The Lupus Forum banner
1 - 7 of 7 Posts

·
Registered
Joined
·
149 Posts
Discussion Starter · #1 ·
Can anyone tell me what the normal range for estimated GFR (glomerular filtration rate) is in the UK, and at what point they start saying that kidney function is deteriorating? My test results have been given in the units mL/min/1.7, and I have had results of 62.4, then several months later 55.8. When I have tried to look at reference ranges for this test using these measuring units, what I have found is that above 90 is normal, 60-90 is mild deterioration, 30-60 is moderate kidney damage. However on other sites (where the measuring units weren't specified) I have seen that 60 plus or minus 10 (i.e a range of 50-70) was normal for women. It does seem that there are several different systems of measuring units, so I really just want to know where my results fit into the pattern - are they normal, or are they showing the beginnings of kidney damage that I should be having monitored a bit more often. At the moment its useless asking my GP anything as his response is "I don't know, you will have to wait until you have seen the specialist"
 

·
Registered
Joined
·
2,661 Posts
Hi

This isn't a direct answer to your question sorry, but there are two tests which are also essential elements of the total picture.

GFR is valid of course (or they wouldn't do it), but it is much more revealing in men and the elderly, and tends to under estimate young women's kidney function (ie it will look worse than it is), especially the closer to normal the renal function is.

Do you know what your blood creatinine is?
And have you had a 24 hour urine collection done and what was the total protein resut from this?

Did you get a copt of the test results, and were the lab norms printed alongside your result. There are indeed different ways of calculating GFR and without knowing how your lab did it, I'd be loathed to make further comment.

In any case it is good you are seeing the specialist.

Do you do home urine testing? Simple dipsticks can reveal protein and can be a useful guide as to how your kidneys are doing - anything over 1+ seen more than twice needs to be followed up with a 24 hour urine collection. If you can't self test, your nurse at the GP surgery will be able to do it for you.

X C X
 

·
Registered
Joined
·
149 Posts
Discussion Starter · #3 ·
In answer to your questions, yes, the results do show the creatinine levels and this seems to be withinin the normal range. I haven't had a 24 hour urine done though. I have showed protein several times in the last two years on dipstick testing, but its been ignored, as in between times when the doctor has done it (for suspected UTIs) it has not shown protein - GP has it on record once, and hospital has it on record on two occasions, and thats it. I would much prefer they look at a 24 hour urine though, as I am quite sure that the times it has been "normal" have been when it has been an extremely weak sample - I usually pass between 3.5 and 4 litres a day, so a trace showing in one sample could actually mean quite a lot over the course of a day. On the lab results sheet, there is no "normal range" given for eGFR, so I can't tell from that.
Unfortunately the specialist I am going to see next is a neurologist and not a kidney person or rheumie, so I'm not sure how much interest they will take anyway. I do wish my GP would take it a little more seriously though, as the latest thing is that my blood pressure has been on the rise, after years and years of it being very low normal. Again, high BP was noted over the course of two weeks by GP, then with one normal reading he decided it was OK and hasn't checked it since. As I don't yet have a diagnosis of lupus, then I guess kidney damage isn't being considered.
In the meantime I'm continuing to monitor myself with both BP and dipstick urine testing, and if it does seem to be getting worse, then I'll definitely be pushing GP to do something more.
 

·
Registered
Joined
·
4,444 Posts
This is for the USA, but it's the best site I've found that lists the ranges/stages of chronic kidney disease based on GFR. The chart is all the way at the bottom, after a lot of other information.

http://www.kidney.org/kidneydisease/ckd/knowGFR.cfm

The key thing to having mild to moderate kidney damage (given your GFRs and assuming they are in the same metric) is that you have protein loss that is unexplained along with a decreased GFR. If the U/A that showed protein also indicated an infection, then some protein in the urine may be expected due to infection. If it was first morning urine that has tested positive to protein, then it is very possible that it would be undetectable later in the day as early morning urine tends to be the one that will show protein (in many diseases although not all).

I would definitely be having a discussion with your doctor(s) about the reduction in the GFR, and discuss what you can do/should do to monitor and help prevent any additional loss. For instance, if you take a lot of NSAID's for pain relief, then you may want to discuss stopping this or switching to the one NSAID that is considered safer for kidneys. {I can't remember the name right now - it was offered to me but I declined}. Just stopping NSAID's has helped one gal I know return to full/normal kidney functioning!
 

·
Registered
Joined
·
2,661 Posts
Hi, Sorry to be asking so many questions, but how much do you drink (water etc not alcohol) a day? 3-4 l urine per day is really a lot. Do you have diabetes, or are you really thirsty?

Sometimes damaged kidneys lose the ability to concentrate urine, so that they let it into the bladder very dilute and in larger volumes than normal. I would have thought that if your kidney function was at this stage though you'de also have a significantly raised creatinine.

Still, with all these potential signs it would be sensible to ask about a referal to a nephrologist sooner rather than later. By the way, according to most hospital protocols a 24 hour urine collection should be done after 2 abnormal dipstick readings.

Be strong and insist on a referal,

X C X
 

·
Registered
Joined
·
149 Posts
Discussion Starter · #6 ·
Cath, I just naturally seem to drink that amount, and fairly consistently from day to day. A lot of it is water or fruit juices, very little caffeine or fizzy drinks and virtually no alcohol. I also have a neurogenic bladder which means I have to catheterise to empty. When I was in hospital last with this, I specifically asked them if I should try and reduce the amount I drink (in order to reduce the need for catheterising) and they said quite clearly NO. I think also that keeping my urine fairly weak does help with reducing the number and severity of infections I get. I think I used to drink this amount years ago as well, as I can remember asking a GP probably at least 20 years ago if 3 litres a day was normal, and was told yes. It does seem though that most people drink and urinate considerably less than me.
 
1 - 7 of 7 Posts
Top