Low Glomerular Filtration Rate: What You Need to Know - Internal Medicine

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Understanding a low Glomerular Filtration Rate (GFR) is crucial for maintaining kidney health and overall well-being. GFR is a measure of how well your kidneys are filtering blood, and it is an essential indicator of kidney function. A normal GFR typically ranges from 90 to 120 mL/min/1.73 m², and values below 60 mL/min/1.73 m² may indicate chronic kidney disease (CKD).

In your case, your GFR has decreased from approximately 94.58 to 80.89 over the course of a year, which is a notable decline. While a GFR of 80.89 is still considered to be in the mild stage of CKD (stage 2), it is essential to monitor this trend closely. Factors that can contribute to a decrease in GFR include hypertension, diabetes, certain medications, and underlying kidney conditions such as kidney stones, which you have a history of.

Your blood pressure readings, while slightly elevated, are not excessively high. However, it is important to manage blood pressure effectively, as uncontrolled hypertension can lead to further kidney damage. Maintaining a healthy lifestyle, including a balanced diet low in sodium and rich in fruits and vegetables, regular exercise, and proper hydration, can help manage blood pressure and support kidney health.

The medications you mentioned, particularly those for nasal congestion, can sometimes have side effects that impact kidney function. Nonsteroidal anti-inflammatory drugs (NSAIDs), for example, can lead to kidney injury if used long-term or inappropriately. It is advisable to consult with your healthcare provider regarding any medications you are taking, especially if you have concerns about their impact on your kidney function.

Your lab results indicate that your creatinine levels have increased slightly from 1.02 to 1.16, which aligns with the decrease in GFR. Creatinine is a waste product that kidneys filter out of the blood, and rising levels can indicate declining kidney function. Your blood urea nitrogen (BUN) levels have also increased, which can be another indicator of kidney function.

Given your concerns about the significant drop in GFR, it is essential to take proactive steps. Here are some recommendations:
1. Regular Monitoring: Schedule regular follow-up appointments with your healthcare provider to monitor your kidney function. This includes periodic blood tests to check GFR, creatinine, and other relevant markers.

2. Lifestyle Modifications: Adopt a kidney-friendly diet that is low in protein, sodium, and phosphorus, especially if you have any signs of kidney disease. Staying hydrated is also crucial, but be mindful of fluid intake if you have any restrictions.

3. Medication Review: Discuss your current medications with your healthcare provider. They may suggest alternatives that are less harmful to your kidneys.

4. Blood Pressure Management: Keep track of your blood pressure at home and aim to maintain it within a healthy range. If necessary, your doctor may prescribe antihypertensive medications.

5. Avoid Nephrotoxins: Be cautious with over-the-counter medications, especially NSAIDs, and avoid any substances that could harm your kidneys.

6. Consult a Specialist: If your GFR continues to decline or if you have other concerning symptoms, consider consulting a nephrologist (kidney specialist) for a more comprehensive evaluation and management plan.

In conclusion, while your current GFR of 80.89 indicates mild kidney impairment, it is essential to take this seriously and implement lifestyle changes and medical management to prevent further decline. Regular monitoring and proactive care can help maintain kidney function and overall health. If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice.