Doctor is concerned about Kidney GFR numbers: Should I be?

Interesting! The literature I found was for AKI (sorry, should’ve mentioned that!)
which was the concerning part of his labs to me.
I just don’t think semaglutide agrees very well with him given the lack of improvement in his labs & management of his type 2 diabetes.

Thank you for suggesting to have the overseeing MD advise! Even being a nurse I forgot that!

I found what seems to be a credible site (third party tested with reports and great reviews) for a berberine supplement I think would be great for glucose metabolism. Will likely purchase after discussing with his NP!

Also, I feel obligated to state I am in no way affiliated with this company and this is not to be taken as professional medical advice. Please always do your own research and talk to your provider!!

The GFR is a mathematical calculation based on creatinine, gender, and ethnic background. It's not as accurate as a 24 hour urine test, but obviously more convenient once a pattern has been established. Your numbers are close to mine. My creatinine has been in the 2.2-2.4 range for years. My nephrologist is concerned that I stay in that range, and is not so concerned with BUN, which fluctuates more than the other numbers.

Only one time has my GFR dipped below 20. The upside is that it qualified me to pre-emptively get accepted on to the kidney transplant list. I am inactive status, since I'm relatively stable, but am gaining seniority for when/if I need to transfer to active status. It was not my nephrologist who suggested I get on the transplant list; it was a nurse from my insurance company.

Last blood work, BUN jumped to 48! Creatinine 2.4. My disease is Nephrogenic Diabetes Insipidus. Not related to sugar diabetes. It's from long-term use of lithium (40 years). I am so fortunate my kidneys survived this long but wish a smart DR along the way would have put me on Lamotrigine which is so much safer. I am healthy, weigh 134, eat whole foods, exercise...basically take care of myself, water, low sodium etc. This lifestyle has not stopped my declining kidney function. My eGFR is at 21 today. I'll keep living as normally as possible...avoiding UTI's!!!! Had 2 this year but antibiotics are bacteria killers, good and bad. I appreciate your information, so helpful. Seeing my Neph next week.

BUN can fluctuate based on the amount of protein intake and hydration status prior to a test. It's the big picture that counts. You are so smart to avoid UTI's at all costs, since they have the potential to turn into kidney infections if unchecked. All the best to you, and let us know how your nephrology visit goes.

@mrainne Medication side effects can take years to manifest. I don't think doctors set out to place us on the road to long-term kidney concerns, they are trying to help us with the primary problem. I have known several people with the lithium use issue, like you have. My cousin also went through kidney disease due to a cardiac medication many years ago.

Good for you to staying as healthy as possible, and understanding what works best for you in your case! Everyone is different, definitely. We'll be anxious to hear about your nephrologist visit next week.
Ginger

Thanks, Ginger. The lithium treatment was a godsend. No regrets, other than the lamotrigine alternative which I'm on now. My bi-polar disease developed in the early 1970s. I was blessed to find a smart psychiatrist who prescribed lithium. I lived a happy normal life, married to a wonderful man for 40 years. I followed the plan religiously, taking follow-up tests every 6 months for all those years. Then, in 2014, the kidneys simply got tired. I'm grateful and fortunate they held up that long. We'll see what comes next. It's all good. I trust my Nephs, one at my local healthcare and one at Mayo.

Yes, even NSAIDs taken over time create the same dilemma. I have a first cousin who took the maximum dosage daily for pain. There is no warning about this. Her eGFR has been floating @ 20 for years after she quit the NSAIDs. No dialysis.

I just saw an endocrinologist and a rheumatologist on 12/16/2024 who are continuing to investigate my complaints of severe myalgia of the shoulders/neck, possibly caused by incipient hyperparathyroidism. My eGFR has dropped from 89 on 09/10/2024 to 74 on 12/16/2024.

Neither my endocrinologist nor rheumatologist even mentioned this change in their visit recaps.

I'm a 67 year old guy with some symptoms related to deteriorating kidney function: swollen ankles/feet, foamy pee, puffy eyelids, itchy skin, and increasingly elevated Intact PTH: 85.8 on 12/16/2024 which is up from 82.2 on 09/19/2024.

Although my docs don't seem concerned, I am. Anybody out there want to chime in?

Thanks.

@itchyd a lot of us in the Kidney & Bladder group would be envious of your eGFR. It is not surprising that your endocrinologist and rheumatologist didn’t see the need to mention it. Many “normal” people have an eGFR in the 60’s. You mention having “symptoms related to deteriorating kidney function”. That is true, but can also be attributed to your endocrinology & perhaps rheumatology problems. Kidney problems often don’t cause any symptoms until the function is much worse (eGFR in the 20’s or 30’s). If you continue to be bothered by this and are willing to add another specialist to your team, a visit to a nephrologist could shed some light on your situation.

Excellent information.
@itchyd I totally agree wih @cehunt57.

Thanks for your feedback! My concern stems from the 15 unit drop over the past several months. I reviewed my lab history and my eGFR 's always been at >= 89. So, this latest reading's a step change in the wrong direction.
But, I'm no expert, so that's why I'm fishing around you pros who have dealt with much more serious situations. Thanks again!