When to be concerned about eGFR?

My eGFR was about 77 before12/23 norovirus (extreme dehydration, fever, BP spike) resulted in an eGFR of 56. I'm 71 and (was) very active; the eGFR dropped to 32-39 the next summer, enough to see a nephrologist. She said just stay hydrated, 8-9 glasses of water a day. Because 32-39 is stage 3b, I modified my diet to less protein and simple carbs, more fiber and complex carbs. My kidney biopsy last year just showed scarring of glomeri and tubes. I'm now on Jardiance 12.5 mg/d to "relax" my blood and kidney vessels and excrete excess salt and glucose. It is usually diagnosed for those with high BP, Type 2 diabetes, and/or heart disease (none of which I have). With it, my eGFR is 42 and my previous avg. resting BP of 120/70 is now 105/73. I don't know if the CKD is leaving me fatigued, or if the now lower BP is limiting how much O2 I can deliver to cells. My nephology NP just said maybe I will feel better next year. Does having state 3b CKD result in mild to moderate fatigue?

@kayabbott Decreasing your daily protein intake can contribute to fatigue. Perhaps you could experiment and see what happens if you add in some quality protein each day, for several days. Although the consensus is to decrease our protein, we still need enough to function! As we all seem to find out, diet plays an extraordinarily important role in our kidney disease health. What that means to each of us may involve some experimentation.

Are you willing to try that experiment?
Ginger

@gingerw I get more than enough protein, so that is not a contributor. Good point tho. My diet is more a mix of complex carbs, fiber, protein, fats, and less simple carbs (being a scientist I overthink things). I was an athlete before norovirus and kidney damage, so notice the significant difference between before and after. Low blood sugar due to Jardiance could contribute to fatigue, but I haven't seen a difference with snacking between meals (no diabetes, blood sugar has always been stable). I still exercise every day, but far less than before. The fatigue was there before my dietary modifications due to stage 3b CKD. My fatigue has been here since getting norovirus 2 years ago. Some could be residual effects of the covid and LC that year, but it doesn't feel like PEM.

@cehunt57 where are the red flags re comments
Also my Egfr currently is 47..
However it changes..
Meaning it can go up or down..
I also sometimes need to STOP reading posts..
Do yo have any feedback for me??

@tibbylake eGFRbased on creatinine varies with things like hydration. Mine wanders over a range of about 8 52-59. There are other ways to measure eGFR but I don't know much about them. Others here probably do.

s in the 50's are acceptable as far as I know (mine are low 30's) Not sure what is optimal.--long term kidney damage. Drink eight 8ounce cups of water through the day Coffee and tea etc do not count. That is the usual advice. Your doctors do not sound very empathetic. Good luck negotiating the medical profession. Ask "Why? "You can ask for fact sheets when your questions are brushed off. Add that you need to understand. If still not helpful find another doctor. you might find this web site useful
https://www.kidney.org/kidney-topics/estimated-glomerular-filtration-rate-egfr

@tibbylake I think the “red flags” comment first appeared regarding a member with a fairly low eGFR who was inquiring about working. Then it appeared again pertaining to a member who has only 1 kidney and was being reminded to remember to mention it to providers in regards to meds and treatments. I think some confusion can be avoided if we all use “@ mention” when making a response to a specific member. I did that here at the start of my response to you.
One eGFR test is not that meaningful. It is best to look at the trend over time. (Some people like to look at a Cystatin C test.) Your eGFR is better than mine! Do you have a nephrologist? Are you following a renal diet? Is there any other feedback that you are looking for?

Good luck.

@sharlea1313
My eGFR is on a steady decline. 67, 64, 60 in about a year an a half. I didn't realize what was going on until the last reading. I'm on a renal diet, losing weight and hungry all of the time. Ain't we got fun!