Your Health Check Report: Key Insights on Kidney Function and Cholesterol

Q: Your Health Check Report: Key Insights on Kidney Function and Cholesterol

Dear Mr. Anonymous： 1. Estimated Glomerular Filtration Rate (eGFR)： The commonly used formula is MDRD-Simplified GFR (mL/min/1.73 m²) = 186 × Scr⁻¹.154 × Age⁻⁰.²⁰³ × 0.742 (if female). 2. Chronic Kidney Disease (CKD) refers to kidney damage due to long-term infl

Regarding the health examination report?

Hello, doctor.
I had an adult health check at the health center in April and have some questions.
Currently, the test results show some issues: GOT: 18 (normal range 0-39), GPT: 15 (normal range 0-41), creatinine: 1.0 (<1.3), and glomerular filtration rate: 87.96.
The only abnormal result in red was slightly elevated cholesterol.
The doctor mentioned that it wouldn't have an impact and advised me to eat less fried food and exercise more, but he did not address the glomerular filtration rate, which has a note of "mild chronic kidney injury." I'm unsure what this might indicate.
I've been under more stress and have had poor sleep over the past 2-3 years; could this be affecting my health?

Niming, 40~49 year old female. Ask Date: 2019/05/10

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Anonymous:
1.
Estimated Glomerular Filtration Rate (eGFR): The commonly used formula is MDRD-Simplified GFR (mL/min/1.73 m²) = 186 × Scr⁻¹.154 × Age⁻⁰.²⁰³ × 0.742 (if female).
2.
Chronic Kidney Disease (CKD) refers to kidney damage due to long-term inflammation (such as infection, immune complex injury, inflammatory response), chronic diseases (such as diabetes, hypertension), or damage from urinary obstruction, lasting more than three months, leading to permanent structural or functional changes that cannot be restored to normal.
According to the criteria, CKD can be diagnosed if any of the following conditions are met:
a.
eGFR greater than 60 ml/min/1.73 m² with clinical evidence of kidney damage, such as proteinuria, hematuria, or abnormalities in imaging or pathology, with a duration of more than three months.
b.
Regardless of the presence of evidence of kidney damage, eGFR less than 60 ml/min/1.73 m² lasting more than three months.
3.
Staging of Chronic Kidney Disease:
- Stage 1: Normal kidney function but with evidence of kidney damage, such as microalbuminuria.
GFR: ≥ 90 ml/min/1.73 m²
- Stage 2: Mild chronic kidney dysfunction with evidence of kidney damage, such as microalbuminuria.
GFR: 60 - 89 ml/min/1.73 m²
- Stage 3: Moderate chronic kidney dysfunction.
GFR: 30 - 59 ml/min/1.73 m²
- Stage 4: Severe chronic kidney failure.
GFR: 15 - 29 ml/min/1.73 m²
- Stage 5: End-stage kidney disease.
GFR: < 15 ml/min/1.73 m²
4.
Serum creatinine levels can be influenced by many factors, including gender, age, muscle mass, diet, and nutritional status.
5.
Your glomerular filtration rate is 87.96 ml/min/1.73 m², indicating mild chronic kidney injury.
However, as mentioned earlier, serum creatinine levels can be affected by gender, age, muscle mass, diet, and nutritional status; if you have no discomfort, there is likely no need for excessive concern.
It is advisable to avoid high salt, high-calorie, and high-cholesterol diets, and if possible, drink more warm water to help accelerate the elimination of metabolic waste.
You may also consider returning for blood tests in the nephrology or family medicine clinic in three months for follow-up.
6.
If you have further questions, it is recommended that you discuss them with your family physician or visit a nephrology clinic for medical consultation.

Reply Date: 2019/05/10

More Info

Understanding your health check report is crucial for maintaining your overall well-being, especially when it comes to kidney function and cholesterol levels. Based on the information you've provided, let's break down the key components of your report and discuss their implications.

Kidney Function
Your report indicates a serum creatinine level of 1.0 mg/dL, which is within the normal range (typically less than 1.3 mg/dL). This suggests that your kidneys are functioning adequately at the moment. However, the mention of "mild chronic kidney injury" alongside a glomerular filtration rate (GFR) of 87.96 mL/min is noteworthy. A GFR of less than 90 mL/min can indicate some degree of kidney impairment, even if the creatinine level appears normal.

Chronic kidney disease (CKD) is often categorized into stages based on GFR. A GFR of 87.96 places you in Stage 2 CKD, which is considered mild. While this stage may not present significant symptoms, it is essential to monitor your kidney function regularly. Factors such as high blood pressure, diabetes, and lifestyle choices can contribute to the progression of kidney disease.

Cholesterol Levels
You mentioned that your cholesterol levels are slightly elevated, which is a common concern. Elevated cholesterol, particularly low-density lipoprotein (LDL) cholesterol, can increase the risk of cardiovascular diseases. Your doctor’s advice to reduce fried foods and increase physical activity is sound. A heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins can help manage cholesterol levels. Regular exercise, aiming for at least 150 minutes of moderate aerobic activity per week, can also be beneficial.

Lifestyle Factors
You noted that you have been experiencing increased stress and poor sleep over the past 2-3 years. Both stress and inadequate sleep can adversely affect your health, including your kidney function and cholesterol levels. Chronic stress can lead to elevated blood pressure and hormonal changes that may exacerbate kidney issues. Additionally, poor sleep quality is linked to metabolic disturbances, including dyslipidemia (abnormal cholesterol levels).

Recommendations
1. Regular Monitoring: Continue to have regular check-ups to monitor your kidney function and cholesterol levels. This includes blood tests for creatinine, GFR, and lipid profiles.

2. Dietary Adjustments: Focus on a balanced diet. Limit saturated fats and trans fats, and increase your intake of omega-3 fatty acids found in fish, nuts, and seeds. Consider consulting a nutritionist for personalized dietary advice.

3. Physical Activity: Incorporate regular physical activity into your routine. This can help manage weight, improve cardiovascular health, and potentially benefit kidney function.

4. Stress Management: Explore stress-reduction techniques such as mindfulness, yoga, or meditation. These practices can improve your overall well-being and may positively impact your kidney health.

5. Sleep Hygiene: Prioritize good sleep hygiene. Aim for 7-9 hours of quality sleep per night, and establish a calming bedtime routine to improve sleep quality.

6. Consultation with Specialists: If you have concerns about your kidney function or cholesterol levels, consider consulting a nephrologist or a cardiologist for specialized care.

Conclusion
In summary, while your kidney function appears stable at this time, the designation of mild chronic kidney injury warrants attention and proactive management. Your cholesterol levels, though slightly elevated, can be managed through lifestyle changes. Addressing stress and sleep issues is equally important for your overall health. By taking these steps, you can help maintain your kidney health and reduce the risk of complications in the future. Always consult with your healthcare provider for personalized advice and treatment options.

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