
Have Coronary Artery Disease, MS And Diabetes. Blood Work Showing Moderate EGFR. What Does EGFR Represent?

I am not a Nervous Nelly, but I've been concerned about this result. I know it has to do with kidney function, but I don't know if it's Good, Bad, or of no particular consequence. FWIW, White Blood cell count was 11.52, platelets were 411, Glucose was 203, Calcium was 10.7, Potassium was 5.3 and Carbon Dioxide was 21.
I have CAD, MS and Type 2 diabetes. Other than that, I'm just fine! :-)
Can you give me your reading on the test result for eGFR so I can quit worrying about it one way or the other?
Needs monitoring. No need to worry.
Detailed Answer:
Hi,
Welcome to Healthcare Magic!
I understand that this report has worried you a lot and I will try to put in the right perspective for you. The eGFR refers to the estimated Glomerular Filtration Rate. The estimation is done using formulas that are usually based on the serum creatinine level and vary with age, sex, and race. GFR over 90mls/min for a person of average body surface area (1.73 meter square) is considered normal unless there is other evidence of kidney disease. This value refers to the amount filtered by the kidneys per minute.
Since eGFR is an estimated but not the actually measured value, it is not necessarily accurate. It depends on the serum creatinine values and therefore, laboratory differences in creatinine estimations may make significant differences in the eGFR value. The calculation of eGFR assumes that the level of creatinine in the blood is stable over days or longer. The value of eGFR is not valid if the creatinine level is changing. So if you are being regularly monitored and tested for renal function, do not worry because of just one abnormal report. I feel that the test should be repeated at regular intervals so that one can be sure that the abnormality was not just a random deviation. Most probably your cardiologist will agree with me and ask for a repeat test after some time.
Supposing that the report is accurate, let us discuss what implications it may have for you. A GFR of 51 indicates moderately reduced kidney function and requires that the person be monitored regularly and all risk factors including blood pressure be controlled well. It does not require any drastic measures like dialysis.
Since your other blood parameters appear to be on the higher side of the normal range, I suspect if you were somewhat dehydrated on the day your sample was collected. This could also have caused a high creatinine level and a low eGFR.
Please do not worry about this. Most probably, your doctor will advise a repeat test and also take a look at your medication regimen to see what changes should be made. Some medicines may harm the kidney and should be substituted with others. Your blood pressure also should not be too high. Since your glucose level is also high, your doctor may choose to make alterations in your antidiabetic medicines too.
I hope this allays your anxiety. Please feel free to ask if you need any clarifications.
Best wishes.
Dr Preeti Parakh
MD Psychiatry


Thank you very, very much for your detailed and easy-to-understand reply. I truly am not the type of person who gets overly concerned about potential health problems, but my former husband passed away from End Stage Renal Disease and it's a condition that I dread.
It seems like most of my medicines warn about monitoring kidney and/or liver function, so that feeds into my phobia!
I have enough real-life issues to deal with; your explanation has indeed allayed my concerns and the abnormal eGFR and I'll consider these results to be merely a snapshot in time and of questionable importance, but worthy of follow-up in the future. THANK YOU!
PS: Your comment about dehydration being a potential factor struck a nerve. I was extremely thirsty that day and had to ask the doctor's nurse for a large glass of water before leaving the office - I was actually dizzy and light-headed. If the next test comes back within normal range, I'll send you a special "I'm Brilliant!" lapel pin or brooch!
With sincere gratitude, XXXXXXX
All the best!
Detailed Answer:
Hi XXXXXXX
Many thanks for your kind words! I hope your tests come out as normal soon.
Best wishes.
Dr Preeti Parakh
MD Psychiatry

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