Bad lab result from rheumy - low GFR

Hi all -

Goodness, when it rains it pours. My rheumy’s nurse just called me with lab results that I had done during my last infusion and my GFR has lowered quite a bit. I’ve always been in the low 70s but suddenly I’m 59-60. Don’t know how that happened. They asked if I was taking any NSAIDs which I’m not. That’s like taking candy or placebo for my RA.

I’m wondering if this due to me not taking anything for my diabetes. I told the nurse and she said she would relay it to my rheumy’s PA/PN. My cardiologist also wanted a copy of the lab results, because I’ve had a couple of palpitations and told him during my checkup but the EKG was o.k. He’s just worried that the RA may affect my heart. Which it could my kidneys too.

I still can’t find a viable Internist near me. I may just have to go back to the clinic that my PCP retired from…it’s a little less than 16 miles from my house. I don’t trust my PCP to oversee my diabetes because she did full panel blood work in July and said everything was o.k. including my kidneys and now in August my rheumy says otherwise? That’s just strange.

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Mine have been in similar range. The numbers can fluctuate, so a retest may show back in 70 range. Mine was tested weekly when I was doing chemo, and the numbers bounced often, usually 70+, but occasional high 50s which raises eyebrows. But it has always gone back up on retest.

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Oh good MM1, so it may have been just a fluke/bad day. I hope that’s the case.

Thanks!

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I think your hydration level can make a difference, so I try to remember to drink sufficient fluids before test (and every day).

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Yes, that was infusion day and I try to drink sufficiently/hydrate so my infusion goes well.

The nurse who phoned said my CPR and SED rates were still elevated (as usual) as well as my BG levels. I was so shocked by the low GFR I forgot to ask my BG number.

The nurse asked if I was taking diabetic medications and I told her no, and she said she make a note for my rheumy’s new PN.

The kidney tests can be interpreted differently by someone that knows what to look for?

Years ago I had a dog that tested fine on kidney health, but a specialist we went to said they were signs in the tests that the kidneys were not completely normal.
So sometimes a more specialized doctor knows what to look for in the group of tests. You would hope a regular pcp would be more aware but they are probably taught to just look at each result, whereas a specialist has more in depth training.

I always like to get copies of the tests so I can look at them and compare with past tests? Or see if something is off that they just don’t think is important?

Is you BG in the normal range with diet and exercise, without taking anything for your diabetes?
It could be a one off, As you would know, 60 or above, is still considered in the normal range, without more detailed testing.

https://labtestsonline.org/tests/estimated-glomerular-filtration-rate-egfr
A normal eGFR for adults is greater than 90 mL/min/1.73m2, according to the National Kidney Foundation. (Because the calculation works best for estimating reduced kidney function, actual numbers are only reported once values are less than 60 mL/min/1.73m2)

I am on diet and exercise but my range fluctuates anywhere from 89 to 260 (my highest days), usually after infusion once a month. Takes about 2-3 for me to return back to my normal range.

“Where I live” normally is ~110 to 150. My PCP says as long as I stay below 200, I’m fine.