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Kidney Diseases

Decreased Creatinine and GFR

03/05/2010

Question:

I am a 45 yr old female with multiple medical problems including hypertension and a mitochondrial myopathy. I had some blood work done a few weeks ago that showed a creat. 1.3 and GFR 44. Prior to this my kidney function has always been normal with creat. less than 1.0 and gfr <60. I have had a recent issue with bilateral edema in my lower legs. There was a question as to whether I had PH but my RHC was normal. My doctor is repeating labs next week. He did add lasix to my HCTZ and told me to restrict my sodium intake. He has not said whether I have kidney disease but I am a little worried about it. Is kidney disease diagnosed on the basis of one low GFR etc or does it need serial testing to confirm it? Thanks

Answer:

I think you meant "GFR>60", not " GFR<60". You make a good point about serial testing. The GFR can change transiently during an acute illness, dehydration, toxin exposure, etc. Sometimes a urine analysis (UA) and a renal ultrasound or CT scan are used to firm up teh diagnosis. If the reason for the creatinine elevation remains obscure, or is progressing, then a renal biopsy is sometimes considered.

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Response by:

Thomas Zipp, MD Thomas Zipp, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University