GFR

[osiag]

I am 37 year old white male with no known health problems.  I am an advid health enthusiam.  Eat well, exercise, keep weight normal etc.  Recently I was reading that chronic kidney disease is underdiagnosed.  I have been going for a full blood work ups every 6 -12 mos for the last 7 years.  Over the last 7 years my creatine has ranged from 1.0 - 1.2, but most often is 1.1; BUN ranged from 13 - 23, but most often is 18 - 20; albumin ranged from 4.7 - 5.3, but most often is 5.0 or 5.1.  There are 11 tests in all, and there is no real pattern except for higher BUN at times when I was on a higher protein diet (25-30%).  Creatine doesn't seem affect by a higher protein diet.  When I plug these amounts in the GFR calculator at kidney.org, I have GFRs of ~ 78 to 90, and again no real obvious pattern, except a bit lower on the high protein.  Recently, I lowered amount of protein in my diet (15 -20%) and are focusing on whole grains.  My most recent test was 7 mos ago and my numbers were: creatinine = 1.1, BUN = 20, albumin 5.3.  According to kidney.org that translates in GFR = 84.  However, the National Kidney Foundation seems to think that normal GFR is > 90.  Do you think that this is an issue?

One last thing 15 mos ago I had a sonogram due to flank pain.  It reveal kidneys normal in size, shape and texture, an no stones.

Can you give me the most important things to do to keep kidneys healthy.  Does drinking water help prevent kidney decline?

[Kevin Pho, MD]

You are correct in that according to the guidelines, normal GFR is > 90.  Note that the equations used on the websites only gives a rough estimate of the GFR.  

That being said, with a normal ultrasound that would evalute for any structural abnormality or kidney masses.  

You can consider a simple urinalysis to determine if there is any protein or blood that can signify kidney disease.  

Adequate hydration will help prevent kidney damage - however if hydration is adequate, then simply drinking water will not be helpful.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com