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The glomeruli are tiny tubules that filter blood in the kidneys. Muscles produce a waste product called creatinine, which is removed from blood plasma by the kidneys during this glomerular filtration process. Creatinine is then passed into the urine and not reabsorbed by the glomeruli to any significant degree.
The glomerular filtration rate (GFR), also known as estimated glomerular filtration rate (eGFR), represents a test designed to determine how effective this renal clearance of creatinine is in order to assess kidney function. A blood test is taken to determine how much creatinine is in the blood. This result is taken into consideration along with the patient’s age, gender, body size and race.
If the eGFR is found to be low, kidney function is said to be impaired or reduced. In general, the serum or blood creatinine level does not increase until renal function has become significantly impaired. It must be noted that it is not possible to make an accurate assessment if people have high levels of creatinine as a result of a large amount of muscle tissue.
An eGFR test should be used to monitor people with chronic kidney disease (CKD) and people with risk factors for CKD such as diabetes, high blood pressure, a family history of the condition or cardiovascular disease. A doctor can use the eGFR to establish the stage of kidney disease and the best treatment plan. The earlier renal disease is diagnosed, the greater the chance of slowing or preventing its progression.
For adults, a healthy GFR is more than 90, although this gradually declines with age, even in the absence of kidney disease. When a person does have a kidney disease, the GFR changes depending on the stage of the condition. The different kidney disease stages and associated GFRs are listed below.
An eGFR of below 60 for a period of three months or an eGFR of 60 with the presence of kidney damage indicates that a patient has CKD. In this case, a doctor will start to investigate what is causing the kidney disease, monitor the kidney function and start to plan an adequate treatment.
A urine test is carried out to check the urine level of a protein called albumin. Albumin leaks into the urine when a person has kidney disease and this is referred to as albuminuria.
A doctor may also recommend further testing (such as an ultrasound scan or computed tomography scan) to help determine whether there are problems such as a kidney stone or tumor or abnormal structure of the kidney and urinary tracts. In some cases, a biopsy may be taken to assess how much damage has occurred and to aid treatment decisions.
Regardless of a person’s eGFR result, steps that can be taken to keep the kidneys as healthy as possible are described below: