eGFR and Creatinine Levels: Should You Be Concerned?

eGFR, creatinine

Hello doctor, I would like to ask about my situation.
In September 2021, my blood test showed an eGFR of 67.06 and a creatinine level of 1.
After seeing these values outside the normal range, I consulted my doctor, who suggested that if I was concerned, I could have a urine test.
I subsequently had the urine tested, and during my follow-up, the doctor said there were no issues with the urine.
So, I left it at that.
Recently, in February 2022, I had another blood test before an MRI, which showed an eGFR of 60.08 and a creatinine level of 1.1.
I am unsure if this indicates a kidney problem, and I am a bit worried.

Chi, 30~39 year old female. Ask Date: 2022/02/18

Dr. Huang Yaoxuan reply Internal Medicine

Hello Ms.
Chi, you mentioned that you have had two blood creatinine tests in the past six months, with results of 1 and 1.1, and eGFR values of 67.06 and 60.08, respectively.
The urine test report indicated no issues.
Here is some information for your reference:
1.
eGFR stands for estimated glomerular filtration rate, which is an indicator used to assess kidney function.
However, measuring the actual glomerular filtration rate is challenging with standard testing methods.
Therefore, clinicians and laboratory technicians have sought various "alternative" methods to estimate the glomerular filtration rate.
(I will not elaborate on the details of these alternative methods, as research in this area is ongoing worldwide.) The current standard method is to measure serum creatinine levels through a blood test (note that creatinine is not a uremic toxin; it simply behaves similarly to uremic toxins in terms of renal metabolism).
Based on age and gender, the estimated glomerular filtration rate (eGFR) is calculated to simulate kidney function.
The most commonly used formula for calculating eGFR today is the MDRD equation, which becomes less accurate when eGFR exceeds 60.
Additionally, eGFR values vary by age and gender.
For a 35-year-old female, eGFR values of 60 and 68 are not far from normal, and since eGFR above 60 is inherently less accurate, there is no need for excessive concern.
If needed, you can discuss this further with a nephrologist.
2.
I believe it is more important to focus on how to "maintain" kidney health rather than fixating on minor fluctuations in blood test results: monitor your blood pressure daily (and record it if possible), control your diet (avoid excessive oil and salt, and refrain from binge eating), and engage in moderate exercise.
I hope this information is helpful to you.
Thank you!

Reply Date: 2022/02/18

More Info

Understanding your eGFR (estimated Glomerular Filtration Rate) and creatinine levels is crucial for assessing kidney function. The eGFR is a calculation based on your serum creatinine level, age, sex, and race, and it provides an estimate of how well your kidneys are filtering blood. Normal eGFR values typically range from 90 to 120 mL/min/1.73 m², but values can vary based on individual factors.

In your case, your eGFR values have decreased from 67.06 mL/min in September 2021 to 60.08 mL/min in February 2022, and your creatinine levels have increased from 1.0 mg/dL to 1.1 mg/dL. While these values are not drastically outside the normal range, they do indicate a decline in kidney function, which can be concerning.

A decrease in eGFR can suggest that the kidneys are not functioning as well as they should be. An eGFR below 60 mL/min is generally considered indicative of chronic kidney disease (CKD), particularly if it persists over time. However, it is essential to consider other factors, including your overall health, medical history, and any symptoms you may be experiencing.

Since your doctor recommended a urine test, and it came back normal, this is a positive sign. A normal urine test can indicate that your kidneys are still functioning adequately in terms of filtering waste products and maintaining electrolyte balance. However, it is essential to monitor your kidney function regularly, especially if you have risk factors such as diabetes, hypertension, or a family history of kidney disease.

Here are some additional considerations regarding your situation:
1. Lifestyle Factors: Maintaining a healthy lifestyle can significantly impact kidney health. This includes staying hydrated, following a balanced diet low in sodium and processed foods, managing blood pressure, and controlling blood sugar levels if you have diabetes.

2. Follow-Up Testing: Regular follow-up with your healthcare provider is crucial. They may recommend periodic blood tests to monitor your creatinine levels and eGFR, as well as urine tests to check for protein or blood in the urine, which can indicate kidney damage.

3. Potential Causes: There are various reasons for a decline in kidney function, including dehydration, medications, high blood pressure, diabetes, or underlying kidney disease. Discussing your medical history and any medications you are taking with your doctor can help identify potential causes.

4. Symptoms to Watch For: While you may not currently have symptoms, it is essential to be aware of signs that could indicate worsening kidney function, such as swelling in the legs or ankles, fatigue, changes in urination patterns, or persistent nausea.

5. Consultation with a Specialist: If your eGFR continues to decline or if you have concerns, your doctor may refer you to a nephrologist (kidney specialist) for further evaluation and management.

In summary, while your eGFR and creatinine levels indicate a decline in kidney function, the normal urine test is reassuring. It is essential to continue monitoring your kidney health and maintain open communication with your healthcare provider. They can provide personalized advice and determine if any further action is necessary based on your overall health and risk factors.

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