eGFR Fluctuation.

[Alan_G]

Because I'm on a blood anticoagulant I have blood tests yearly, one of which is for kidney function. Over the last few years my eGFR has been in the 60s, but last year it was recorded at 58 which I found a bit worrying as it put me into Stage 3. I have what I consider a reasonably healthy diet, I am a normal weight and take regular exercise and by blood pressure is normal. I am 73 years old. I decided the only changes I could make were to take in more liquids during the day to stay properly hydrated and be more selective about what I eat.

That said, I was nervous about the results on my latest blood test. To my surprise and delight, my eGFR was recorded as 72. That seems quite a leap to me and at odds with what is said on the internet about being able to slow its decline but not reverse it.

Is this normal and have other people experienced this, or is the method of calculating this score a bit unreliable. I have definitely upped my liquid intake and am wondering if the hydration factor applied to me. Interested in any thoughts on this.

If nothing else, it gives hope to people that t can be reversed.

thanks

[Bassetmommer NKF Ambassador]

It cannot be reversed. However, GFR blood tests are a picture of the day you took it. It will bounce up and down. Just keep doing what you are doing.

[Alan_G]

Thanks for the reply. I see that my creatinine level is now within the recommended range whereas last time is was just outside. My urine tests also have it in range too, so I guess that's what you have to look out for. If creatinine is being expelled in your urine and is not overly present in your blood then your kidneys are not performing too badly irrespective of the eGFR score.

Also, if your GFR is only representative of the day it was measured, doesn't that make it a bit of a meaningless test? I assumed the score would be representative of your position at that time, namely weeks rather than just a single day. As it's taken just once a year it seems to be pot luck what it comes out as then, in which case I thought you'd be tested more regularly to see if any patterns emerge.

[WildIris]

I'm in a similar situation with my eGFR fluctuation in about the same range as yours (same age also). However my eGFR was stuck in the low 50s for several years.

I must be doing something right, because its been over 60 for three years now, over 70 last year, since I went on a strict vegan diet, ate a lot of blueberries and got fit. I don't know whether my kidney function has actually improved, but its not going downhill. My labs were always weird and still are, overall, a lot of minerals and cell counts a bit low, but not declining. I had lupus and frequent atrial fibrillation that also faded away when I changed my diet. I just feel so much better now it's hard to complain about anything. (Other than Trump)

Maybe eGFR just varies more when its higher? A lot of people on this forum in later stages of CKD don't seem to vary more than a couple of points from test to test.

Anyway, congratulations on staying fit and bringing you number up. And being aware of the need to take care of your kidneys.

[Alan_G]

I recently came off Tamoxifen having been on it for 5 years. I came off it between my last blood test (eGFR:58) and my most recent one (eGFR:72). It is possible the following may have a bearing on these results.

"Tamoxifen-induced renal impairment was evident from significant elevation in serum urea and creatinine levels, reflecting a reduction in glomerular filtration rate and nephrotoxicity."

[Darlenia]

You've likely answered your own question with the excerpt you found re Tamxifen-induced renal impairment. Another thing that may have raised your eGFR is your increased hydration. Often, as we age, we fail to drink enough liquids and that reflects in labs. It's also good to check all the entries on your labs, not just eGFR. The various items (albumin for instance) will show whether or not other issues might be involved - for example diabetes, inflammation, blood disorders, etc. Many of those other entries are very specific regarding "here and now" whereas eGFR is an estimation/prediction and incorporates variables. Then keep an eye on trends - those can be very meaningful. However, generally speaking, an eGFR of 60 or more is considered to be good/normal for seniors - especially since kidney function (along with other organs) slowly declines as we we get older. It's rare for humans to live beyond the century mark - everything simply wears out. Indeed, there's considerable controversary in the medical community regarding labelling seniors with CKD when it involves the usual normal aging process. For example, see jamanetwork.com/journals/ja... I'd like to add that my husband and I are around your age. While he has experienced dialysis and transplant; I have not. So we've seen a lot of labs in our lifetime. I'm not a medical professional, but it's my personal view that you're doing well and I sense that you'll have many good years ahead of you. But if you have worries, I urge you to have a nice conversation with your doctor. Ask him to clarify matters for you. Doctors truly appreciate patients who are willing to hear what they say (many don't want to listen to their providers). In the meantime, keep doing what your doing! Life is meant to be enjoyed. We're right there with you.

[Alan_G]

Thank you for that detailed explanation. I do check all the other lab results that accompany the eGFR result, and they have all fallen within the recommended ranges. I realise that eGFR is based on an algorithm that is based on the creatinine levels, and so I tend to attach more importance to that falling in the required range than I do the actual eGFR score. A couple of months ago I had a urine test and my creatinine level also fell into the recommend range and so I am feeling comfortable with the way things are at the moment.

[Darlenia]

That's wonderful! My husband's nephs largely ignored eGFR and went straight to the hard data - creatinine, BUN, protein, etc. I recall his team gathering around and grimly watching his creatinine levels rise as he neared dialysis, and I recall another team gathered around a computer screen happily looking at the dramatic fall in his creatine post transplant. It's great that your creatinine and other data are the normal range today. In my opinion, that's all that truly matters.