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Possible to have CKD and normal GFR?

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  • Possible to have CKD and normal GFR?

    Hello all,
    Three months ago lab work revealed I had a GFR of 55 and creatinine of 1.2. I'm a petite, thin, 46 yr old woman with a history of high blood pressure (preeclampsia too with both pregnancies). Over the past several years, I've had fluid retention and visible blood in my urine, on and off. When I've been to the doctor, there was only trace amounts of blood and protein detected at different times. My latest blood work shows my GFR has currently risen to 97. I'm still concerned I have an issue though-- thru testing my right kidney measures 9.3 cm (left 10.5)-- Dr. says this is normal. Looking on internet 9.3 seems small? The most worrisome thing to me though, is that since late April my eyes have been very puffy. The puffiness is worse in the morning, but never goes back to normal. I cannot get used to my face in the mirror; the change is dramatic and getting worse. I've been tested for thyroid, which is completely normal. I get headaches, worse in the morning (but also evening), which began at the same time as my eye puffiness. I have new obvious fluid retention in my lower legs, but I am not as disturbed by this as I am by my eyes. There is also mild flank pain on my right side. I've called my nephrologist's nurse about this, and she said that it's likely only muscle pain. I feel way more tired than I did months ago. My current labs look fine though. Thoughts?

  • #2
    Hello Penelope28,

    The swelling in your lower legs and the puffiness around your eyes is consistent with fluid retention and kidney function that is not removing sufficient amounts of fluid. Your GFR and creatinine do not reflect the degree of kidney function loss that produces fluid retention.

    You may be able to resolve the condition by reducing your sodium intake. Have a renal function blood panel conducted to see if your sodium value is up. If you are consuming a good deal of salty foods, this can explain some or all of the fluid retention.

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    • #3
      Thanks for your response stump54. I've dramatically reduced my sodium intake since getting the puffy eyes. I'm sure my sodium intake is very low. My last sodium was 139, which is well within normal range based on what my lab report says. Looking at my eyes, honestly, I feel a bit frightened.

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      • #4
        Hi Penelope,

        Regarding the puffiness and swelling of the feet. I have the same problem, the am is the worst regarding the under eye puffiness. The GFR fluctuates, but I had the same occurrence for some reason my GFR jumped to 89 when the last 10 years my levels have been between 43 and 55. You may want to have the GFR tested again within the next 3 months...don't be alarmed if the number returns to your original number of 55.

        As far as your smaller kidney, I have an appointment next week with a nephrologist for the same thing. Both of my kidneys are smaller than normal. I'll let you know what the outcome is. I've been doing some research regarding smaller kidneys...one thing that always pops up on my search is Renal Artery Stenosis...the renal artery becomes blocked with cholesterol build up just like the heart arteries. I hope this information doesn't alarm you...it's considered informational and something you may want to discuss with your physician.

        Take care and my you find the answers you seek.
        Maggie

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        • #5
          Thank you for responding Maggie. Forgive me that it's been a year and a half to respond to you! It's been awhile, but as you suggested, my gfr has returned back down to 56. My blood pressure hadn't been under control, and the doctor put me back on lisinopril for the past two months. I'd neglected to mention before that I was on lisinopril when the gfr originally took the nosedive. He's waiting a few more weeks, to see if it drops further. He'd been keeping an eye on it over the past year and a half-- my gfr went from 55 to 111 to 97 to 93 to 89 to 83, then 56. The 56 on lisinopril. If it drops further he said he may need to take me off the lisinopril, though it's the only drug that seems to have any effect on the bp. Maggie, your post makes me feel a little better. That maybe the lower gfr was the more accurate and at least steady? The dramatic dropping again of the gfr is worrisome to me. Anybody else have such a steady drop in gfr over time? Or a huge drop on lisinopril? If I stay at or about this gfr for the next ten years, like you Maggie, I'd be thrilled. But I'm not keen on the time span and general trajectory. 😕

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          • #6
            Penelope28
            Have you ever had a biopsy done of your kidneys. That would let you know for sure if you have a major kidney problem or maybe a minor one. That is one of the first steps to take if you have not already had one. Some time lab work is not accurate if other things are going on in your body. If you are having swelling around your eyes there is something going on. If you have had everything else checked out than you should dig deeper into kidney issue. Good Luck and let us know how things go.

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            • #7
              Yes, I've been checked and seem to be in good health other than bp and kidney problem. No, I haven't had a biopsy. The doctor mentioned this past visit that it should maybe be done. He said he was sure there would be scarring, and that doing the biopsy wasn't without risk. The only other lab that was abnormal was phosphorus, was a little high at 4.9.

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