Glomerular Filtration Rate and Hematuria Changes in Kidney Health

The glomerulus and occult blood?

Hello, doctor.
I would like to ask about a glomerular filtration rate (GFR) of 64.6, with the standard being greater than 60.
Two years ago, it was 84.
Does this indicate a decline in kidney function? Additionally, the urine occult blood test has changed from 4+ to 5+.
What does this mean? Will it affect the kidneys? Other indicators, including urine protein, are normal.
Thank you.

A Jun, 40~49 year old female. Ask Date: 2023/10/23

Dr. Wu Hongjie reply Internal Medicine

Occult blood testing is different from hematuria; it may be caused by recent infections, kidney stones, medications, or excessive exercise.
The filtration rate can vary with fluid intake, renal function deterioration, and increased body weight.
It is advisable to assess the presence or absence of proteinuria to determine if there is any renal dysfunction.

Reply Date: 2023/10/23

More Info

Hello! Thank you for your question regarding your kidney health, specifically concerning your Glomerular Filtration Rate (GFR) and the changes in hematuria (blood in urine).
First, let's discuss the Glomerular Filtration Rate (GFR). GFR is a crucial indicator of kidney function, measuring how well your kidneys filter blood. A GFR of 64.6 mL/min indicates that your kidney function is slightly below the normal range, which is typically considered to be above 60 mL/min. This decline from a previous GFR of 84 mL/min suggests a gradual decrease in kidney function over time. While a GFR above 60 is generally considered acceptable, it is essential to monitor any changes, especially if there is a downward trend.
The decline in GFR can be attributed to various factors, including chronic conditions like hypertension, diabetes, or other kidney diseases. It is crucial to identify any underlying causes to prevent further deterioration of kidney function. Regular follow-ups with your healthcare provider, including blood tests and urine analysis, are essential to monitor your kidney health.

Now, regarding the increase in hematuria from 4+ to 5+, this indicates a higher level of blood in your urine. Hematuria can arise from various causes, including urinary tract infections, kidney stones, glomerular diseases, or even more serious conditions like tumors. The presence of blood in the urine is a significant finding and should not be overlooked. It is essential to investigate the cause of hematuria further, especially since it has increased in severity.

The fact that your urine protein and other indices are normal is reassuring, as significant proteinuria often indicates more severe kidney damage. However, the presence of hematuria, especially with an increase in severity, warrants further investigation. Your healthcare provider may recommend additional tests, such as imaging studies (like an ultrasound or CT scan) or a cystoscopy, to determine the source of the bleeding.

In summary, while your current GFR of 64.6 mL/min is still within an acceptable range, the decline from your previous level and the increase in hematuria are concerning signs that should be addressed. It is crucial to work closely with your healthcare provider to monitor your kidney function and investigate the cause of the hematuria. Early detection and management of any underlying conditions can help preserve kidney function and overall health.

If you have any further questions or concerns, please do not hesitate to reach out to your healthcare provider for personalized advice and management strategies. Your health is paramount, and staying informed and proactive about your kidney health is essential. Thank you for your inquiry, and I wish you the best in your health journey!

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