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What is Low Glom Filt Rate, Est?
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What is Low Glom Filt Rate, Est?

Ok, I TRIED researching this on google but as usual I don't get it.

I've never had a low GFR count before but last week's monthly labs show 51.4, LOW, with the normal range 60-128.

I think I understood it has something to do with the kidneys?

Is this related to the TX meds?

Just curious.  I'm way out of my element trying to make heads or tails of the medical studies.

wyntre

ps - week 52 of 72, 1A.t
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173975_tn?1216261375
I did some more research and so far what I found out is it can be related to CKD or chronic kidney disease.

I don't understand why that number would suddenly decrease after 13 months.

GFR stands for Glom Filt Rate, according to my labs.   All my other numbers are the same: low WBC, RBC, HgB and hemotocrit.   HCV is still UND <10, 36 weeks after finally getting there.  Neuts and lymphs are in normal range for the first time since last December, probably coz of the antibiotics I just stopped?

Yeah - 5 more months for me.

What's the latest with Nick's condition and how is he feeling?

wyntre

PS - another avian crisis - The Quaker bit off one of the toes of the remaining budgie.
Hours of phone calls in search of an avian vet and 2 days later, it looks like she's gonna survive but have to give her oral antibiotics for the next week.    

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173975_tn?1216261375
I don't think I've suddenly developed CKD, it's just what comes up when I googled the GFR levels and interpretations.

Pixie only lost 1 of her 8 toes and the vet says he can't believe she was injured only 2 days ago 'coz the wound has healed completely.  She still has a nasty gash on her leg, though, and I have to administer the oral antibiotics to try and keep infection from setting in.

She bites hard but she can't inflict much damage coz she's so tiny.  Venus and the Quaker can take off a finger with one chomp!  Their beaks exert 3000 pounds of pressure and can crack a walnut.

So, what about Nick?   Is he feeling the same, better?

wyn
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Avatar_m_tn
Glad to hear nick and you are well. nick may only be having the CBC bloodwork done not the CMP.  The GFR is listed under the "comp metabolic profile" along with glucose,bun/creatinine, etc. A healthly kindey will have a GFR of >60.
wyn, if your doc does not bring this up i would mention it to him. it is possible that even though you feel ok that the meds or all the water that is drunk while on tx is taxing your kidneys. CKD has a way of sneaking up on you so make sure to adress this with your doc. wishing you the best.
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Avatar_dr_m_tn
Glomerular Filtration Rate is fairly difficult to measure, albeit it is an exremely important parameter(indicator) of kidney function, basically an indicator of the amount of functional nephrons left.
BUT: In your case it was simply estimated from the srum Creatinine concentration, your sex, weight and age using as mathematical formula.

It must be that your serum creatinine level is on the high side, I assume 1.3 or 1.4 mg/dL.

It could be that the antibiotics that you took have temporarily caused some decrease in renal function.
Serum creatinine is not a good indicator of GFR, but it is cheap and easy and therefore typically used.
A Creatinine clearance test  is a more precise test to assess GFR, but still not great.
Meanwhile you could have your serum Cystatin C levels measured, a more specific test of kidney function.
This should be done in a few weeks from now, to give the kidneys a chance to recover from the antibiotic stress. If cystatin C is still high, then there might be CKD present, which is a slowly progressive disorder over prologned time and in many small steps , quite frequent unfortunately.
The true measurement of the GFR using Inulin or Iodothalamate clearance is available only in a few places in the US for routine patients. The Mayo clinic does it, at a cost of about $ 1500 per test.
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173975_tn?1216261375
Thanks for you answer, HR.  Now i understand it better.

Just one more question, if you don't mind:  So, low eGFR isn't necessarily associated with TX meds, is it?

BTW, Serum cretinine is 1.1 in  a normal range of .5 to 1.5.

Thanks Copyman.  I will mention this mid-December at a consult with a local gastro.

wyntre
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Avatar_dr_m_tn
So, low eGFR isn't necessarily associated with TX meds, is it?

No, but if you are, for other reasons, in progressive loss of GFr, then Tx is not good for that process.

Your serum creatinine is not especially high, but it might be for your height, age and weight.

I just wrote the Cockroft Gault Formula that is used typically  to calculate the est GFR, but the post was lost.

{[140-age] x weight}/[pCr x 85]  then normalized from your body surface area to 1.73 m2

weight is in kg, pCR =serum creatinine in mg/dL

This formula is for women.

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173975_tn?1216261375
LAUGHING!!!!

You are so kind as to give me credit for actually being able to compute that cute formula.

I've never had a low eGFR count and I get labs every month but I am absolutely going to bring it to the Dr's attention if the next labs show continued low levels.  (I'm assuming this is no immediate emergency, right?)  

Thanks very much, HR,

wyn


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Avatar_dr_m_tn
Since you get labs every month, how were the last six   serum creatinine levels?

If you provide the data ( age,sex, height, weight ( no cheating) , we can calculate the est GFR for you.

No, there seems to be no immediate emergency.
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173975_tn?1216261375
Groan!!!!  I am not the most meticulous record keeper.

Ok, here goes.  (I may miss a month or two).

Creatine serum levels:

12/1/07 ----  1.1

10/26/07 ----0.8

(Can't find 0/8 and 0/9 reports)

6/22/07 ........0.8

6/10/07 -----0.8

5/19/07 ----0.8

4/13/07 ......0.8

3/30/07 ....0.8

2/16/07....0.9

1/29/07 ....0.8

Pre-TX, 11/14.06 .....0.8

As you can see, the only spike, except for 2/07 when it went up to 0.9, was  last week's when it went to 1.1.

Thoughts?

BTW - you did me a favor.  I have to put these records in order for consult with a local gastro.  :)

One other question, if you don't mind;  Can antibiotics increase WBC and ANC counts?  Mine rose to almost normal in last week's labs.

Thanks HR,

wyntre

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173975_tn?1216261375
Here's the rest of the data:

age; 47
weight; 135
height; 5'3
female
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Avatar_dr_m_tn
So this list clarifies a lot. There was some acute extra damage to the kidneys -most likely the antibiotics, that drove the creatinine up by 30%, hence the formula puts you now in the below normal GRF category. You have that low weight, thus your "personal "normal" creatinine is around .8.

Hopefully, this is a temporary condition. Remember to add the Cystatin C test next time.

Acute stress by any means, infectious or otherwise can raise WBC counts. Remember mremeet, who outsmarted the WBC lab expectations to stay on trial by running up the stairs before the blooddraw?
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173975_tn?1216261375
Mrmeet is way smarter than me!  :)

BTW - could that higher creatine serum level account for why I felt so thoroughly lousy on the bactrin?  I almost stopped taking it coz i was so nauseous and dizzy.  Is bactrin one of those antibiotics that's counterindicated in TX patients?

Thanks for the heads up about the Cystatin C test.

wyn

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Avatar_dr_m_tn
Bactrim is fairly harmless and normally well tolerated. I assume you had 2 x 400mg/day. So probably several factors came together.  
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