to catch it as early as possible.

[Mandyloubag]

Have you had your thyroid checked?