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Dear Sandi,

I hope this helps:

" GFR is test is used to screen for and detect early kidney damage and to

monitor kidney status. It is performed by ordering a creatinine test and

calculating the eGFR. The creatinine test is ordered frequently as part of a

routine Comprehensive Metabolic Panel (CMP) or Basic Metabolic Panel (BMP), or

along with a Blood Urea Nitrogen (BUN) test whenever a doctor wants to evaluate

the status of the kidneys. It is ordered to monitor those with known kidney

disease and those with conditions such as diabetes and hypertension that may

lead to kidney damage.

" The eGFR can be determined, with no extra testing, at the same time that a

blood sample is sent for a creatinine measurement. The National Kidney

Foundation (NKF) has recommended that it be calculated automatically every time

a creatinine test is done. A creatinine test and eGFR may be ordered any time

that a doctor wants to evaluate a person's kidney function as part of a health

checkup or if kidney disease is suspected. Warning signs of kidney disease may

include:

a.. Swelling or puffiness, particularly around the eyes or in the face,

wrists, abdomen, thighs, or ankles

b.. Urine that is foamy, bloody, or coffee-colored

c.. A decrease in the amount of urine

d.. Problems urinating, such as a burning feeling or abnormal discharge during

urination, or a change in the frequency of urination, especially at night

e.. Mid-back pain (flank), below the ribs, near where the kidneys are located

f.. High blood pressure (hypertension)

" As kidney disease worsens, symptoms may include:

a.. Urinating more or less often

b.. Feeling itchy

c.. Tiredness, loss of concentration

d.. Loss of appetite, nausea and/or vomiting

e.. Swelling and/or numbness in hands and feet

f.. Darkened skin

g.. Muscle cramps

" An eGFR may be ordered periodically when a person has a chronic kidney disease

or a condition such as diabetes or hypertension that is associated with kidney

damage.

" What does the test result mean? The eGFR test detects kidney disease in its

early stages more reliably than the creatinine test alone. Because the

calculation works best for estimating reduced renal function, the NKF suggests

only reporting actual results once values are < 60 ml/min (normal values are

90-120 ml/min, according to the NKF). An eGFR below 60 ml/min suggests that some

kidney damage has occurred. The NKF recommends that a person's eGFR result be

interpreted in relation to his clinical history and presenting conditions. The

NKF has suggested that all persons " know their GFR number. " They recommend

interpreting eGFR results based on the following table:

Is there anything else I should know?

" Another method of evaluating renal function involves the measurement of the

serum level of a molecule called cystatin C. There is increasing interest in the

use of this test for this purpose.

" The creatinine clearance test also provides an estimate of renal function and

of the actual GFR. However, in addition to the serum creatinine, this test

requires a timed urine collection (24 hours) for urine creatinine measurement in

order to compare blood and urine creatinine concentrations and to calculate the

clearance.

" The actual amount of creatinine that a person produces and excretes is affected

by their muscle mass and by the amount of protein in their diet. Men tend to

have higher creatinine levels than women or children. A person's GFR decreases

with age and some illnesses and can increase during pregnancy.

" The calculation for eGFR is intended to be used when kidney function, and

creatinine production, is stable. If a creatinine level is measured when the

kidney function is changing rapidly, such as with acute renal failure, then it

will not give a useful estimate of the filtration rate. A slightly different

equation should be used to calculate the eGFR for those under the age of 18. An

eGFR test may not be as useful for those who differ from normal creatinine

concentrations. This may include people who have significantly more muscle (such

as a body builder) or less muscle (such as a muscle-wasting disease) than the

norm, those who are extremely obese, malnourished, follow a strict vegetarian

diet, ingest little protein, or who take creatine dietary supplements. Likewise,

the eGFR equations are not valid for those who are 75 year of age or older

because muscle mass normally decreases with age.

" The eGFR test may also be affected by a variety of drugs, such as gentamicin,

cisplatin, and cefoxitin that increase creatinine levels, and by any condition

that decreases blood flow to the kidneys. The most commonly used equation for

calculating the eGFR, and the one recommended by the National Kidney Foundation

for general use, is called the MDRD (Modification of Diet in Renal Disease

study) equation. It requires a person's serum creatinine, age, and assigned

values based upon gender and race. "

http://www.labtestsonline.org/understanding/analytes/gfr/test.html

FYI,

Lottie Duthu

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Hi Lottie.

Thank you for your information. I know that others in the group are concerned

with their GFR,too; and we greatly appreciate your quick response and detailed

information. The website that you listed is an excellent source for

understanding the testing and kidney functions.It

points out another way of getting what I believe is a more accurate test of EFG.

Robyn's EFG no. was 47 which is moderate. The interesting thing is that she

does not show symptoms that her kidneys are being effected. The only sympton is

the swelling under her eyes when she has food with high salt. This is the

reaction from the Gleevec.

Hopefully, the number resulted from too much or too little water and little

protein in her diet. We shall see what the number is when she has bloodwork

done again.

Thanks again.

Sandi

>

> Dear Sandi,

> I hope this helps:

>

> " GFR is test is used to screen for and detect early kidney damage and to

monitor kidney status. It is performed by ordering a creatinine test and

calculating the eGFR. The creatinine test is ordered frequently as part of a

routine Comprehensive Metabolic Panel (CMP) or Basic Metabolic Panel (BMP), or

along with a Blood Urea Nitrogen (BUN) test whenever a doctor wants to evaluate

the status of the kidneys. It is ordered to monitor those with known kidney

disease and those with conditions such as diabetes and hypertension that may

lead to kidney damage.

>

> " The eGFR can be determined, with no extra testing, at the same time that a

blood sample is sent for a creatinine measurement. The National Kidney

Foundation (NKF) has recommended that it be calculated automatically every time

a creatinine test is done. A creatinine test and eGFR may be ordered any time

that a doctor wants to evaluate a person's kidney function as part of a health

checkup or if kidney disease is suspected. Warning signs of kidney disease may

include:

> a.. Swelling or puffiness, particularly around the eyes or in the face,

wrists, abdomen, thighs, or ankles

> b.. Urine that is foamy, bloody, or coffee-colored

> c.. A decrease in the amount of urine

> d.. Problems urinating, such as a burning feeling or abnormal discharge

during urination, or a change in the frequency of urination, especially at night

> e.. Mid-back pain (flank), below the ribs, near where the kidneys are

located

> f.. High blood pressure (hypertension)

> " As kidney disease worsens, symptoms may include:

>

> a.. Urinating more or less often

> b.. Feeling itchy

> c.. Tiredness, loss of concentration

> d.. Loss of appetite, nausea and/or vomiting

> e.. Swelling and/or numbness in hands and feet

> f.. Darkened skin

> g.. Muscle cramps

> " An eGFR may be ordered periodically when a person has a chronic kidney

disease or a condition such as diabetes or hypertension that is associated with

kidney damage.

>

> " What does the test result mean? The eGFR test detects kidney disease in its

early stages more reliably than the creatinine test alone. Because the

calculation works best for estimating reduced renal function, the NKF suggests

only reporting actual results once values are < 60 ml/min (normal values are

90-120 ml/min, according to the NKF). An eGFR below 60 ml/min suggests that some

kidney damage has occurred. The NKF recommends that a person's eGFR result be

interpreted in relation to his clinical history and presenting conditions. The

NKF has suggested that all persons " know their GFR number. " They recommend

interpreting eGFR results based on the following table:

>

> Is there anything else I should know?

> " Another method of evaluating renal function involves the measurement of the

serum level of a molecule called cystatin C. There is increasing interest in the

use of this test for this purpose.

> " The creatinine clearance test also provides an estimate of renal function and

of the actual GFR. However, in addition to the serum creatinine, this test

requires a timed urine collection (24 hours) for urine creatinine measurement in

order to compare blood and urine creatinine concentrations and to calculate the

clearance.

>

> " The actual amount of creatinine that a person produces and excretes is

affected by their muscle mass and by the amount of protein in their diet. Men

tend to have higher creatinine levels than women or children. A person's GFR

decreases with age and some illnesses and can increase during pregnancy.

>

> " The calculation for eGFR is intended to be used when kidney function, and

creatinine production, is stable. If a creatinine level is measured when the

kidney function is changing rapidly, such as with acute renal failure, then it

will not give a useful estimate of the filtration rate. A slightly different

equation should be used to calculate the eGFR for those under the age of 18. An

eGFR test may not be as useful for those who differ from normal creatinine

concentrations. This may include people who have significantly more muscle (such

as a body builder) or less muscle (such as a muscle-wasting disease) than the

norm, those who are extremely obese, malnourished, follow a strict vegetarian

diet, ingest little protein, or who take creatine dietary supplements. Likewise,

the eGFR equations are not valid for those who are 75 year of age or older

because muscle mass normally decreases with age.

>

> " The eGFR test may also be affected by a variety of drugs, such as gentamicin,

cisplatin, and cefoxitin that increase creatinine levels, and by any condition

that decreases blood flow to the kidneys. The most commonly used equation for

calculating the eGFR, and the one recommended by the National Kidney Foundation

for general use, is called the MDRD (Modification of Diet in Renal Disease

study) equation. It requires a person's serum creatinine, age, and assigned

values based upon gender and race. "

>

> http://www.labtestsonline.org/understanding/analytes/gfr/test.html

>

> FYI,

>

> Lottie Duthu

>

>

>

>

>

>

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