GFR results are a 56. Should I be concerned?

I just had my annual blood tests done and my GFR came back as a 56 which says it's stage III CKD. My Dr. said not to worry as I may just be dehydrated as my Creatinine was within the right levels (barely). I told her that I drank three 8 ounce glasses of water before the blood draw. I have also been diagnosed with high calcium levels via the 24 hour urine. I've had 2 now with no change. I'm also getting more and more calcium bumps under my skin on my forearms. I have Sarc in the elbows as well. I know I can get an honest response from this group! thanks much!

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Hope this helps.
"Risk factors for kidney disease include diabetes, high blood pressure, family history, older age, ethnic group and smoking. For most patients, a GFR over 60 mL/min/1.73m2 is adequate. But significant decline of the GFR from a previous test result can be an early indicator of kidney disease requiring medical intervention. The sooner kidney dysfunction is diagnosed and treated the greater odds of preserving remaining nephrons, and preventing the need for dialysis.

The severity of chronic kidney disease (CKD) is described by six stages; the most severe three are defined by the MDRD-eGFR value, and first three also depend on whether there is other evidence of kidney disease (e.g., proteinuria):

0) Normal kidney function – GFR above 90mL/min/1.73m2 and no proteinuria
1) CKD1 – GFR above 90mL/min/1.73m2 with evidence of kidney damage
2) CKD2 (Mild) – GFR of 60 to 89 mL/min/1.73m2 with evidence of kidney damage
3) CKD3 (Moderate) – GFR of 30 to 59 mL/min/1.73m2
4) CKD4 (Severe) – GFR of 15 to 29 mL/min/1.73m2
5) CKD5 Kidney failure - GFR less than 15 mL/min/1.73m2 Some people add CKD5D for those stage 5 patients requiring dialysis; many patients in CKD5 are not yet on dialysis.
Note: others add a "T" to patients who have had a transplant regardless of stage.

Not all clinicians agree with the above classificaiton, suggesting that it may overlabel patients with mildly reduced kidney function, especially the elderly, as having a disease.[26][27] A conference was held in 2009 regarding these controversies by Kidney Disease: Improving Global Outcomes (KDIGO) on CKD: Definition, Classification and Prognosis, gathering data on CKD prognosis to refine the definition and staging of CKD.[28]"

http://en.wikipedia.org/wiki/Renal_function

Regards,
I.

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Hi Nanski,

An eGFR is a calculation based on blood tests and is not necessarily a true reflection of kidney function. If you are worried about kidney function, you could have a kidney ultrasound as a first step, particularly if you have a history or raised calcium levels. In sarcoid patients, excess calcium can begin to coat the tubules of the kidney and decrease function, so I don't think it would be unreasonable for you to have at least an ultra sound to have this checked out. You could also have a creatinine clearance test which is a blood creatinine and a 24 hr urine collection testing urine creatinine and sometimes calcium too. This is a more accurate reflection of kidney function than an eGFR. If the creatinine clearance is abnormal, then you would need to have further tests. Another thing you could consider is a urine microscopy. This can also tell you a lot about the state of your kidneys. The type of casts, crystals and cells in the urine can indicate if there is a possible problem or not. In my case, I had unexplained dysmorphic red cells in my urine for over twenty years. I saw a kidney specialist for five years, but all tests were normal, and he thought a kidney biopsy was not worth the risk. Since leaving his care, my kidney function has deteriorated. In hindsight, I now believe hypercalciuria caused by sarcoidosis is chief suspect as a cause for the dysmorphic red cells in my urine during those years. I had calcium problems this year (mild and shortlived, but none the less real). I was able to get access to urine dipsticks and kept weekly checks on urine for any change, like the sudden addition of protein - which to my knowledge has never happened.

Generally a doctor will not even send a patient to see a kidney specialist until the GFR (as opposed to the eGFR) drops below 50. A kidney specialist will not even begin preparing a patient for possible transplant or dialysis until the GFR drops below 30. And, as IreneMarie says, there are plenty of people still walking around and functioning in Stage 5 kidney failure not on dialysis yet. Patients like this can have protein and creatinine levels in the high hundreds or low thousands.

Nevertheless, in saying that, a person with sarcoid who has calcium issues needs to have kidney function scrutinised more carefully than the average patient who comes off the street. You need to bear that in mind and press your case.

Pris

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I am in CKD stage 3 and have been since September 2008 - and I am not seeing a nephrologist. My rheumy says unless I go below 30 my condition does not warrant it. I suffered Kidney failure in Aug 2008 when my GFR dropped to 9 but had no dialysis. They treated me with massive steroids 120mg per day for 6 days in the hospital and then decreased to 60mg and so on. I also had severe kidney stones at that time and had stents put due to blockage in the uretha. Now my GFR stays around 43-48.
I think a GFR of 52 should not worry you very much -

Good luck to you - I know how painful kidney stones can be - I've had them removed 4 times!

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Thanks everyone. I knew I would get straight answers on this site!

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