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Old 01-05-2007, 11:28 PM   #1
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Can you help re: slightly low eGFR?

Hi

Wondering if any of you have any input here: Some recent lab work of mine showed a slightly low eGFR of 57. The normal parameter from that lab says should be = or > 60, so it's not off by much. The neurologist who ordered my labs was investigating my peripheral neuropathy and said he wasn't really familiar with the eGFR, but I could ask my family doc about it. I'm not diabetic, but I have read where kidney disorders can cause peripheral neuropathy.

I have had hidden blood in my urine for years and years. About 20 years ago I had an IVP that was fine and a cystoscopy that seemed okay too ...I was told it might be inflammation causing the blood. Well, since nothing was too concerning, I have not been worried when my u/a's have shown anywhere from trace to large amts of hemoglobin all these years. Now, tho.... with this eGFR, I am wondering if I should look into this.

I don't want to investigate this if it's no big deal. I've had so many tests for my neuropathy that i feel like all I do is go to docs and I don't want to be a professional patient. The only other abnormal labs have been minor things... lipids too high, B12 slightly low, Globulin slightly high and C-reactive protein (a non-specific measure of inflammation) twice normal.

I'm slightly worried that I may have damaged my kidneys from years of NSAIDS, so I am a little interested, but I don't want to ask about this if it's not a big deal.

Thanks for any experience you can share re: the eGFR.
Lilacs & Lillies

 
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Old 01-06-2007, 06:08 AM   #2
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Re: Can you help re: slightly low eGFR?

Between the nsaids, the blood, the inflammation, and the low eGFR, I would definitely get my kidneys checked out. The good news is that it is a simple test. You do a 24 hour urine collection and then the morning you hand it in, you get blood drawn. This is a good indicator of what your kidneys are filtering out and what they are leaving behind.

BTW, GFR (glomerular filtration rate) gives an indication of how fast/well your kidneys are filtering. The fact that the calculated amount is a bit low could be a bit worrisome.

Good luck to you.

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Old 01-06-2007, 07:50 AM   #3
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Re: Can you help re: slightly low eGFR?

Thanks Coravh.

I thought maybe with a normal BUN & Creatinine that maybe the GFR was a fluke. Shouldn't those be abnormal too if I had kidney troubles? Or do other people also have those normal with an abnormal GFR?

I'm glad to hear the lab tests to investigate this are not a big deal.

Thanks so much.

Last edited by Lilacs&Lillies; 01-06-2007 at 07:53 AM.

 
Old 01-06-2007, 01:20 PM   #4
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Re: Can you help re: slightly low eGFR?

I would think that your Creatinine at least would be a little high for your GFR to be low like that. It can still be within "limits" and be headed towards high, if it is higher than it was the last time it was checked.

Mine is at 50. My Creatinine is 1.2, slightly elevated. Of course your age and race is taken into account. What is your Creatinine and BUN count? And how old are you?


Yes, you need further investigation, and the NSAIDS could very well be part of the picture.

 
Old 01-06-2007, 02:18 PM   #5
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Re: Can you help re: slightly low eGFR?

Hello Isis & thank you for your help...

-My creatinine was 1.1, I'm 45 & caucasian. (I'll have to dig to see if I can find any labs previous to that to see if it has risen.)

-I have cut back on the NSAIDs, but can't get through the day without them. I am using Darvocet for some of my pain now, but that doesn't help with inflammation the way they do.

***Have you been diagnosed with a kidney disorder with your GFR @ 50?

***If the NSAIDS are part of this, is any damage reversible if you stop using them? (I can't imagine my life without them but need to know what I might be doing to myself.)

Again, thanks for helping with all my questions.
L&L

Last edited by Lilacs&Lillies; 01-06-2007 at 02:25 PM.

 
Old 01-06-2007, 08:17 PM   #6
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Re: Can you help re: slightly low eGFR?

Quote:
Originally Posted by Lilacs&Lillies
Hello Isis & thank you for your help...

-My creatinine was 1.1, I'm 45 & caucasian. (I'll have to dig to see if I can find any labs previous to that to see if it has risen.)

-I have cut back on the NSAIDs, but can't get through the day without them. I am using Darvocet for some of my pain now, but that doesn't help with inflammation the way they do.

***Have you been diagnosed with a kidney disorder with your GFR @ 50?

***If the NSAIDS are part of this, is any damage reversible if you stop using them? (I can't imagine my life without them but need to know what I might be doing to myself.)

Again, thanks for helping with all my questions.
L&L
I'm 56 and caucasian. I'm not diabetic, no high BP, no known reason for my declining kidney function, but my Neph thinks it could be due to taking NSAIDS over the years, even though I did not take them a lot. Or maybe from an allergy to a past antibotic use. I have been told to never, ever take them again. believe me, I won't. And, if I were you, I wouldn't either. I would bet if you see a Neph you will be told the same thing. I was told I could take Tylenol. I have arthritis in my neck from a car accident years ago, so it's not easy, but I deal with it.

No, I doubt it is reversible at this point, but you could keep it from hopefully progressing faster. A year ago my GFR was 55, now it's 50, so that does worry me. My Neph doesn't really have any advice for me except not take any NSAIDS, always make sure I never have elevated BP. And watch for diabetes of course. I am supposed to have blood work every 6 months, is all. I had the full workup when this all first came about, the renal ultrasound, 24 CC, etc.

Why do you need to take the NSAIDS and darvocet for pain, if you don't mind me asking? Do you have a chronic illness?

 
Old 01-06-2007, 10:30 PM   #7
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Re: Can you help re: slightly low eGFR?

I don't have a major medical illness, but several minor ones.

Early use of NSAIDs was for GYN pain from stage IV endometriosis, adenomyosis and fibroids. Ongoing use has been for significant osteoarthritis. My legs, hip and hands are miserable if I don't take something. The arthritic bone spurs in my spine caused spinal stenosis & I had to have a fusion 6 month ago. I am hoping my new med for the peripheral neuropathy (Lyrica) helps cut down on the need for the other analgesics once it kicks in.

How'd you find your low GFR? Where you having trouble or just on a rountine lab test? Did you go to a neph on your own or did your family doc send you?
Hope your level doesn't continue to drop at the rate it did this year.


Thank you

 
Old 01-07-2007, 08:17 AM   #8
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Re: Can you help re: slightly low eGFR?

Quote:
Originally Posted by Lilacs&Lillies
I don't have a major medical illness, but several minor ones.

Early use of NSAIDs was for GYN pain from stage IV endometriosis, adenomyosis and fibroids. Ongoing use has been for significant osteoarthritis. My legs, hip and hands are miserable if I don't take something. The arthritic bone spurs in my spine caused spinal stenosis & I had to have a fusion 6 month ago. I am hoping my new med for the peripheral neuropathy (Lyrica) helps cut down on the need for the other analgesics once it kicks in.

How'd you find your low GFR? Where you having trouble or just on a rountine lab test? Did you go to a neph on your own or did your family doc send you?
Hope your level doesn't continue to drop at the rate it did this year.


Thank you
Mine was found in routine blood work for something else. My Dr sent me to a Neph, who DX'ed me with Interstitial Nephritis. I disliked that Dr. so much, horrible personality, I went to another, well respected highly recommended one, who said it was NOT that at all. But agreed with all the other recomendations.

I also had spinal stenosis, and had a lumbar laminectomy a few years back. Have you tried any other things for your osteoarthritis? Is it just pain there, or definite arthritic joints? Have you been tested for Lupus or RA? Do you by chance have any Thyroid disease? Reason I ask these things is that my Drs. went thru some of these things with me, and had a hard time for a while. I do have Thyroid disease for many years, which I believe are responsible for a lot of this, as it went undertreated for several of these years. I also had some PN. But also B-12 deficiency. Shots, then pills resolved that.

It was thought I might have Lupus or RA, but I did not, because of the widespread joint pain.

Sorry for going off on the tangent, but I was just wondering......

 
Old 01-07-2007, 12:33 PM   #9
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Re: Can you help re: slightly low eGFR?

We sure seem to have some things in common. I am on 2000 of B12 daily, but will l drop down to 1000/day next week. Neuro said my low B12 could be contributing to nerve pain. So far, adding the large dose hasn't helped any though. It helped you though, right? The investigation of my PN did include tests for RA & Lupus and thyroid, but those were okay. They did an electromyelogram and nerve conduction studies on my extremities that both showed the neuropathy. It also showed carpal tunnel in both hands, even though I've already had it fixed in one of them. I am fortunate that it does not hurt me to walk. Just the opposite, it hurts me to be still or elevate my legs - sleeping through the night is a rare gift when it occurs.

Some pain is definitely in the joints (some of my fingers/knuckles and my hip) but the rest are random sharp pains in my extremities, that they say is part of the peripheral neuropathy. The only thing my GP has given me for the OA is prescription NSAIDs. I took the chondroiten (sp) stuff for a while but no help that I could tell.

I had the cervical fusion to relieve pain & extreme numbness down my right arm and it did a good job of helping that. Right away too - woke up in recovery without the "blood pressure cuff" feeling in my arm, so it was worth the recovery in the neck brace - in the heat of the summer.

What do you take for your arthritis other than Tylenol? I hope your back holds out.

Anyway.... I'm glad you found a nephrologist you really like. What are they using for your diagnosis? Are your U/A's okay? My sister (who lives far from me) switched nephs for her proteinuria and. like you, she got a different diagnosis and better treatment from the second doc. I don't know any nephs, but have a uro that did prostate cancer surgery on my husband.

Thanks for sharing.

 
Old 01-07-2007, 12:53 PM   #10
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Re: Can you help re: slightly low eGFR?

Quote:
Originally Posted by Lilacs&Lillies
We sure seem to have some things in common. I am on 2000 of B12 daily, but will l drop down to 1000/day next week. Neuro said my low B12 could be contributing to nerve pain. So far, adding the large dose hasn't helped any though. It helped you though, right? The investigation of my PN did include tests for RA & Lupus and thyroid, but those were okay. They did an electromyelogram and nerve conduction studies on my extremities that both showed the neuropathy. It also showed carpal tunnel in both hands, even though I've already had it fixed in one of them. I am fortunate that it does not hurt me to walk. Just the opposite, it hurts me to be still or elevate my legs - sleeping through the night is a rare gift when it occurs.

Some pain is definitely in the joints (some of my fingers/knuckles and my hip) but the rest are random sharp pains in my extremities, that they say is part of the peripheral neuropathy. The only thing my GP has given me for the OA is prescription NSAIDs. I took the chondroiten (sp) stuff for a while but no help that I could tell.

I had the cervical fusion to relieve pain & extreme numbness down my right arm and it did a good job of helping that. Right away too - woke up in recovery without the "blood pressure cuff" feeling in my arm, so it was worth the recovery in the neck brace - in the heat of the summer.

What do you take for your arthritis other than Tylenol? I hope your back holds out.

Anyway.... I'm glad you found a nephrologist you really like. What are they using for your diagnosis? Are your U/A's okay? My sister (who lives far from me) switched nephs for her proteinuria and. like you, she got a different diagnosis and better treatment from the second doc. I don't know any nephs, but have a uro that did prostate cancer surgery on my husband.

Thanks for sharing.
If the B-12 is causing the PN probs, it can take some time to heal, sometimes it's a slow process. The only arthritis that bothers me is my neck, from the previous accident. I use heat when it's really bad, and get by with the Tylenol. I tell myself I HAVE to, I have no choice. Maybe something better will come along someday.

My back is great. (knock on wood!) It never really hurt, all my pain was down my leg, and it was very heavy feeling from it. Like you, the relief was almost instant after surgery.

My new Dr has not really given a diagnosis, other than declining kidney function. I've only ever had a very small amount of protein in my urine, no blood or anything. I did have a few urinary tract infections years ago.

You really need a Neph, not a Urologist, they handle bladder issues. Your Dr should refer you to one.

Can you find out what your thyroid numbers are? The accepted values/limits are different than a few years ago. Thyroid problems can cause a mulitude of issues. You should know for sure what your TSH, your FreeT-3, and FreeT-4 numbers are.

 
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