kidneys officially 'normal', but are they really?

[NickF60]

Hi all, I’m new here and am hoping you can help with my current situation. I appreciate that many people here will have far more significant problems than me, but please bear with me. I‘ve had a few health issues recently and one thing that has emerged from the various tests is that my kidney function is relatively poor for my age (55 years). It seems it’s been this way for at least four years, but my GP only raised the issue when a recent blood test produced an eGFR of 59. The test was repeated a month later and my eGFR was 66. The GP told me that I had measured 62 and 64 in tests a couple of years earlier, so he was happy that everything was stable and there was no downward trend. He kept saying that an eGFR greater than 60 is ‘normal’ so I was reassured by this.

Two things then happened – my wife’s a nurse and she sees a lot of eGFR figures, and she said mine seemed remarkably low for someone of my age. She mentioned my numbers to a couple of doctors at her workplace and they agreed. They said that my eGFR would only be ‘normal’ if I was 80 years old! After hearing this I spoke to an old friend who is a GP. He responded similarly and said that my situation merited further investigation in his view. One thing that all the medics highlighted was the relatively poor quality of the GFR estimates – I understand that my true GFR could be anywhere within +/-20 points of the estimates, so they all suggested that obtaining a more accurate measure would be a good first step. My GP doesn’t agree, he is stuck in the black and white world of “more than 60 is normal, below 60 is not”. The GP hasn’t ordered any urine tests at all. On my last blood test appointment I took a sample anyway and the nurse was happy to perform a dipstick test which was ‘normal’ apparently.

I have looked online at the NICE guidelines and I can see where my GP is coming from. There is nothing in these guidelines which would trigger further investigations in my case. What I can’t get out of my mind is the advice given by the other medics who seem very clear that investigations would be appropriate, especially as I am borderline hypertensive. In a nutshell, it seems I may have kidneys that are only running at 50% of normal capacity and my GP doesn’t seem to be interested. What do you think I should do – go back and press the GP into further action, or relax in the knowledge that my kidneys are officially ‘normal’? Sorry for the long post. Any advice would be appreciated, many thanks

Regards
Nick

[Grey]

In my opinion having started with a eGFR of 60 odd and watching it drop to below 10 over 5 years, the significant thing about your kidney performance is it is stable. An eGFR of 60 odd is a pleasure, and it is not dropping, so in my opinion you have nothing to worry about. Actually even with readings of below 20% it is still OK, as long as it is not dropping significantly. High blood pressure can be caused by many things, not just kidney performance so for now stop worrying, get on with life but make a point of checking your eGFR once a year or so and if it starts dropping then take action.

[NickF60]

Thanks for the reply, that sounds perfectly reasonable. I know my situation is fortunate compared to many here. I was just a bit surprised that my GP hadn't even raised this topic until now, and I am very curious about why my kidneys are like this. Maybe I only have one? Maybe they've always been this way - is that possible do you think?

[NickF60]

The thing I didn't elaborate on is my other health issues, which are basically various manifestations of poor circulation. One specific thing I have which is new is burning feet, not all the time but triggered by warm weather, exercise or alcohol consumption. It's a new thing which I've been suffering for a few months now. If you google that you see kidneys coming up as a possible cause, and as my kidney function is the only thing that has shown up in blood tests as slightly unusual I do wonder if there's a connection

[Grey]

Sorry from my experience I cannot say much more. If it really bugs you ask the GP about the possibility of kidneys causing the feet problem or any of the other problems you may experience and if he feels it necessary he may refer you to a kidney specialist, however again I think as long as your eGFR is not on a downward trend, nothing to worry about from a kidney point of view. Perhaps someone else may wish to offer some opinions.

[Chris In Trowbridge]

I would not worry to much, i am like you, i am 51 and my egfr is 65, yes it is normal but, my dad is 81 and his egfr is 55, i read that people at 75+ years old, many are at stage 3 around egfr 50-60 but this is also normal, think a normal kidney looses between 0.5 and 1 egfr a year normally, i do worry thou that me being egfr 65 already at just 51years old, my kidney may not last, but some lady on this forum stayed at stage 3 egfr30-egfr59 for like 30 years, and she had kidney disease, remember you can go right down to under 10 egfr before needing a kidney, so depending on progression your kidneys could easily last you rest of your life, my doctor did not want me to even keep having checkups for my blood, so i just went behind his back and just book myself in every 3 months for a repeat blood test for kidney bloods.

[NickF60]

Thanks folks, appreciate your inputs. Chris - your situation does sound similar. Have you ever been tempted to seek out a more accurate measure of GFR? I assume your regular blood tests give you the normal type of estimate, which is a pretty sloppy measure as I understand it. Your point about actually having kidney disease is a good one. From what I've read a low/borderline eGFR is only significant if accompanied by other signs of disease. I don't have blood or protein, but I've only had a dipstick test and I'm not sure how sensitive those tests are.

[Chris In Trowbridge]

Nick, last year i had a few urine tests as i was and am still peeing a bit of foam, but the few dipstick tests i had showed no protein in urine, but strange as i still pee foam a bit now, also i had a ultra sound on my kidneys and they found nothing serious just a 8mm simple cyst on my right kidney, but doctor said 50% of over 50's have these simple cyst's on there kidneys, maybe ask doctor for a ultra sound for piece of mind, and remember, 10,000's of healthy people could be walking around with a egfr like ours, unless there is a reason for doctors to test these people, there never no any difference, i would just ask for 3 monthly kidney blood tests for piece of mind like i do, then if it goes down alot, you can make the doctor do something, mine did go down to egfr 55 early last year, and that is stage 3 even if you have no other symptons, but my doctor still did not worry, so i just started booking myself in for 3 monthly tests, so i can keep a eye on it myself.

[scary2112]

Hi nick welcome im 35 years old and my egfr is 60, it has been for the last 5 years. Docs and consultant are happy that its stable for the time being but am currently awaiting further tests to check for any underlying problems. I've discovered over the years that when the doc says everythings 'normal' he means normal for me lol. Everyone is different so any concerns i would ask your doc. Theres no such thing as a stupid question xx

[NickF60]

Thanks again folks.Chris how did you persuade them to do an ultra sound? My GP is reluctant to do anything as my egfr is a little over 60 so I don't meet the criteria for extra investigations

[Chris In Trowbridge]

Well my egfr went down to 55 early last year, so he done it just to check really, i reckon i had a kidney infection possibly at the time also, thats why egfr went low, it then went to 78, then down to where it is now 65, try to maybe do blood tests every 3 months.

[rheaybou]

Hello Nick and welcome to the group.

GFR can only ever be an estimate, it will vary on a number of factors such as what you have eaten, hydration and also the time of day the sample was taken. However from your run of results you dont seem to be on a downward trend of sudden function loss(however I am no medical professional, just a seasoned renal patient). Please dont accept what you have been told by the GP if you have underlying concerns, force the issue as in your mind a GRF of 60 seems low and many people hear will say you should feel lucky to have that - thats not what you should be hearing!

My GRF went from 98% in 2003 as a routine healthcheck to 8% in 2012 without ever knowing, so the advice of asking for regular blood tests is a good start - how regular will be down to your GP I would guess.

As pointed out by another poster the average 'healthy' person will lose about 0.5-1% of kidney function per year. But as that is spread over two that only work at 50% - based on 100% function then that decline seems less scary.

You can help reduce the impact your lifestyle has on decrease by taking lots of excercise, keeping hydrated (even beer is allowed for hydration) and keeping control of your BP and cholesterol - reduce your salt intake and eat a healthy balanced diet.

But as I pointed out above, I am not a medical professional......just talking from experience. Good luck, Richard

[NickF60]

thanks rheaybou! I guess I was just a bit shocked to find that my kidneys are only working at about 60% efficiency. I had no reason to suspect this was happening. I was also surprised that none of my GPs thought it was worth mentioning – I don’t think their black and white view of ‘normal’ is very helpful to be honest. I’m also curious about exactly when my kidneys starting declining. Is it possible they’ve always been this way I wonder? I’m going back to my GP at some point as I do have symptoms which could be kidney related. Off on hols tomorrow though so I’m going to put it out of my mind for a couple of weeks and tackle it when I get back. Thanks for your inputs

[rheaybou]

Nick,

I forgot to add that the internet is the worst place to get advice

Go on holiday, relax and forget about it all for a while. Regarding how your kidney function has come to this point?? It could just be natural decline, not everyone will decline at the same rate and someone at 50 may have lived a similar lifestyle to someone who is 80 and have less function. Finding out when this decline started is almost impossible now I would suspect.

When you get back, have another chat with your GP, be your own health advocate as nobody else will.

[NickF60]

will do rheaybou. By the way, I feel like a fraud talking to you folks with real kidney issues, appreciate your help