@mrainne I am 67 also and have been diagnosed with stage 4 chronic kidney disease (CKD).
My eGFR has bounced between 14 - 42 for the past 8 1/2 yeas. It is currently in the low 30’s. If you are interested in pursuing kidney transplant the first thing you need to do is undergo a pre-transplant evaluation. Do you have a local nephrologist who will support this effort?
In 2016 I had pre-transplant evaluations at 2 transplant centers. I was approved and accepted for transplant at both of the centers. I ended up choosing Mayo in Rochester, MN. Then I started looking for a living kidney donor. I’ve been hoping for a preemptive kidney transplant before dialysis becomes necessary.
It is important to get this evaluation done, get approved / accepted and “listed” for kidney transplant ASAP if it is inevitable that you will need it at some point. That way you can start accruing time on the waiting list (which is important, especially if you don’t have a living donor.)
There are two kinds of listings Active & Inactive. An Active listing requires approval / acceptance by the center and an eGFR of 20 or less. Your eGFR of 21 is so close to that and as you say has been steadily falling by 3-4 points.
Inactive listing happens for a number of reasons. The main reason is not having an eGFR quite bad enough for active listing (like me). It can also mean that you still have things to accomplish as required by the transplant center you choose for your pre-transplant evaluation. That could be things like tests, procedures etc. that haven’t been completed yet. When I was doing my pre-transplant evaluation I was impressed at how thorough Mayo was. They utilize a number of collaborative specialties to check you from head to toe inside and out to make sure all your needs can be met by their facility. There was no comparison between the pre-transplant evaluation at Mayo and the other transplant center I went to. I also found out that Mayo has stellar follow up which the other center didn’t. That is why I chose Mayo. My recommendation is that you get on this right away.