"Glom Filt Rate/Est" is low - Concerned

[Susan1022]

I recently had blood work to determine why I have had two bouts of red spots and blotches on my hands, underarms, inner thighs and between toes in the last three months.  Most of that has subsided and I'm not sure it's even related, but the Basic Metabolic Panel (8) indicated a "Glom Filt Rate, Est" of 51.7  BUN is 14, Serum Creatinine is 1.1 - both of which appear to fall inside a normal range.  Four months ago "Glom Filt Rate, Est" was 57.7 but neither doctor brought this to my attention after review of the lab results, so I didn't think it was any big deal.  But if a low Glom Filt Rate indicates that my kidneys are not filtering impurities efficiently, shouldn't further testing be done?  Also abnormal was Occult blood in urine 1+, which has been the case on and off for ten years.  It also says RBC is 4-10/hpf and the normal range should be 0-3.   In the urinalysis it also indicated "Epithelial Cells (non renal)" >10/hpf and the normal range is 0-10.  Should I be pursuing this with a urologist or a nephrologist or someone?  Everything else in my BMP and my CBC with Differential/Platelet was normal, as were all other values in my routine urinalysis.  I am very nervous about kidney disease, although no one in my family ever had it. My 80 year old father has been diagnosed with some plaque in the kidneys about three years ago, but there are no other kidney conditions in the family.  My BP has always been on the low side, but now is around 110/70.  I am a 54 year old female, and about 50-60 pounds overweight. I am not sure if I am in menopause because I still take Lo-Ovral and still get normal periods.  What do you make of this?

[Stephen Liroff, MD]

First of all, the glomerular filtration rate that was reported may not be accurate. The most accurate way to get that answer is to do something called a "creatinine clearance." This requires a 24 hour urine collection as well as a blood test. Your family physician can easily order this.  Your BUN and Creatinine values are, you are correct, quite normal. As regards your kidney function, a nephrologist would be the person to evaluate this if such is needed.
Your urinalysis is not normal, however, and you need to see a urologist if you persist in having red blood cells (not just hemoglobin positive urine by dipstick) in your urine.
That being said, your urine samples have to be properly collected. They must be mid-stream urinalyses or the results are useless.
Don't get bent out of shape. Get the proper testing and see what is found. Discuss this with the ordering physician.
S.A.Liroff, M.D.

This information is provided for general medical educational purposes only. It
does not  necessarily reflect the opinions of Henry Ford  Hospital  or the
Vattikuti Urologic Institute.  Please consult your physician for diagnostic
and treatment options pertaining to your specific medical  condition

[Susan1022]

By the way, I am not a diabetic and no one in my family has ever had diabetes.  And my health  has been great with the exception of a diagnosis of Sjogren's Syndrome about 15 years ago. The only symptoms I have from this are dry eyes and mouth, and some vaginal dryness.

[Susan1022]

Also, can anything else beside CKD affect the Glom Filt Rate? Can anything be one to make the measurement more normal?

[Susan1022]

Update:  I have now had several exams.  Most recent urinalysis was negative for blood.  All five doctors reiterated what Dr. Liroff says above:  This reading is merely an ESTIMATE based on some of the other values in the urinalysis and age of patient.  All five doctors told me to ignore this reading because all my other values, including serum creatinine were completely normal and have been stable over the last 15 years.  

[PeterPan60]

A related discussion, CKD was started.