GFR and dialysis

[TDPowers]

Does everyone know what their GFR number is since they’ve started PD or HD I was just wondering if it improves or declines with dialysis. Thanks

[Darlenia]

After you're on dialysis, GFR doesn't matter very much anymore. That figure is based on your native kidney's ability to filter toxins and provides a time line for their viability. Once you're on dialysis, the machines take over that function and "clearances" become very important - Kt/V, URR, BUN, etc. - to see how well the equipment is removing urea and waste products. Individual data re electrolytes (potassium, phosphorus, etc.) as well as overall blood function and so on are also tracked very closely in that regard.

[TDPowers in reply to Darlenia]

Thank you for the information

[MToQ]

It is supposed to stay stable once you have started dialysis. Although severe stress can cause it to decline as well as infections. When I started on PD, my gfr was 16. Less than 2 years later, it declined to 0. This is NOT very normal. I had an unbelievable amount of familial stress, where everyone treated me as if there was nothing wrong with me, even though I was on the machine for 9-13hrs a night.

Take care of your mental health. Build up a good support system. Stay on boards like this. Eat a dialysis friendly diet. Get enough rest. You should be good.

Good luck.

[TDPowers in reply to MToQ]

Thank you

[Darlenia in reply to MToQ]

GFR is largely used to measure native kidney filtration capability. It involves the amount of water in your body along with other variables. If one still has some native kidney function left and if one removes a lot of water with dialysis immediately prior to labs, then that number may improve. (Infections can be part of the problem too.) Sadly, native kidney function generally declines further for those on dialysis and often ceases entirely. In that case, GFR can fall to 0. So, for dialysis patients, doctors turn their attention to clearances to see how well their machines (and prescriptions) are doing in removing waste and toxins from the body.

[MToQ in reply to Darlenia]

My team told me the sooner I started dialysis, the better chance I would have keeping what function I had left. I was fastidious and never had an infection. When I had fallen to 0, they were very surprised. They told me that it was unusual and not what usually happens. I even went to the hospital's head of nephrology for the West Coast. She told me the same thing. It is unusual that it dropped to zero. Most people don't totally loose the remaining function once they start dialysis and she told me the team discussed it and they didn't know why. Until I mentioned the lack of support at home, and that's when she had her answer. Stress.

And yes, they tracked my labs very carefully. But they always provided me with my gfr. It definitely didn't go up after I started.

Apparently, being at 0 did help rank higher for a deceased kidney. How much exactly, I don't know. But the transplant doctors did mention it as well

So that was a silver lining!

Again, this is what my team shared with me.

Good luck.

[TDPowers in reply to MToQ]

Thank you for the information

[Darlenia in reply to MToQ]

Yes, natural kidney function can stick around - there's some reports out there that residual kidney function stays around longer with PD, etc. Sadly, a lot of people lose everything - no longer urinating as well. More needs to be done in this field.

[TDPowers in reply to Darlenia]

Thanks for the reply

[Jk2023]

We were told they don't check gfr once your on dialysis but my mam started hemodialysis 10 months ago she was at 13% but kept getting infection (sepsis) after infection from her chest tube luckily since she's had it out and using fistula she hasn't had one since touch wood she's now at 6%.

[TDPowers in reply to Jk2023]

Thank You

[Ziggydoodah]

I keep track of gfr through an app. I started dialysis at 7% after my first full session, it jumped up to 28% and I felt great. Never happened again! My gfr is usually 6% before a dialysis session and rises to 22%. After 2 years on dialysis it is going down. First year it was about 22/26%...It seems to be the clearance rate my dialysis unit is interested in. Under 68% and they become concerned

[TDPowers in reply to Ziggydoodah]

Thank you

[horsie63]

I'd been told that once you are in dialysis eGFR doesn't really matter. I look at my kt/V, hemoglobin, protein, potassium and phosphorus and calcium. My protein continues to remain low and sometimes my hemoglobin is low so they give me Mircera. The dialysis center wants me to start IV Protein to build that up.

Since I still urinate quite a bit I know my kidneys are functioning but the machine helps.

[Roorook22]

I have been on dialsis for 8 months, your Gfr can go higher. Depending on what stage your at, I'm at kidney failure so theirs no getting back to where it's fully working again. But yes it does go slightly higher with dialysis

[TDPowers in reply to Roorook22]

Thank you