Category Archives: GFR

Hi Dr. Spry, I have a question regarding dehydration and the progression of chronic kidney disease. I know that BUN lab could also be affected by dehydration. How do you distinguish true dehydration and worsening of the disease in renal patients based on the lab values like BUN, BCR, serum creatinine, GFR or serum Na?

The blood urea nitrogen (BUN) may reflect kidney function but is affected by many other things other than kidney function.  The best test to estimate kidney function is the estimated glomerular filtration rate (eGFR).  The BUN to creatinine ratio (BUN/Creat) … Continue reading

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

My 88 year old mother has been recently diagnosed with stage III Kidney disease. Her potassium levels were found to be high. She’s already on warfarin to prevent clotting due to a genetic blood factor. The poor thing doesn’t know what to eat and is rapidly losing weight. Her urologist gave her a booklet which lists foods she can’t eat. Those foods coupled with the Vit K list of foods not to eat are leaving her with very little food choices. She’s not able to see a dietician for weeks. I’m afraid she’ll lose so much weight that her kidneys will fail. Can you help with a couple day menu of foods she can eat?

I am a strong advocate for the DASH diet.  The DASH diet will be the best thing for her chronic kidney disease (CKD).  Since she is taking warfarin as a blood thinner, it is important to eat consistently and avoid … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments

I was recently diagnosed with Stage 3a CKD, much to my shock. It is stable since last year, according to my doctor. He didn’t recommend anything specific other than healthy diet, exercise, no NSAIDs and monitor blood pressure. However, I read a lot about lowering protein and phosphates, etc. I also think I am at risk for osteoporosis and had been taking a lot of supplements, including calcium. I am wondering if I should see a nephrologist and/or dietician for advice at this stage. I would like to be proactive and delay worsening of this condition. I am 66. I would appreciate your input.

Your primary care physician is well qualified to care for early stage chronic kidney disease (CKD).  It is most important that you continue to see your physician regularly and have blood and urine testing for CKD.  If your blood pressure … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney-Related Health Questions, Laboratory Testing, Treatments

Hello sir. I am male and 37 years old. Weight is 55 Kg. I am athletic muscular. I do regular walking, jogging, karate exercises. Recently I had tests. My creatinine is 1.14 . I calculate eGFR online. It says my GFR is 69. Now, I just wanted to know, do I have kidney disease? Should I do more check up tests? because I don’t feel any pain in kidneys. Also my blood pressure and sugar level is normal.

I cannot make a diagnosis of chronic kidney disease (CKD) based on the information that you present.  You should also have urine testing for blood, protein or infection in the urine to determine if you could have CKD.  People who … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

I am a 51 y.o. caucasian woman with a GFR of 45, Creatinine of 1.27, 4.3 Albumin and BUN of 11. I am overweight, have slightly elevated cholesterol (204) though I exercise religiously 3x a week – 180 minutes total – doing cardio exercise, circuit training, and weight lifting. My BP is pretty average and I am not diabetic. My question is this: Am I at a point that I should pursue treatment with a nephrologist, or is it still relatively early? My GFR has dropped steadily for years and this is the highest creatinine reading I’ve had as well, so I am concerned.

The information that you provide would suggest that you have Stage 3 chronic kidney disease (CKD).  Most primary care physicians (PCP’s) are very capable of managing Stage 3 CKD.  The main treatment for your disease is likely to lose weight, … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Hypertension/High Blood Pressure, Kidney Biopsy, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Treatments

(Lab #1) S-creatinine 123 umol/L Abs. eGFR 50 mL/min U-alb. 100 mg/L; U-cre. 6.25 mmol/L ACR 16.00 g/mol 2016-10-07 09:24 (Lab #2) S-creatinine 150 umol/L Abs. eGFR 46 mL/min U-alb. 98.3 mg/L U-cre. 8.45 mmol/L ACR 11.63 g/mol 2017-03-23 11:07 (Lab #2) S-creatinine 144 umol/L Abs. eGFR 48 mL/min U-alb. 89.3 mg/L U-cre. 14.48 mmol/L ACR 6.17 g/mol A) From these numbers can it be said that the kidneys’ condition is probably a) getting worse, b) stable c) getting better? B) Why or why not? Thank you, Doctor!

The urine microalbumin level and the estimated glomerular filtration rates (eGFR’s) that you quote are not different from each other.  These measurements are within the usual variation expected with laboratory measurements.  Hence, these measurements are stable.  

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

I am concerned about my kidney function. I am a 56 years old, white male in seemingly good health. About three years ago the doctor measured my GFR at 93. A year ago, my GFR had dropped to 82. I also had a kidney stone removed at that time. My GFR is now at 83. I’m concerned that my creatine levels increased so abruptly. How concerned ought I be about this? Should I have more tests run? What should I do now? FYI: I am generally healthy, except for occasional bouts with constipation (especially on weekends and long holidays). All of my other serum levels are normal (see below). My doctor is tells me I’m healthy, but based on what I found here (looking up GFR), it looks like I have Stage 2 kidney disease. My diet is very similar to the DASH, except that my wife likes to cook with a little more salt than I wish. My weight is good (I’m 5’8″ and 135-145 lbs). Also, my GI doctor had me on Nexium for nearly 3 months for gastritis. Recent Serum levels: SODIUM 137 POTASSIUM 4.5 CHLORIDE 102 GLUCOSE 80 UREA NITROGEN 9 CREATININE 1.01

I do not identify any kidney disease based on the information that you present.  There is some variability to the estimated glomerular filtration rate (eGFR) and the two levels that you mention are within the usual range of variability for … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Diet/Nutrition, GFR, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

I am taking blood thinners for a clot in my leg. I have stage 3 kidney disease. What are the risk?

Patients with Stage 3 chronic kidney disease (CKD) can take blood thinners but they should be carefully monitored with blood testing and monitored for bleeding.  Most blood thinners are approved for use in Stage 3 CKD.  You should discuss your … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Function, Symptoms and Side Effects, Treatments

I am a female, age 58, no diabetes, or high blood pressure, recently tested GFR 48, down from GFR 68 twenty days ago. I have fluid retention and a lot of back pain with fever 100 – 102. No UTI (but suprapubic pain). Urinalysis: No protein, Leukocyte (70), hemoglobin small, all other normal. Doctors point at creatinine level (1.17) and believe due to dehydration and other symptoms not related to kidney. No referral to urologist, no diagnosis of kidney disease, no treatment offered for symptoms. Any recommendations to treat symptoms — now can’t work/function. Thanks. (p.s. I know need to push for more tests).

I am unable to make a specific diagnosis based on the information that you present.  I agree that you need further testing.  I suggest that you consult with your primary care physician for further testing or referral.  An ultrasound examination … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Diabetes, GFR, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis

I have type 2 diabetes. My last blood test shows my GFR is 41. My Doctor recommended that I drink 64 ozs of water daily but I see on different kidney websites that liquids should be limited. Should I follow her advice. She is a general practitioner and not a kidney or endocrine specialist.

I would recommend that you continue to drink water and avoid dehydration.  Water should only be limited if you are on dialysis or have significant problems with heart failure.  I do not recommend limiting your water intake with Stage 3 … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, GFR, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments