CluelessJoe
Member
In genereal the whole system is bad in Spain, and the way they treat you is awful
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Diabetes and Kidney Problems (and sorry for my other depressing post)
- Thread starter CluelessJoe
- Start Date
ickihun
Master
Hi @Roseanne01 is this thread any use?
JohnEGreen
Master
How low had your eGFR gone? because with CKD it's quite uncommon for the eGFR to be reversed.
Bluetit1802
Legend
Just looked at mine. On diagnosis and at the start of my LCHF way of eating in 2014 it was 64. By the end of 2014 it was above 90 and has stayed that way ever since. It could be down to low carb or could be down to weight loss.
JohnEGreen
Master
Mine was 63 when first found out about it it was mentioned by chance when having pre operation, for AAA stents, check out by anesthetist.
Now at 50 and have lost a lot of weight over the past couple of years or so and am low carb also.
I suppose like so many things it's down to the individual as people vary.
Now at 50 and have lost a lot of weight over the past couple of years or so and am low carb also.
I suppose like so many things it's down to the individual as people vary.
Yes, but with the eGFR the emphasis really should be on the 'e'. Mine goes from 30% to 65%, with this variation meaning absolutely nothing according to my renal consultant.
There is a more accurate way of measuring the gfr, but it's also more invasive and more time consuming.
Consistently high eGFRs, though, are definitely good. Congratulations.
JohnEGreen
Master
GFR is Glomerular Filtration Rate and it is a key indicator of renal function. eGFR is estimated GFR and is a mathematically derived entity based on a patient’s serum creatinine level, age, sex and race. This is usually calculated by the laboratory analysing the blood sample and reported along with the serum creatinine result. A number of recognised and well validated formulae have been used for this purpose including the MDRD and CKD-EPI equations. “Normal” GFR is usually >90 ml/min/1.73m2. (Note the correction for body surface area “per 1.73m2” which is important for certain patient groups, e.g. amputees, extremes of body habitus.) It is best to follow the locally calculated eGFR if possible although one can be calculated using an eGFR calculator.
It is important to bear in mind the following pitfalls and cautions when interpreting the eGFR:
It is only an estimate of kidney function and a significant error is possible. The eGFR is most likely to be inaccurate in people at extremes of body type e.g. patients with limb amputations, severely malnourished and morbidly obese individuals
Confidence intervals: The 90% confidence intervals are quite wide, e.g. 90% of patients will have a true GFR within 30% of their estimated GFR and 98% have measured values within 50% of the estimated value. For an individual patient, however, serial values will be much more consistent than this just as creatinine values are – e.g. a 20% fall in a patient’s eGFR is certain to reflect an important change.
Look at the trend in eGFR – Identifying trends in eGFR is often more informative than one-off readings. i.e. a progressive fall in eGFR across serial measurements is more concerning than stable readings which don’t change over time.
Race: Some racial groups may fit the equations used to calculate the eGFR less well. This is mainly because the datasets used to derive these equations were predominantly white and black US citizens. There is usually a need to apply a correction factor for Black people which varies depending on the formula used: add 21% if MDRD equation and 16% if CKD-EPI is used. In the UK population both the MDRD and CKD-EPI equations seem to work quite well.
Not so good near normal: The equations used for estimating eGFR tend to underestimate normal or near-normal function therefore slightly low values (i.e. around the 60 ml/min/1.73m2 CKD “cut-off” level) should not be over-interpreted. In this situation repeat testing, looking for a progressive decline in renal function over time, or measurement of cystatin C (a different biomarker of kidney function) may be useful. Additional indicators or renal disease should also be sought in these patients – e.g. urinalysis looking for blood and protein, positive family history of renal disease etc… Routine reporting of eGFR values >90 is not recommended and many labs are now reporting all values over 60 as >60. Note, however, that a significant (e.g. 20%) rise in creatinine while eGFR is >60 may still be important as it will usually reflect a real change in GFR.
Values can differ between laboratories. Creatinine measurements can differ significantly between laboratories depending on the methods used to measure it. Furthermore, different laboratories may use a different formula to calculate the eGFR further complicating comparison of eGFR measurements obtained from different laboratories.
Creatinine level must be stable: eGFR calculations assume that the level of creatinine in the blood is stable over days or longer i.e. steady-state; they are not valid if it is changing. It is therefore not valid in patients with acute kidney injury or in patients receiving dialysis, for example.
Age: MDRD and CKD-EPI equations are not valid for individuals under 18 years of age.
https://renal.org/information-resources/the-uk-eckd-guide/about-egfr/
Patients with CKD stage G3 (eGFR 30-59 ml/min/1.73m2) have impaired kidney function. These patients can be further subdivided based on their eGFR as follows:
CKD stage G3a: eGFR 45-59 ml/min/1.73m2
CKD stage G3b: eGFR 30-44 ml/min/1.73m2
Remember that eGFR is only an estimate of kidney function and may require adjustment depending on the patient’s race.
If the decrease in the estimated glomerular filtration rate (eGFR) is due to acute kidney injury with a sudden decrease in kidney function, this can commonly be reversed. If the kidney disease is due to chronic kidney disease (CKD), the recovery of eGFR is usually not possible.
https://www.kidney.org/blog/ask-doctor/can-low-egfr-be-reversed
It is important to bear in mind the following pitfalls and cautions when interpreting the eGFR:
It is only an estimate of kidney function and a significant error is possible. The eGFR is most likely to be inaccurate in people at extremes of body type e.g. patients with limb amputations, severely malnourished and morbidly obese individuals
Confidence intervals: The 90% confidence intervals are quite wide, e.g. 90% of patients will have a true GFR within 30% of their estimated GFR and 98% have measured values within 50% of the estimated value. For an individual patient, however, serial values will be much more consistent than this just as creatinine values are – e.g. a 20% fall in a patient’s eGFR is certain to reflect an important change.
Look at the trend in eGFR – Identifying trends in eGFR is often more informative than one-off readings. i.e. a progressive fall in eGFR across serial measurements is more concerning than stable readings which don’t change over time.
Race: Some racial groups may fit the equations used to calculate the eGFR less well. This is mainly because the datasets used to derive these equations were predominantly white and black US citizens. There is usually a need to apply a correction factor for Black people which varies depending on the formula used: add 21% if MDRD equation and 16% if CKD-EPI is used. In the UK population both the MDRD and CKD-EPI equations seem to work quite well.
Not so good near normal: The equations used for estimating eGFR tend to underestimate normal or near-normal function therefore slightly low values (i.e. around the 60 ml/min/1.73m2 CKD “cut-off” level) should not be over-interpreted. In this situation repeat testing, looking for a progressive decline in renal function over time, or measurement of cystatin C (a different biomarker of kidney function) may be useful. Additional indicators or renal disease should also be sought in these patients – e.g. urinalysis looking for blood and protein, positive family history of renal disease etc… Routine reporting of eGFR values >90 is not recommended and many labs are now reporting all values over 60 as >60. Note, however, that a significant (e.g. 20%) rise in creatinine while eGFR is >60 may still be important as it will usually reflect a real change in GFR.
Values can differ between laboratories. Creatinine measurements can differ significantly between laboratories depending on the methods used to measure it. Furthermore, different laboratories may use a different formula to calculate the eGFR further complicating comparison of eGFR measurements obtained from different laboratories.
Creatinine level must be stable: eGFR calculations assume that the level of creatinine in the blood is stable over days or longer i.e. steady-state; they are not valid if it is changing. It is therefore not valid in patients with acute kidney injury or in patients receiving dialysis, for example.
Age: MDRD and CKD-EPI equations are not valid for individuals under 18 years of age.
https://renal.org/information-resources/the-uk-eckd-guide/about-egfr/
Patients with CKD stage G3 (eGFR 30-59 ml/min/1.73m2) have impaired kidney function. These patients can be further subdivided based on their eGFR as follows:
CKD stage G3a: eGFR 45-59 ml/min/1.73m2
CKD stage G3b: eGFR 30-44 ml/min/1.73m2
Remember that eGFR is only an estimate of kidney function and may require adjustment depending on the patient’s race.
If the decrease in the estimated glomerular filtration rate (eGFR) is due to acute kidney injury with a sudden decrease in kidney function, this can commonly be reversed. If the kidney disease is due to chronic kidney disease (CKD), the recovery of eGFR is usually not possible.
https://www.kidney.org/blog/ask-doctor/can-low-egfr-be-reversed
Can't remember exactly and don't have time to look up the results. 63% I think . I was told it was stage 3 though, I don't remember that much, so the % may be a bit wrong.
My friend aged 60, had an eGFR of around 30% and it has now increased to 50% with a gluten free, dairy free diet (as advised to her by her naturopath.)
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