Declining eGFR: Kidney Health Concerns and Solutions

Q: Declining eGFR: Kidney Health Concerns and Solutions

Hello "lulu"： An eGFR of 117-118 or 99, 94 is considered normal, so you don't need to worry. <br>If you are concerned about your kidneys, it is recommended to measure your blood pressure at home daily (after resting for 20 minutes before taking the measurement). <br>Thank you!

Kidney problems

Hello Dr.
Huang, my estimated glomerular filtration rate (eGFR) values from previous years (2017 to 2020) were consistently between 117 and 118.
However, after undergoing surgery for a gynecological chocolate cyst at the end of March 2021, I started taking a medication called Eltrombopag (one tablet daily) on April 1, 2021, and continued for over a year and a half.
My health check on April 25, 2021, showed an eGFR of 108.
In December 2021, it dropped to 99, and in August 2022, it was 94.
All these tests were conducted at the same hospital.
Is this decreasing trend abnormal? Does it indicate that my kidneys are gradually starting to be damaged? Could the use of Western medicine affect these values? Is there a chance for this value to reverse, and what should I do? I am very worried about the continuous decline in my eGFR and the possibility of developing kidney disease.
What should I do?

lulu, 30~39 year old female. Ask Date: 2022/09/19

Dr. Huang Yaoxuan reply Internal Medicine

Hello "lulu": An eGFR of 117-118 or 99, 94 is considered normal, so you don't need to worry.
If you are concerned about your kidneys, it is recommended to measure your blood pressure at home daily (after resting for 20 minutes before taking the measurement).
Thank you!

Reply Date: 2022/09/19

More Info

Understanding the implications of declining eGFR (estimated Glomerular Filtration Rate) is crucial for assessing kidney health. Your concern regarding the gradual decline in your eGFR from 117-118 in previous years to 94 in August 2022 is valid and warrants a thorough understanding of the potential causes and necessary actions.

Firstly, eGFR is a key indicator of kidney function, estimating how well your kidneys filter waste from your blood. A normal eGFR is typically above 90, and values below this threshold can indicate varying degrees of kidney impairment. The decline you’ve experienced, especially from a high baseline, suggests that there may be underlying factors affecting your kidney function.

Several factors could contribute to a decrease in eGFR:
1. Age: As individuals age, kidney function naturally declines. However, your previous eGFR values were significantly higher, indicating that age alone may not be the sole factor in your case.

2. Medications: You mentioned starting a medication (likely for endometriosis) in April 2021. Some medications can have nephrotoxic effects, meaning they can potentially harm the kidneys. It is essential to discuss with your healthcare provider whether the medication you are taking could be impacting your kidney function.

3. Underlying Health Conditions: Conditions such as hypertension, diabetes, or other systemic diseases can lead to kidney damage over time. If you have any of these conditions, they should be managed effectively to prevent further decline in kidney function.

4. Diet and Lifestyle: A diet high in sodium, processed foods, or excessive protein can strain the kidneys. Maintaining a balanced diet, staying hydrated, and avoiding excessive intake of harmful substances (like alcohol) can help protect kidney health.

5. Hydration: Dehydration can lead to temporary decreases in eGFR. Ensuring adequate fluid intake is essential for kidney health.

Regarding the potential for reversing the decline in eGFR, it is important to note that while some kidney function loss can be reversible, especially if caught early and managed appropriately, chronic kidney disease (CKD) is often progressive. Here are some steps you can take:
- Regular Monitoring: Continue to have regular check-ups with your healthcare provider to monitor your kidney function. This includes routine blood tests to check eGFR and creatinine levels.

- Medication Review: Discuss your current medications with your doctor to evaluate their potential impact on your kidney function. If necessary, adjustments can be made.

- Lifestyle Modifications: Adopt a kidney-friendly diet, which includes reducing sodium intake, limiting processed foods, and ensuring adequate hydration. Regular physical activity is also beneficial.

- Control Risk Factors: If you have any risk factors such as high blood pressure or diabetes, managing these conditions effectively is crucial. This may involve lifestyle changes and medications.

- Consult a Specialist: If your eGFR continues to decline or if you have concerns about your kidney health, consider consulting a nephrologist (kidney specialist) for a more comprehensive evaluation and tailored management plan.

In conclusion, while a decline in eGFR can be concerning, understanding the underlying causes and taking proactive steps can help manage and potentially improve your kidney health. It is essential to maintain open communication with your healthcare provider and follow their recommendations closely. Your health is paramount, and addressing these concerns early can lead to better outcomes.

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