@wgj the operative word is “bounce”. Think of a red rubber child’s ball at recess or gym class. (What goes up does eventually tend to come down.) I’m 67, have had diabetes since my teens and a history of hypertension controlled by meds. I was hospitalized with nephritis when I was 5 years old. No one can tell me if that is related to the stage 4 chronic kidney disease (CKD) that I have now. I also have anemia and osteoporosis. I have a primary Dr. (Internal Medicine), an endocrinologist and a nephrologist. These people prescribe my meds and over the counter (OTC) things too. I am blessed that they are part of the same healthcare system and can collaborate on my overall treatment plan. I also have access to nutritional services who are well versed in diabetes and renal diets. I’m thankful that we are all on the same page. I see the GP as needed. I see endocrinology and nephrology about quarterly. The doctor’s in endocrinology and nephrology alternate between themselves and nurse practitioners. I see endocrinology later this month and nephrology in May. My last eGFR was in the low 30’s. It is important to remember that a single lab result is less important than the overall trend.