Feb 06, 2012 - 7:24 pm (MST)
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Asked by timbuk2 (Male; 68; 78747; Good health-- Asthma when growing up--Glucose 99--A1c 5 1/2-- heart healthy; Relevant drugs:I take omeprazol
for GERD )
on Sun 20, Jun 2010 10:55am for $49.00:

My last medical checkup showed a reading of 50 L ( GFR estimated ). I am 68 years old and otherwise in good shape. I run or walk at least 3 miles per day and my heart is in good shape. Can a low reading be reversed with lifestyle changes. I take a lot of vitamins and minerals. My potassium level is 4.9 and my creatnine is 1.41. I do know that most of my life I have not been drinking enough water. WD
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Answer by Dr. A. Srivastava (doctor) on Sun 20, Jun 2010 12:39pm:

Hi, Thank you for your question to the forum. Although without being able to examine you and knowing your urinalysis report and BUN, serum total protein, serum albumin/CBC, I can not conclude any final diagnosis to let you know reversing the eGFR result. Any significant fall in eGFR (estimated GFR-Normal above 60 mL) indicates toward Chronic Kidney Disease, but only if this level persists for more than three months. Your present eGFR may be considered normal if you do not have any other symptoms or rest of the investigation reports are within normal range since GFR decreases by 10 ml/min/1.73 m2 every decade of life after 30 years. Additionally, sometimes vegetarian diet may also cause a lower GFR as there is minimal animal protein in the diet, therefore decrease in protein load can cause decrease in filtration. To diagnose early stages of CKD investigations like your detailed history, physical exam, lab tests and imaging of the kidney are required to know the probable cause. Risk factors for CKD include diabetes, high blood pressure, family history, older age and smoking. I encourage you to discuss in details with your doctor and find out what is the probable cause of your low eGFR in order to start appropriate measures. If you have not been evaluated by a Nephrologist until now, please get an appointment at your earliest convenience. Any significant deviation in eGFR results can be an early indicator of kidney disease requiring medical intervention. If kidney dysfunction is diagnosed soon and treated, it will be helpful to preserve remaining nephrons, and preventing the need for dialysis in future. Hope this helps. If you have any more queries related to the health concern, please do not hesitate to post us. Take Care & Regards.
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Comments:

Comment by Dr JS Anand on Mon 21, Jun 2010 12:03am:
Hello, Welcome to the forum and thanks for posting on it. Dr Anurag has answered your query very well. I agree with him that low GFR is indicative of chronic kidney disease but with age, GFR decreases. The National Kidney Foundation (NKF) published the Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for chronic kidney disease (CKD) and used the MDRD formula to classify kidney disease into five stages ranging from a GFR greater than 90 (Stage 1), GFR 60-89 (Stage 2), GFR 30-59 (Stage 3), GFR 15-29 (Stage 4) and less than 15 cc/min (Stage 5). With this classification, we can see the extent of chronic kidney disease. Apart from this, you need to get certain other investigations like urinanalysis, 24 hours urine test, blood tests like eGFR, Creatinine and urea (BUN) in the blood, electrolyte and acid base balance and radiological studies like ultrasound done. A sample of the kidney tissue (biopsy) is sometimes required in cases in which the cause of the kidney disease is unclear. I suggest you to consult a nephrologist and get these investigations done. I hope it helps. Take care and please do keep us posted on how you are doing or if you have any additional doubts. Kind regards.

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