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Significant Decline in eGFR
xomolly posted:
Hi, I had some routine blood work last year and my eGFR was 82, no one told me anything about that being low for my age at the time (I am 35). Last week I had more blood work performed for heart palpatations, my eGFR was 70. I was told that was "low for my age" and that I should drink more water. I did some research and am concerned. First, that is a signigicant drop in less than a year. Second, I think this means I have stage 2 CKD, but no one even mentioned that to me. I have no risk factors (no hypertension, or disbetes), and am in shape and eat healthy. Is there additional testing I should have done? What could be the cause of the low numbers and the drop in GFR? Is it possible to raise my GFR? I am a little freaked out. Thanks.
john-skpt responded:
Probably no need to rush out for another test. Just be thoroughly hydrated when the next routine tests come around. (This can get tricky, because a lot of docs specify 'nothing by mouth after midnight". It's a stupid compromise: great for testing cholesterol, lousy for testing renal function.

First, this was surely an eGFR, e for "estimated", and it is a cheap, quick mathematical calculation based solely in blood numbers. True GFR tests account for age, gender, body mass, and urine output as well as blood values. Thus, it is only "estimated" and can vary a whole lot without really meaning anything. Slight dehydration will definitely make the GFR numbers look worse.

Second, whoever said this was 'low for your age' was just wrong. Most labs don't even bother to report numerical values as long as they are over 60. ( >60 is the usual way of listing 'normal' values. GFR is NOT measured on a zero-100% scale, though a lot of ill-informed techs and nurses assume that it is. The numbers are calibrated on a scale of ml/min/1.72 meters squared. (The '1.72 meters squared' is a calculation of body surface area, which roughly accounts for body mass.)

If it bugs you, have the test repeated when you are well hydrated, but frankly I wouldn't waste the money. Just wait for the next annual physical.

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