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Old 03-20-2011, 06:24 PM   #1
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Unhappy Fluctuating and low eGFR 66-89

Hi,

I have been having an awful lot of blood tests the past year as I have been trying to find out what is wrong with me (vitamin induced symptoms). I've been going through my lab tests and noticed that my estimated GFR has been consistantly low and fluctuates greatly - because my creatinine fluctuates, as does my urea. I don't think I have any risk factors for kidney disease - no diabetes, high blood pressure... but possible autoimmune disease. I'm wondering what would cause these results to fluctuate so much? Also, is it likely I am in stage 2 kidney disease? Can you have low eGFR and normal kidney function?

25/1/10 14/5 27/7 06/8 7/12 9/12 17/1/11 14/2
Creatinine
(45-122 umol/L)84 80 85 86 72 65 78 73
(0.5-1.38 mg/dL)0.95 0.90 0.96 0.97 0.81 0.73 0.88 0.82
eGFR 71 86 66 79 89 72 78
Urea
(3.3-6.7 nmol/L) 5.3 4.5 5.3 5.7 4.6 3.4 5

I'm afraid I can't get the layout right - it changes when submitted. The results follow the date order given at the top, except there is no eGFR result for 14/5, eGFR 86 is for 27/7. There is no urea for 14/2.
Notice that in a 2 day period my eGFR went from 79 to 89
Sodium, pottasium, albumin all middle of range. Urine dipstick test was negative for protein. I'm 37, female, not particularly muscular, average size, caucasion and mainly vegetarian. No doctor has noticed this. I asked my gp but she did not have much to say.

I would be very gratefull for any feedback.

Thank

Last edited by tammyp; 03-20-2011 at 06:50 PM.

 
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Old 03-20-2011, 07:28 PM   #2
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Re: Fluctuating and low eGFR 66-89

Hello Tammy,

I am glad you are here, I hope I can answer some of your questions. I am no expert in the numbers and how all the portions of the blood tests all relate, I am a person living in stage 4 Kidney disease, and have been holding at and average eGFR of 20 for about 4 years. My kidneys failed after surviving 4 strokes about 7 years ago, with a gain over the first few years from eGFR of 0-43 or so, I then dropped to my current level little by little.

May I ask your age?

Most of adult Americans drop out of the Stage 1 during regular maturation, as we are born with (in most cases) with 100% of our kidney function. As we age, we loose Kidney function simply by living. A score of 66-89 % is interpreted as you operating between 66 and 89% of your kidney function...very good functions, where with no risk factors, you can expect to maintain for a long time. There should be no symptoms, and without any other health problems should not be a great concern.

You could potentially remain at stage 2 for years and years to come. Kidney disease is a very slow moving illness, especially without the "help" of the most common damaging health issues such as HPB and diabetes. You can make lifestyle changes that will reflect in your eGFR. I was able to bring mine up from almost 0 to 43 just by getting my BP in control, but it did take me years to do it.

It was the hypertension that got me. The years when I was living with extreme hypertension were years that we had little knowledge about how dangerous HBP was, and I was only in my 20's, not the typical target group.

My words of encouragement go out to you. Keep this information in your mind, talk to your doctor, do some research, and then relax and enjoy your life. If you do show signs of kidney disease that needs further attention, you will have a nephrologist, which is a kidney specialist, to care for you,

My best to you!
janet

Last edited by writeleft; 03-20-2011 at 07:30 PM.

 
Old 03-21-2011, 04:48 AM   #3
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Re: Fluctuating and low eGFR 66-89

First off, keep in mind that it is an "e" GFR, which stands for "estimated". It will also fluctuate depending on how hydrated you are before a test. All your values are normal, not low. Anything above 60 is considered normal and not to be concerned about. Your creatinine will also fluctuate for the same reason of hydration as well as of exercise and is also normal. You are not in any stage of kidney disease.

I hope you find out what is wrong.
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Old 03-26-2011, 10:01 PM   #4
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Re: Fluctuating and low eGFR 66-89

Quote:
Originally Posted by Cora1003 View Post
. . . . Your creatinine will also fluctuate for the same reason of hydration as well as of exercise and is also normal. You are not in any stage of kidney disease.

I hope you find out what is wrong.
Hi! What is the relationship between creatinine and hydration/exercise? If hydration is better (higher) does that mean the creatinine value would be lower? Does exercise increase creatinine? (I'm new here but I've been reading posts for a while, especially yours - over the past five years, my creatinine has gone from 1.3 in year 1 to 1.28 in year three to 1.34 in year five, with my eGFR of between 65 in year one down to 60 in year five on the CKD EPI scale and from 59 in year one to 56 in year five on the MDRD scale. So I'm concerned.) Thanks for reading.

 
Old 03-26-2011, 10:33 PM   #5
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Re: Fluctuating and low eGFR 66-89

Thank goodness for our resident expert, Cora.

 
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Old 03-27-2011, 05:26 AM   #6
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Re: Fluctuating and low eGFR 66-89

Quote:
Originally Posted by hawkeye85 View Post
Hi! What is the relationship between creatinine and hydration/exercise? If hydration is better (higher) does that mean the creatinine value would be lower? Does exercise increase creatinine? (I'm new here but I've been reading posts for a while, especially yours - over the past five years, my creatinine has gone from 1.3 in year 1 to 1.28 in year three to 1.34 in year five, with my eGFR of between 65 in year one down to 60 in year five on the CKD EPI scale and from 59 in year one to 56 in year five on the MDRD scale. So I'm concerned.) Thanks for reading.
Hi Hawkeye. When you are well hydrated, the kidneys are working better and more and will filter more - so the resulting cr. will be lower. Exercise will raise your cr. level because cr. is a byproduct of muscle metabolism. This is why men typically have a higher cr than women.

So far your cr and eGFR seems pretty stable so you must be taking care of yourself. You are also a very long way from needing any sort of intervention. To put it in perspective for you, while I did wait too long, I didn't go on dialysis until my creatinine was about 8 or 9. It will be necessary for you to be monitored, but with modern drugs like ace inhibitors, keeping a low sodium and low animal protein diet, and keeping your bp under control, you may remain stable for a very long time.
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Old 03-27-2011, 06:45 AM   #7
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Re: Fluctuating and low eGFR 66-89

So far your cr and eGFR seems pretty stable so you must be taking care of yourself. You are also a very long way from needing any sort of intervention. To put it in perspective for you, while I did wait too long, I didn't go on dialysis until my creatinine was about 8 or 9. It will be necessary for you to be monitored, but with modern drugs like ace inhibitors, keeping a low sodium and low animal protein diet, and keeping your bp under control, you may remain stable for a very long time.[/QUOTE]

Thanks, but that's kind of the rub. I haven't been doing anything - I just noticed this last week when I got some blood work back and compared it to the records from prior tests. But I plan on following a better diet now! My blood pressure is typically 100/70 or so, and I'm pretty fit - I run and I lift weights so I'm a little muscular. And I'm 52 years old, so this kind of came as a shock to me. I plan on seeing my doctor but no doc has recommended I do anything yet. In any case, my prior tests were after fasting - but this last test was not. So I plan on getting re-tested but it sounds like I shouldn't expect a significant disparity. Also, my lab results always come back at 60 - I guess they don't use the MDRD calculator.

 
Old 03-27-2011, 11:04 AM   #8
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Re: Fluctuating and low eGFR 66-89

Tammy and Hawkeye, I hope you both have had your questions answered. We are so lucky to have Cora to straighten all this our for us. I am continuing to learn as I go along, so I make a point to read the kidney related questions.

My best to Tammy, Hawkeye and Cora!

 
Old 03-27-2011, 12:16 PM   #9
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Re: Fluctuating and low eGFR 66-89

Back at ya writeleft! Cora is a very good resource. Take care.

 
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