GFR

I just found out my GFR is 48.  I'm worried and I was wondering if I can increase my GFR by any means?  Thanks.

[Vanessa Lacuesta]

Hi Cindy,

How old are you?

Do you have any underlying conditions like early onset diabetes, recurrent kidney infections, kidney cysts and hypertension?

Have you been assessed along this line?

Keep us poted with your answers.

[Cindy1972]

Hello and thank you for your response.  I am 53 yrs old and do not have hypertension, nor diabetes at this time my A1c test was 6.  I've had 3 blood draws that show my GFR is 47 or 48 within the last 8 months.  My creatinine is in the high normal range and my BUN is also high normal.  I've been on antidepressants for year for fibromyalgia and have used lots of ibuprophen in the past but not for 2 yrs.  I have had a urnine analysis and they said it was normal.

I have had no other test yet but I don't go back to the doctor for a couple of weeks.  They had suggested after the 1st low GFR to get a ultrasound but the doctor who saw me on the follow up was a different doctor and he said it wasn't necessary.  

I'm not a smoker but have always lived with smokers.  So, anyway, I am just concerned and a bit frightened.

Thank you for your reply.
Cindy

[warney]

HI cindy you cant increase your egfr. An egfr of over 60 with no other symptoms can be considered ok. An egfr under 60 is stage 3 kidney disease, with or without other symptoms. Often stage three symptoms will also include anaemia, blood and or protein in urine, itching, mild swelling, low vitamin D and other things, even resltess legs Stage 4 is 30 down to 15. . While you can tincrease it you can slow down, and even halt further decline of it.  It is the speed at which it falls that is the big warning. Mine has dropped by 37 iin less than 8 months, which indicates rapid progression kidney disease, so am seeing neph next month.  A one of egfr test could be not entirely valid and may be the result of other factors. It should be repeated. If there are 3 tests that signal it and if it declines over those tests, start pressing doctor for answers, referal etc.

[WorriedaboutGFR]

Hey, that's a 4-year-old post, but I'm glad you responded to it because you said a 37-point drop in less than 8 months indicates rapid progression of kidney disease.  This is something I have been trying to find out from docs, but getting no definite answer from them - since my GFR dropped 40 points in 3 months' time, putting me at stage III!  Then my next labs indicated "lipemic blood draw" so those results were essentially worthless.  I just saw another doctor who didn't even want to look at the lipemic blood draw results and ordered a repeat test which I will have done next week.  I've been restricting my protein intake and hope that will help my GFR not decline further.  You said that once the GFR has dropped, it can't go back up, yet I heard someone on this forum say that their GFR actually did go back up over time when they followed a prudent kidney diet of low protein, low potassium, low phosphorus etc.

[warney]

hi as far as I have been told, you cannot undo kidney damage?ave read a couple of posts where egfr has gone back up but thye also say had an infection or surgery etc and only had the one low egfr, so am guessing was acute kidney and not chronic???? gad wish mine would do that lol I. have almost a non existant protein diet!! not helped me ah well,  I have read some different opinions on a low protein diet, some say it can do even more harm. Low potassium is suggested in later stages as the kidneys poor fliteriring allows too much potassium into blood whcih then leads to heart disease ie it reduces risk of heart disease from kidney disease but doesnt later the filtering rate ie egfr.  Hope I am more informed when see nephrologist next month, so worrying and conflicting.  Your drop is very high.  What I have read and oh boy have read lots, says that OVER the age of 75 a ftop of two points per year is expected. However, regardless of stage of CKD, a drop of MORE THAN 4 per year warrants early referal. So were a both in a lot of crap!!!!!! look at it this way. I have lost 37 in 8 months, taking me from stage 1 to 3. If I lose another 37 in next 8 nihts, thats end stage ESKD.   this drop, although fast, has shown a stable trend ie over a few tests in the 8 months.  suggesting further rapid decline is likely. if you show an ongoing decline start jumping up and down for a early referal. some doctors dont refer till 40, unless there is a rapid decline. OVER 5 IS RAPIID  we are extreme, so PUSH

[lindahand]

You can increase your GFR. I know because I did. I raised it about 13 points following a kidney diet strictly. Right on the sheet we are given by the nephrologist it says "Kidney diet to maintain or raise GFR" I was very good about not cheating. I go back in April to see if it is staying the same or rising. By taking the strain off the kidneys you are given the chance to heal them. I don't think you can 'cure' CKD, but you can help slow the progression and make moderate gains in terms of GFR.

Diet is so essential so that you don't lose more function. Everyone with CKD should follow a kidney diet. There is a lot that is out of our control but there is a lot that is in our control.

And the diet isn't that bad. I miss tomatoes, spinach and dark colas. That took a lot of adjustment. I made tomato based dishes at least 3 times a week. It is a pain in the butt to soak potatoes overnight to remove the potasium, but it is doable. I am never that organized. I decide what to make for supper about 2 hours before I make supper. lol. I find I feel better overall ditching the processed food (too much phosphorus), and eating a more balanced diet.

We can make a difference in our GFR.

[Katarina2010]

I have been having trouble lately with doctors agreeing with diagnosis.  In June of last year, after several months of feeling crappy, having bad rash on face and chest, and ANA 320 a rheumatologist diagnosed Lupus.  Was put on Prednisone and Plaquenil, got off prednisone in September.  Initial work up in July showed GFR 110' great!  I was happy, doctor happy, all good.  August was 93, and in September result was 79.  Not so happy anymore.  Since Sept have moved to new city, found new Rheumi that has decided that since my ANA rate has gone down and she never saw my rash I don't have Lupus.  She was very busy (because she was late to office) and said she didn't have time to go over all results, so told me to come see her again if I had any arthritis problems which she can handle.  I asked for more tests because those ones were almost two months old and I wanted most recent for GP appointment tomorrow.  I have been feeling pretty good, Plaquenil seems to be working well for me (she told me to stay on Plaquenil even though she thinks I am fine) but I am anxious about what my GFR will show.  I know that 79 is still in normal range, and will be happy if it is still there.  Since the GP tomorrow is also new and did not see me during flare I am concerned he will also brush me off as a woos, and I won't know how to respond without looking like a crazy person.

[lindahand]

Bring in a written list of questions and refer to it matter of factly. Don't leave until you get your questions answered.

You are not a crazy person so you will not appear to be one. Too if you got your chart transferred (which if you haven't you should) your original doctor's notes will be in there and doctors tend to believe doctors.

[Katarina2010]

Well, I went to appointment with GP yesterday only to find out that the Rheumi I saw had not forwarded any of my test results to him as requested, so there was nothing to go over.  I tried to tell him how my appointment had gone but he felt I should be happy that she said I did not have Lupus, because it was a horrible disease.  I wild be happy if kI trusted her judgement, which at this point is iffy.  The nurse made it her job to get lab results before I left and I got a copy of both the November and December.  By then my doc had gone on to other patient and told me he would call if there was anything alarming to report.  On going through results myself, I found it alarming that it did not show results of ANA in Nov which she had said were good, and she had not ordered a GFR.  The results for Dec did not show GFR either, but did show positive ANA +1280.  So, after GFR drop of 31 points in three months, I have nothing for the last four.  Do I give GP time to decide there is a problem and phone me or do I call him.  I have given both Rheumi and GP copies of my records with diagnosis, and I asked him why now I had to start all over again.  He said well the new Rheumi had apparently not seen anything to confirm, but since she did not seem to have looked at lab results she was just going by my appearance, and seemed to be disappointed I had no Arthritis which she is apparently more comfortable with.  I agree with you that you would think they could trust another doctors diagnosis and try to work forward from there, but I guess not.  I have been feeling pretty good for over a month and was looking forward to seeing some nice labs, feel quite frustrated now.  I guess if I am feeling OK I should just wait and see???  Thanks for listening!

[CindyM1972]

Katarina,

The squeaky wheel gets the grease!  In other words, bug your doctors until you feel satisfied.  If they seem to be paying no attention to your concerns you should find a new doctor.  You can ask your GP to refer you to a Nephrologist but I was wondering if you've had any new lab work done or urine collections done to address a possible kidney disease threat.  That much of a drop in a short period of time should be investigated.  Be squeaky.  You are your own advocate.  

When my eGFR droped to 47 my GP acted like it was no big deal.  I pressed him to do further test in a couple of months which he did.  My GFR was then 46 and upon my request he referred me to a Nephrologist.  I have another post on here from yesterday which explains more about my problems but I think you should get your doctor going on a follow up.

Good Luck!

[lindahand]

You are entitled to a second opinion and I believe should ask for one. I hope you don't have lupus. It is a horrible disease.

I would go back and insist on getting a GFR done. Soon. I also always go back and get them to go over the lab results. I have had things missed by not doing that.

It is a fine line. You don't want to be labelled a 'difficult' patient because then they will treat you like crap, but you need to get your answers to. I would use a lot of words like "I am very concerned". That should be neutral enough.

[WorriedaboutGFR]

Suggestion:  Do what I do:  After I have labs drawn, I always go back a few days later to the lab and obtain a copy of the results myself.  That way, not only do I have the results to show my doctor (in case the lab doesn't send them to him) but I also have time to read my labs before my appointment and understand what issues there might be.  This is very important!!  The one time I didn't get a copy of my labs before going to my appointment, my doctor told me that all my labs were all "normal."  That happened to be the time that my GFR had dropped 40 points to 53!!  Another time I obtained a copy of my labs and took them to my doctor and behold - the lab had omitted a couple of very important abnormalities from the set of labs sent to my doctor!!  In other words, our two sets of lab test results were slightly different - only mine was complete and I was able to show the abnormalities to my doctor.  Once you return home from your doctor appointment, put your labs in a notebook so you will have a collection of all your recent labs.  That way you can observe trends in your questionable lab results over time.

[WorriedaboutGFR]

Dear Lindahand:   THANK YOU SO MUCH for sharing with me that it is possible to raise GFR by going on kidney diet restrictions!  Yes!  It worked for me!!
I have drastically cut my protein and salt intake along with my phosphorus and potassium intake (because I always felt so much worse - including heart rhythm irregularities -  after consuming foods high in potassium and phosphorus).  I also discontinued one medication and reduced dosage by 50% of another I had been on for about a year for my Lyme disease.  I just got back my most recent lab test results:  My GFR went up 19 points from 53 to 72!!  I am sooooo happy about that!  However, 72 is still a 21-point drop from what my GFR was 5 months ago.  Do you think I should still see a nephrologist?  If I were to resume eating as I used to, I believe my kidney labs would worsen.  My most recent labs I had done fasting early in the morning whereas my other labs were done in the afternoon and were nonfasting.  Does time of day labs are drawn and whether or not patient is fasting make a difference in the test results?
Again, thanks for the valuable input!  Consider yourself hugged!!!

[lindahand]

Congratulations!!!!

I would ask the doctor about going to a nephrologist, but I wouldn't worry too much. 72 is a good number.

I don't think time of day matters for blood tests - I've never been told to go at a certain time.

[bgnana]

Please let me know how I can get a copy of your diet to increase GFR. My nephrologists says he only knows of the kidney diet,  If you could send me a copy of any info would be greatly appreciated. thx, bgnana

[lindahand]

I bumped the post "Diet does make a difference" it outlines what I did to raise my GFR. It doesn't raise the numbers for everyone but it hurts no one. It can only help your kidneys function better. It is the kidney diet. I googled it and it didn't come up with any good results. I know that I read a really good booklet that I think came from the Canadian Kidney Foundation, but I am sorry I don't remember exactly. My post pretty much covers it I think.