Glomerular Filtration Rate (GFR)

[ddsherbie]

Is GFR a good indicator of kidney disease, and at what point would it actually be an indication of a possible issue?  I am a 28 y/o Female with a Creatinine level of 0.9 MG/DL, which appears to put me at a 79.83 GFR.  Based on the charts in the lab paperwork - that would put me at levels of a 60-70 year old, and an online calculator said Stage 2 Kidney Disease...but it looks like the magic number is 60.  Are there other indicators that would show up in my blood work if there was a problem?  It is a couple weeks before my Dr. appt, and I'm just trying to get some more information.

Thank you!

[ddsherbie]

Thank you for the information!  I asked my doctor about it, and she wasn't concerned about it.  She said she doesn't even calculate GFR unless creatinine is >0.9, and a GFR of 79 is within normal ranges.  I guess I just need to take this all a piece at a time.  I was diagnosed with focal partial seizure disorder a couple months ago, and while the anticonvulsant medication has resolved some of my symptoms, I'm still having others.  I'm seeing a cardiologist right now, and we'll see what he has to say in the next couple months.  I'll keep this in mind, though!

[warney26]

I tried to do a copy and paste but it was in a table so didnt come up as well. You should still be able to follow it thogh. It pretty much says what I have already told you. The web site is belwo and is the renal association. copy and paste into browser, hope it helps

http://www.renal.org/whatwedo/InformationResources/CKDeGUIDE/CKDstages.aspx

The K stages of kidney disease are:

stage 1
EGFR

90+

Normal kidney function but urine findings or structural abnormalities or genetic trait point to kidney disease

Observation, control of blood pressure. More on management of Stages 1 and 2 CKD.



stage 2

egfr 60-89

Mildly reduced kidney function, and other findings (as for stage 1) point to kidney disease

Observation, control of blood pressure and risk factors. More on management of Stages 1 and 2 CKD.


STAGE 3A and 3B

egfr 45-59
egfr  30-44

Moderately reduced kidney function

Observation, control of blood pressure and risk factors. More on management of Stage 3 CKD.

STAGE 4


egfr 15-29

Severely reduced kidney function

Planning for endstage renal failure. More on management of Stages 4 and 5 CKD.


STAGE 5 eskd


<15 or on dialysis


Very severe, or endstage kidney failure (sometimes call established renal failure)

Treatment choices. More on management of Stages 4 and 5 CKD.

* All GFR values are normalized to an average surface area (size) of 1.73m2

[warney26]

close but not entirely correct .  A NORMALl egfr is 100.
IM not sure where the idea that a HIGH wegfr indicates kidney disease. I can assure you it is the complete opposite!!!
egfr 0-15 is eskd (end stage 5), egfr of 15-30 is stage 4 (usually when symtpoms become troublesome),  30-60 is stage 3 (moderate loss of kidney function, but usually not symptomatic), 60-90 is stage 2 kidney disease (mild loss of function.  Often an egfr of 90 or above is not considered kidney disease UNLESS there are other suggestive signs eg via ultrasound, if there is an egfr of 0ver 90 BUT an ultrasound indicates changes consistent with kidney disease, then it is classified as stage 1.
Some countries believe an egfr of 60 or over is not kidney disease, however, this is because some countries pathology do not report an egfr of 60 or more. Many countries now ie Australia (where I am from) and the UK, report and egfr of under 90. That is because they are now dscovering that there are indicators of early kidney disease in patients with egfr of over 60.  In australia, an egfr of over 50 is monitored. Once it reaches under 50 (so only 10 less) there is referal to a nephrologist - even though usually not symptomatic. It has been shown that such early referal is frequently helpful in slowing down deterioration.
Unfortunately many countries have not yet taken the lead by the UK and still do not report an egfr of under 90 !!!
Keep in mind though, that (depending on cause)  not all kidney disease is progressive !!! if you are 79 egfr now, it is correct that you are in stage 2 - mild loss of kidney function.  it is uunlikely that anything else, at that stage would show up in bloods. Depending on the cause you could stay in stage two until your 90 and NEVER progress, or progress so slowly that your "time was up " anyway - sorry.  
I had an egfr of 62 a year ago. As in australia that is reported and considered as stage 2 and bordering on stage 3, my doctor thankfully did not ignore it as being "normal" ie over 60. But classified it as stage 2 and kept an eye on it. Thank god he did as mine progressed very very quickly.  I am now hovering between 28 - 38, stage 3-4 (egfr do often fluctuate depending on hydration and diet) in less than 12 months.  If he had not been watching it he would not have known, kidney diesases is known as the silent killer as symtpooms do not usually present until into late stage 4.  I was sent to a nephrologist quickly and am now under good medical care. My cuase was unusual though, no bladder but an ileal conduit, so I was a sitting duck for kidney disease.
I would juust insist, at this stage, that it be repeated every 6 months

[Arti Sharma, M.D.]

Hi there,
A normal gfr is 60.A value below 60 can be an indication of kidney disease. A high GFR is seen in kidney disease, hypertension and diabetes mellitus. There can be few variations in the GFR test. An overweight individual may not show correct results due to increased mass. A strict vegan diet or those who ingest little to no protein may not show correct results. You may need to repeat your creatinine tests after a month and calculate eGFR each time. If your report stays same over this period consult a doctor. He may recommend medication or action to correct kidney malfunction. Any test result should be correlated clinically. Consult a doctor.
Best luck and regards!