Change to GFR numbers

Posted by happydaysies @happydaysies, May 25 5:13pm

Hi everyone,

I was hospitalized with acute pyelonephritis and a small stone in February that caused a temporary dip in GFR. In April I moved to a different, larger medical group system because I've been suffering from a mystery medical problem since mid-March.

When I first became sick again I had many of the same symptoms as during the kidney infection, and all but the last have persisted: constant nausea, extreme weakness and fatigue, back pain, urinating every 10-15 minutes. But no fever, normal UA, and only elevated neutrophils/immature granulocytes in CBC.

I'm just wondering -- are the two different labs likely to be calculating GFR differently? Is this something I should ask more about? I asked why the number has been dropping and was told by the new doc office that it fluctuates.

I don't know much about GFR calculations so I was hoping someone might be able to provide a little more insight. I attached the numbers for reference, if needed. I appreciate your time, regardless.

Thanks.

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Have you checked your blood sugar levels?

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@happydaysies Welcome to Mayo Clinic Connect. We are not medical professionals, but a platform for patients and caregivers with similar health concerns, offering support and examples through our own experience. We cannot and will not give medical advice.

Looking at the attachments you offered, it looks like one of the tests uses the standard calculation for eGFR, while the other one uses Creatinine eGFR calculation. There typically is a difference in those two values. The more accurate and consistent test is the Creatinine eGFR, where body mass and diet do not come in to play for the results. Gosh, I would love to have that number you have!

@collegeprof may be able to give you additional information on this testing. It is important to remember that when we have testing of any sort done, our hydration level, activity levels, and different other components may affect the final results! Typically we will say to follow a trend, not a one-time test.
Ginger

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@happydaysies @gingerw First, I like your Mayo name. Different labs may calculate eGFR differently only because at times during the same day, you may be dehydrated or have a slight inflammation or some other reason. In addition all labs strive to practice standardization even though they may use different centrifuges or lab instruments when testing blood results. The goal for all labs are accuracy and reliability but sometimes you will find slight differences in results. No one test should frighten you as it is the trend that matters most. If you believe your test result is totally out of whack, have your PCP or other doc retest that result.

As I said the other day, there are 2 types of eGFR, one that uses creatinine for body muscle mass and the other looks at cells in your body and gives you a measurement based on age and is called Cystatin C. The creatinine eGFR is not based on age, and does fluctuate. My nephrologists find Cystatin C to be the more accurate, and tend to find less fluctuation.

Unfortunately, your tables show only a relatively short period of time as many of us have had CKD for many years. Infections, accidents, and injuries may be treated differently as these tend to be "acute" as opposed to "chronic". Sometimes acute kidney disease may have better outcomes as opposed to many of us who have been living with CKD for many years. My former acupuncturist resolved some of her patients back to normalcy with acute kidney disease.

Lastly, regarding your tables, anything above 60 is great. Even short term from Feb. 2024 is great. All of us with CKD would love to have your values. Finally, if your insurance company covers it, take the Cystatin C eGFR as your tables show the creatinine eGFR values.

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@gingerw & @collegeprof have explained eGFR and the Cystatin C values beautifully. They also highlighted the importance of overall trend’s versus single tests in time. They are also correct about folks with CKD who would be thrilled with your numbers. I have stage 4 CKD and my eGFR is in the low 30’s.
Since your hospitalization in February with an acute kidney illness and then a “mystery” illness since March you continue to have symptoms of “constant nausea, extreme weakness and fatigue, back pain, urinating every 10 - 15 minutes. But no fever, normal UA, and only elevated neutrophils / immature granulocytes in CBC” ?
Have you asked your provider what the cause of these symptoms could be? Your situation sounds miserable. I hope you get some answers soon that will lead to helpful treatment.

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@cehunt57

@gingerw & @collegeprof have explained eGFR and the Cystatin C values beautifully. They also highlighted the importance of overall trend’s versus single tests in time. They are also correct about folks with CKD who would be thrilled with your numbers. I have stage 4 CKD and my eGFR is in the low 30’s.
Since your hospitalization in February with an acute kidney illness and then a “mystery” illness since March you continue to have symptoms of “constant nausea, extreme weakness and fatigue, back pain, urinating every 10 - 15 minutes. But no fever, normal UA, and only elevated neutrophils / immature granulocytes in CBC” ?
Have you asked your provider what the cause of these symptoms could be? Your situation sounds miserable. I hope you get some answers soon that will lead to helpful treatment.

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@cehunt57 @gingerw @happydaysies Frequent urination could be the result of new medication. Happydaysies could check with pharmacist or Internet to see if there are any adverse reactions to any new medication(s) she/he is now taking.

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@celia16

Have you checked your blood sugar levels?

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Hi, thank you! My fasting glucose has been hanging around 95 the last couple years, my A1C 5.4.

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My eGFR (creatinine based) is 36-47 and my Cystatin C has been 51-60. The Cystatin C is more stable and less affected by loss of muscle mass. Hydration issues, and low blood pressure also may be factors in keeping my eGFR down.

@happydaysies your values look good! That chart showing a large drop is between 97 and 98 and makes it look like a big drop- but it is not significant mathematically 🙂

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@collegeprof

@cehunt57 @gingerw @happydaysies Frequent urination could be the result of new medication. Happydaysies could check with pharmacist or Internet to see if there are any adverse reactions to any new medication(s) she/he is now taking.

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Thank you for the suggestion! I was not taking any medications at the time, just a multivitamin and vitamin C, and this is actually the one symptom that seems to have largely resolved now.

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Hello everyone, and thank you for the welcome and the helpful information! @gingerw @cehunt57 @windyshores

@collegeprof I was hopeful someone would get a kick out of the name! 😁

I do appreciate that my values are still in a good range -- I've just been concerned about the difference in numbers and trending down again alongside this new bout of illness. I was only given 5 days of antibiotics and sensitivity testing was never performed by the hospital, so I found myself wondering if the infection might have reestablished and developed into a chronic, low-grade infection.

I've also been shuffled through several specialists so far and communication and consultation of lab work between them have not been so great, so now that an ob-gyn has ordered a CT with IV and oral contrast, I wanted to make more sense of my GFR values.

Nobody has any idea so far what's going on because the symptoms cross the spectrum -- who has time to unravel all that with so many patients and so little time?

Thank you all again for the helpful information! It's great what you do here. 🌞

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@happydaysies

Hello everyone, and thank you for the welcome and the helpful information! @gingerw @cehunt57 @windyshores

@collegeprof I was hopeful someone would get a kick out of the name! 😁

I do appreciate that my values are still in a good range -- I've just been concerned about the difference in numbers and trending down again alongside this new bout of illness. I was only given 5 days of antibiotics and sensitivity testing was never performed by the hospital, so I found myself wondering if the infection might have reestablished and developed into a chronic, low-grade infection.

I've also been shuffled through several specialists so far and communication and consultation of lab work between them have not been so great, so now that an ob-gyn has ordered a CT with IV and oral contrast, I wanted to make more sense of my GFR values.

Nobody has any idea so far what's going on because the symptoms cross the spectrum -- who has time to unravel all that with so many patients and so little time?

Thank you all again for the helpful information! It's great what you do here. 🌞

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@happydaysies Perhaps the antibiotics were not the best one for the infection you had, or the course of treatment was too short.

You owe it to yourself to find out just what is going on, definitely. Being our own advocate in healthcare can be tedious, and exhausting.
Ginger

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