Daily Archives: June 6, 2019

Good morning, this was your response to my question. If the creatinine clearance is high and the elevated serum level is also high why is that? You said it was creatinine generation. Is it due to kidney size at all? I have 10.9 and 10.7 kidney size. I was at 1.7mg/dl and I had eaten a meal with chicken a few hours before. The 1.4mg level was when I was so scared I practically cut out all meat. I am just curious how this can still be normal? Please describe normal for me in Depth. Can normal still be reduced?? How can one have a low gfr and still have normal function that doesn’t make sense. Please explain this to me as well. I appreciate it. Response: If this is the case, then your serum creatinine is elevated because you have an increased creatinine generation rate. This is most commonly due to increased muscle mass as compared to the average individual. An increased intake of red meat can also increase the creatinine generation rate and lead to an elevated serum creatinine. The equations that we use to estimate the glomerular filtration rate (eGFR) are not very accurate or reproducible with values above 60 milliliters per minute per 1.73 meters squared. There are other ways of measuring the glomerular filtration rate but if you are using a serum creatinine and the estimating equation, anything above 60 is considered a normal GFR. Stage 2 chronic kidney disease (CKD) requires a eGFR between 60 and 89 for at least three months AND the presence of abnormal urinary findings (blood, protein, or infection), abnormal ultrasound examination, or abnormal kidney biopsy that is also present for at least three months. For eGFR’s above 60, you need more than just the eGFR in order to diagnose CKD. It is true that an accurately measured glomerular filtration rate (GFR) should be greater than 120 milliliters per minute per 1.73 meters squared.

I am not sure I can explain this any better. If your kidneys are clearing creatinine from your body at an elevated rate, then they are doing their job and they are normal. If your blood creatinine is still elevated, … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Serum Creatinine

I recently had routine bloodwork done as part of my annual checkup. My BUN was 26, my Creatinine was .66. My ratio was 39. Is this a cause for concern? Thank you in advance.

The Blood Urea Nitrogen to creatinine ratio (BUN:Creat) is not a very good test. I do not recommend using this test to define any specific illness or condition.  

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions

Hello, Hello, I am a 34 year old male. Every time I get my eGFR tested, it comes back in the 70’s. First at 78, then at 76, and most recently at 73. This message also appears under each reading: An eGFR from 60-89 ml/min/1.73 m2 is consistent with mildly decreased kidney function. I have been having a number of health challenges over the past few years and I am wondering if this is something I should be concerned about based on my age. Thank you.

The equation that we use to estimate the glomerular filtration rate (eGFR) is not very consistent at measuring an eGFR greater than 60 milliliters per minute per 1.73 meters squared. From one test to the next, variation of 10 or 20 … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions

Hi Dr. Spry. I just want to know if a patient can be diagnosed with stage 5 kidney disease with creatinine fluctuating 4.5 – 5.6 for the past year with NO symptoms? Once he started to feel weak and fatigued; slept a lot, felt like that every day and gradually felt worse and worse showing more symptoms of CKD that lead to dialysis or can those symptoms fluctuate; a few days slept a lot, no energy; but still ate well and the next days felt well and able to walk 1/4 of a mile? I guess my question is once you are going down with CKD symptoms, can you go down gradually but not fluctuating with the symptoms? Thank you Dr. Spry for listening.

Each patient is very different. In many cases, patients have some good days and some bad days. There is not a sudden change with progressive chronic kidney disease (CKD). Dialysis is commonly offered when there is more bad days than … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney-Related Health Questions, Nephrologist

Re: 47 yo, Stage 3b CKD, GFR 34 Cr 198. Thank you for your response to my questions regarding “ACKD”, my apologies for not specifying this acronym; is in reference to Acquired Cystic Kidney Disease. 3 yrs ago I only had a few small cysts during a stone search CT and now they’ve taken over the entire interior of both organs. I’m looking for links, studies, or journals referencing the effects of Acquired Cystic Disease in pre-dialysis cases. I understand it’s caused by the CKD rather than dialysis, and can occur before treatments begin. I am trying to research in what ways will having both kidneys already completely full of aqcuired cysts, as well as the usual stones and calcium pools may affect my treatment options and outcomes. As most cases don’t advance to this level until several years into treatment. I’m not finding any information regarding cases of fully developed ACKD in pre-treatment patients. Thank you for the links and information regarding cardiovascular issues related to CKD. My nephrologist recommendation to see a neurologist and cardiologist are well explained in the links you provided. Thank you for spending your time with this blog helping CKD patients this is a wonder resource and help to our community.

Acquired cystic kidney disease is generally a benign disease. It is caused by the chronic kidney disease (CKD) and as people age, the cysts become more numerous. It is very common. About 40% of the population will show cysts in … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney Cysts, Kidney-Related Health Questions