eGFR history and latest test results

[Glenmac]

Ive just now found how to access my results for this particular test on the Scottish My diabetes myway site.At the last diabetes clinic Iwas told that my potassium levels had dropped,but nothing to worry about.However, the eGFR test has shown a drop from 60 to 51.Ive had a low carb diet for the last year and on the GPs advice have dropped 1 Metformin and the Gliclazide tablet.Im now on 2 Metformin and tablets for blood pressure each day.Ive made an appointment with my GP(next week) just to ask about this. Does anyone on the site have any experience of this.Im hoping it's not connected to my diet as so far the diet has been brilliant and
made an improvement to most results.

I should add I have had type 2 for 16 years and am definitely in the elderly bracket,so I don't expect miracles,just trying to stay as healthy as possible!!

 

[Guzzler]

I can't advise you on this but just wanted to say you have made a wonderful job on your T2 control, well done.

 

[Brunneria]

Hi,

Sorry your test result has fallen.
You may want to have a read up on the use of Metformin with patients of reduced kidney function.
I have seen it mentioned that Metformin is contraindicated for people whose kidney function falls below a certain level. Unfortunately I cannot remember the specifics of how much kidney function, nor how much Metformin were being discussed.
Perhaps worth asking your doc and/or consultant, and searching out the studies in question.

You may also find it useful to read up on the eGFR test, since I would imagine that a number of things affect the test.

I will tag in @Bluetit1802 because I recently saw a post from her that suggested she had been reading up on the subject.

 

[Mbaker]

Ive just now found how to access my results for this particular test on the Scottish My diabetes way site.At the last diabetes clinic Iwas told that my potassium levels had dropped,but nothing to worry about.However, the eGFR test has shown a drop from 60 to 51.Ive had a low carb diet for the last year and on the GPs advice have dropped 1 Metformin and the Gliclazide tablet.Im now on 2 Metformin and tablets for blood pressure each day.Ive made an appointment with my GP(next week) just to ask about this. Does anyone on the site have any experience of this.Im hoping it's not connected to my diet as so far the diet has been brilliant and
made an improvement to most results.

I should add I have had type 2 for 16 years and am definitely in the elderly bracket,so I don't expect miracles,just trying to stay as healthy as possible!!

You might want to phone your GP and ask her / him if you can put on hold your Metformin, this caused a drop in my kidney function when on Metformin.

 

[Boo1979]

Different BP meds also have different impacts on kidney function - Im on an ACE inhibitor - my consultant said that this class of medication has some protective features for kidney function as opposed to other classes of BP meds.
Strangely enough my late cat was also prescribed an ace inhibitor when she developed kidney problems - getting the thing down her throat was another matter - blood (mine) was spilt!

 

[Bluetit1802]

Thanks for the tag @Brunneria but I don't know a great deal about it.

It is an estimated figure, not an actual one, and age and sex are included in the calculation along with the other kidney markers (sodium, potassium, urea and creatinine). The original level to achieve used to be above 60. This was then increased and is currently above 90.

The person with knowledge on kidneys is @pleinster

I agree with the others above that Metformin is contraindicated if there are kidney issues, so you need to mention this to your GP.

I don't believe a low carb diet can cause a drop.

 

[ringi]

I don't believe a low carb diet can cause a drop.

I agree, but if someone has VERY low egfr, they should greatly limit how much protein they eat, so can only do low carb, if they increase 'good' fats.

 

[Glenmac]

@Guzzler.....Thankyou,hopefully I'm proof that it's never too late!

 

[Seacrow]

My doc told me eGFR values can vary considerably over as little as a day, so 50 and 60 are effectively the same result. What you want to look for is a longer term trend of consistently decreasing values, then you can say your kidney function is decreasing.

 

[Glenmac]

@ringi
@Guzzler
@Bluetit1802
@Boo1979 @Mbaker @Brunneria
Thankyou so much for your replies.This forum is just great.Im planning to use Dr Google and read some more.Ill also look again at the Scottish website as I'm sure I've probably missed some details.Its a great website but is full of charts and graphs which I need to study.Ill speak to my GP next week but go armed with some information.(I'll also take a print off of the graphs)My DN felt I could possibly lower the Metformin if my Hbac continues to fall.I panicked initially because long ago 46 yrs!! I had kidney damage after eclampsia when my youngest son was born.I will check that it is still on my records.Thankyou all again.

 

[Glenmac]

My doc told me eGFR values can vary considerably over as little as a day, so 50 and 60 are effectively the same result. What you want to look for is a longer term trend of consistently decreasing values, then you can say your kidney function is decreasing.

Thankyou @Seacrow That makes sense to me,as mine over 10 years had been consistent and then this sudden drop which on a graph looked alarming.Mr Mac reminds me that my pancreas and kidneys are also getting ready for their next big birthday!

 

[novorapidboi26]

I had a panic moment on My Diabetes My Way a year or two back when my eGFR came back and was displayed as 59.....

Googling this result came back with some worrying stories about kidney disease of various stages...

I then discovered that it should have read >59 as this was how it was displayed on the test sheet......a quick email to the site and it was changed.....so panic over.....

if its above 59, then it gets displayed as >59.....it doesn't tell you if its 67 or 98 for example.....

Or it doesn't on mine anyway...

 

[Glenmac]

Thankyou,@novorapidboi26, in my case it's a little knowledge being a dangerous thing.Ill just read up a bit more!I find the Scottish site really helpful as a type 2. I don't understand why the HPs at my practice don't even mention it or display details.Perhaps they don't want the questions that arise from it.

 

[Dark Horse]

A drop in eGFR should be discussed with your GP when you see them. Meanwhile, there is some information from the Renal Association about eGFR here:- https://renal.org/information-resources/the-uk-eckd-guide/about-egfr/

 

[Lally123]

One off blood result usually isnt a problem and a drop in egfr can be caused by lots of things including whether you were a bit dehydrated at the time. As someone else said higher up it's the trend that matters not a one off blood result. Best thing to do is see your gp but don't worry too much at this stage it may well have gone back to normal on your next test. If it hasn't your gp will review your meds then. I work in a different area and monitor bloods one of my patients once had a drop in her eGFR from.99 to 15. Caused her a lot of panic and it turned out it was actually someone else's blood and the person who took the blood put the wrong names on the tubes! Not ideal!

 

[Glenmac]

Thankyou@Lally123,that's very reassuring.
@Lally123

 

[Glenmac]

Thankyou @Dark Horse,lots of information there

 

[pleinster]

Hi @Glenmac. Thanks @Bluetit1802 for tagging me. My current post transplant (nearly 3 years ago) renal function is around 45% and that is enough. It was 8% before transplant. I got my diabetes after that...because of drugs used. Despite some mention of "normal" kidney function being around 90%, this is not exactly accurate. I was diagnosed with an inherited renal disease at 17 and was assessed regularly for decades and have kept myself informed at all times. Whatever you may read on some sites, over 60% is still considered normal range kidney function. As for 90%, four of my renal doctors (who I see regularly) assure me that none of them has more than 80% function. 90% would be excellent kidney function. More important than the very loose eGFR numbers is the Creatinine level (the real indicator of kidney function/issues) and so you should ask about that. Too much protein can increase the level as can a bit of meat or various other things (including dehydration) and one reading tells you very little as others have said. A few readings over a period of time would let doctors know what your expected baseline would be...it will bounce around inside a small margin. Keep your fluid intake up. I suggest you ask about whether or not the doctor is concerned and if your creatinine level can be tested for a while if he thinks it necessary to reassure you. For your info, if I don't get any rejection, I expect to cope fine on 45% for a long time. My doctors all still see 60% as normal and the level could easily temporarily drop to 50ish for a lot of reasons...so it's the pattern you want to know about not one number. Even if it was hovering between 60 and 50% (and factors like age and weight are relevant), I would only expect a doctor to be really concerned if it kept dropping.

 

[Glenmac]

Hi @pleinster .Thankyou for your reassuring reply.Im beginning to understand the science of it better.I had several IVP tests after my son was born and continued to be checked for ten or so years.Id put it all out of my mind and moved on,so I panicked a wee bit when I saw my results.My creatinine levels have also risen so I'll ask about that.Hopefully it's just a blip.Sometimes I wish I had an A level in biology then I'd grasp the science more quickly.I don't discuss these details with my grown up children as they tend to worry!

 

[Bluetit1802]

@pleinster . Your point about creatinine levels being raised due to protein (even a bit of meat) is interesting.

Whilst my kidney functions have always been excellent ( eGFR and creatinine) I have had 2 tests since diagnosis when the creatinine levels were higher than usual for me - and these tests are the only two I've had that were not fasting and done in the afternoon, so presumably this was due to what I had eaten for breakfast and lunch. Every other test (and there have been many) have been fasting with the creatinine levels a lot lower.