Kidney Disease: Improving Global Outcomes (KDIGO) guidelines define rapid progression as rate of eGFR declines > 5 mL/min per 1.73m2 per year [1, 2].
Rapid decline in kidney function was defined as a decline in the estimated glomerular filtration rate (eGFR) of > 3 mL/min/1.73 m2/year. Rapid deterioration of HRQOL was defined a change in the HRQOL value greater than the median. Among 970 patients, 360 (37.1%) were in the rapid kidney function decline group.
GFR generally declines at a rate of 1 mL/min/year. However, patients who lose renal function faster than the average age-related decline in GFR tend to progress to ESRD. Krolewski et al. defined progressive renal decline as an eGFR loss of ⩾3.3% per year.
A decrease or decline in the GFR implies progression of underlying kidney disease or the occurrence of a superimposed insult to the kidneys. This is most commonly due to problems such as dehydration and volume loss.
gFR must remain low for three months for CKd to be diagnosed. If your GFR is below 60... when gFR is below 60 for more than three months, this is moderate-to- severe chronic kidney disease. you may be referred to a nephrologist (kidney doctor) for evaluation and treatment.
The estimated glomerular filtration rate (eGFR) is variable and it relies on a blood test, which may have day to day variations and it is an "estimation". Hence, the more times you do the test, the more accurate will be the estimate.
A person with stage 2 chronic kidney disease (CKD) has kidney damage with a mild decrease in their glomerular filtration rate (GFR) of 60-89 ml/min. There are usually no symptoms to indicate the kidneys are damaged.
If you eat well and exercise but do not keep healthy blood sugar or blood pressure levels then your GFR may continue to decline.
Kidney disease progresses at different rates for different people, and it can take between two and five years to pass between different stages. Kidney disease stages are measured by using a blood test to check the estimated glomerular filtration rate (eGFR).
In the general population, approximately 38% of adults aged 70 or older have an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2, with most having moderate reductions in eGFR in the 30-59 ml/min/1.73 m2 range (1).
The only way to adjust GFR from moment to moment is to change glomerular blood (hydrostatic) pressure.
As one of the fastest aging organs, the kidney shows an age-related reduction in some structures and functions. The annual decrease of renal parenchyma is about 1%,2 and the decline of creatinine clearance or glomerular filtration rate (GFR) is approximately 1.0 mL/min per 1.73 m2 per year in elderly subjects.
While it's not possible to reverse kidney damage, you can take steps to slow it down. Taking prescribed medicine, being physically active, and eating well will help.
Dehydration does cause the serum creatinine to rise and the estimated glomerular filtration rate (eGFR) will, accordingly, fall. The degree of change is generally proportional to the degree of dehydration. Severe dehydration can actually cause acute kidney injury and may lead to a need for dialysis therapy.
Following the classical way, we can assert that normal GFR values are largely over 60 mL/min/1.73 m2 in healthy subjects, at least before the age of 70 years. However, we know that GFR physiologically decreases with age, and in adults older than 70 years, values below 60 mL/min/1.73 m2 could be considered normal.
Both fat and lean body mass decrease with weight loss, and reduction in muscle mass could lead to lower serum creatinine levels and, thus, higher eGFR.
Indications for referral vary across guidelines but there is one commonality: Patients with a severely decreased estimated glomerular filtration rate (eGFR) of < 30 mL/min per 1.73 m2 require prompt referral to a nephrologist for comanaged care.
It is important to start getting ready for dialysis or a transplant well in advance — when your kidney disease reaches Stage 4 (severe, with glomerular filtration rate, or GFR, less than 30 mL/min).
In this population-based study, we examined factors associated with glomerular filtration rates (GFR) in both genders. The findings of our study showed that obesity, diabetes, blood urea nitrogen, atherogenic factor, hypertension, meat consumption, and smoking were associated with lower GFR.
Life Expectancy by Sex
For a 60-year old woman, stage 1 life expectancy is 18 years, while stage 2 is only one year less. For stage 3 kidney disease, her life expectancy would be 11 years.
If the function is somewhat low but stable, you may need to see your doctor only once per year. If the GFR is declining or it is already under 50, it's best to see a kidney doctor, if for no other reason than to become educated.
Don't eat ham, bacon, sausage, hot dogs, lunch meats, chicken tenders or nuggets, or regular canned soup. Only eat reduced-sodium soups that don't have potassium chloride as an ingredient (check the food label.) Also, only eat 1 cup, not the whole can.
In adults, the normal eGFR number is usually more than 90. eGFR declines with age, even in people without kidney disease. See chart below for average estimated eGFR based on age.
An increase in renal arterial pressure (or renal blood flow) causes an increase in GFR. A reduction in renal arterial pressure (or renal blood flow) will have the opposite effect (1).