Declining gfr

Posted by amjav @amjav, Mar 11 2:14pm

I am 37year old female and I have RA which is well under control( all my inflammatory are normal) . I do take hydroxycloriquine and I have to go for complete blood work every 3 months. And I observed that my gfr is declining and I am really worried about it. Below is the timeline and my gfr value . I would be grateful if someone can assure if this is normal .

September gfr was 116
October gfr was 106 - I started experiencing RA flares
December gfr was 98 - I changed my diet , included lot of protein and spinach kale smoothie in my diet
March gfr was 82 - I had UTi and I was on antibiotics.

My rheumatologist is not at all concerned about I am bit scared since it's declining

Interested in more discussions like this? Go to the Kidney & Bladder Support Group.

Ginger, Volunteer Mentor | @gingerw | Mar 11 5:49pm

@amjav Welcome to Mayo Clinic Connect. There can be multiple reasons for declining eGFR, and it certainly bears looking in to.

Here is the information about the hydroxychloroquine from Medline Plus: https://medlineplus.gov/druginfo/meds/a601240.html
Is it possible your medications are reacting between each other? Another cause of declining eGFR could be infection, dehydration, change in eating habits, another malady raising its head.

Have you been able to ask your doctor to refer you to a nephrologist to have this investigated?
Ginger

gently | @gently | Mar 11 6:14pm

The antibiotics that are eliminated through the kidneys can temporarily lower gfr, as can HCQ, but so can dehydration, intense exercise and high protein intake. You might hydrate, delay protein intake the day before and take it easy before your next testing.
Still your kidney function is enviable. It's excellent that you are watching your labs and questioning your physician. Like your rheumatologist, I don't think the decline significant. I also think it is temporary.
Congratulations on catching and controlling your RA early.

Cheryl, Volunteer Mentor | @cehunt57 | Mar 13 2:01pm

@amjav I also want to welcome you to Mayo Clinic Connect. As @gingerw and @gently have noted there are lots of things that can affect your eGFR. The overall trend is more useful than any one test. You have noticed a gradual decline that your rheumatologist is not concerned about. As Ginger said, a nephrologist would be the specialist to weigh in on this topic. (I have not heard of such great eGFR numbers that you have. Mine is in the low 30’s). A nephrologist is the best one to address your concerns.

amjav | @amjav | Mar 13 2:46pm

Thank you everyone for your reference. I will wait for my next blood draw and if my gfr keep on declining then I will consult a nephrologist. Also I wanted to add that my PCP has done urinalysis because of my UTI and It was normal like there was no protein found in urine.

Also I just observed there is type in my original post . My last GFr reading was 92 not 82