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Reason for fluctuating eGFR and CREATININE levels?

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I am a 76 year-old male. My eGFR for the past 9 months has gone from 61, to, 50 to 47. Creatinine from 1.16 to 1.37 to 1.44. Microalbumin is <3.0. BUN/Creatinine ratio is 10. My cholesterol and blood pressure are controlled with medications and test normal. All other metrics are in the normal range. I am 5’11” and weigh 245 lbs. My PCP is not concerned about my eGFR and Creatinine readings and trends, but I am. Should I be? Should I consult a specialist?

Category: Nephrologist

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Category: Pediatric Nephrologist
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I am extremely sorry for the delay in reply. 



Most of the GFR estimations take age in to consideration. GFR changes with age and as per your age, you will not be considered as having CKD. As your serum creatinine is normal, you should not bother about those reports. Always remember, while evaluating a kidney disorder, the most important value we take into consideration is serum creatinine. If it's normal, then other values can be ignored.All those values are routine fluctuations expected in all human beings in physiological ranges.



Microalbuminuria should not be done in your age group and what ever may be the value, you don't need to consider that.I personally feel that you don't need to consult any specialist in this regard. Avoid unnecessary drug intake and also avoid conditions causing dehydration. Make sure you drink plenty of fluids everyday at least 3-4 litres, so that the kidney can maintain its excretion in a normal range.



Please post additional queries.



Regards





Patient replied :

Thank you for the reply. It makes me feel better. You mentioned that my creatinine of 1.44 as being normal. However, accprding to the lab report, it is high. The report shows normal range to be .76 to 1.27. Also I am concerned about the developing nine month trend from 1.16 to 1.31 to 1.44.


Thanks for writing to us again.



1.44 is slightly higher definitely, but that can be expected at your age. As i said make sure you avoid dehydration of any sorts, consume plenty of fluids preferably 3-4 litres of water everyday. Also avoid high-salt diet and reduce the salt in your diet to bare minimum. If possible engage yourself in some kind of daily routine activity such as walking for 30 minutes or so ( 2.5 KPH- 3 KPH ) depending on your comfort zone. Avoid foods with added salt such as bacon, olives, nuts, pickles.



Don't worry about the 9 month increasing trend. You just need some minor adjustments in your lifestyle. Starting with drinking a lot of water. And regular low intensity exercise.



After a month you can get your Serum BUN and creatinine values re-checked. You can expect a much better report after that.



Take care,



Regards



Dr. Sree Bhushan Raju
Category: Pediatric Nephrologist
Experience: 
FISN : Fellowship of Indian Society of Nephrology(ISN), 2012
FIACM : Fellowship of Indian Association of Clinical Medicin(IACM), 2012
FICP: Indian College of Physicians Association of Physicians of India, 2012
Fellowship: DM, DNB, All India Institute of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, Nizam's Institute of Medical Sciences, 1998
Medical School: MBBS, Gandhi Medical College, 1994
Dr. Sree Bhushan Raju and 4 other Medical Specialists are ready to help you

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