What is EGFR (CKD-EPI)?

One of the most important parameters that show the function of the kidneys in a situation such as kidney failure; is the glomerular filtration rate. Glomerular filtration, which stands for GFR; Rate is an important test that shows the filtering ability of the kidneys and can be estimated by taking into account parameters such as blood creatinine level, age and gender.

What is EGFR (CKD-EPI)?

The lower the GFR, the lower the kidney functions. In some cases, such as acute urinary tract infections, temporary decreases in EGFR may occur. This does not mean permanent kidney damage. However, especially if used to monitor kidney failure, this value gives important information about both the stage of the disease and the current working capacity of the kidneys.

The most basic function of the kidneys in the body is to filter the blood and remove excess water, electrolytes and waste from the body through urine. The extent to which the kidneys can perform this function is evaluated by the amount of blood filtered per unit time. The filtering function is performed by the glomeruli in the kidneys. In healthy individuals, glomeruli filter approximately 200 liters of blood daily, and as a result, approximately 2 liters of urine are produced in the kidneys.

EGFR is the short name for the estimated glomerular filtration rate, or in other words, the amount of blood filtered by the glomeruli per minute. It can also be seen in some tests, also called CKD-EPI. It is one of the most reliable tests used to measure kidney function level and determine the stage of the disease in chronic kidney failure patients. EGFR measurements can also be used to monitor kidney diseases and investigate the effect of any treatment applied. If the EGFR (CKD-EPI) value is below 60 for three months and is above 60 with kidney damage, but there is deterioration in albumin level, the presence of chronic kidney diseases can be mentioned.

An abnormal EGFR test result is evaluated by the physician. If chronic kidney disease is suspected, further investigations and different diagnostic tests can be performed to diagnose it.

Determining the glomerular filtration rate precisely rather than as an estimate requires a more demanding test. The best method for this is the procedure called inulin clearance. In this procedure, a radioactively labeled liquid is given to the patient intravenously and urine is collected for a period of 24 hours.

The GFR value can be precisely determined by investigating urine volumes and the labeled inulin level in each sample. Since this test requires longer time and effort and EGFR is a very reliable calculation method, the primarily used function test around the world is EGFR.

There is a different medical condition called EGFR mutation. This is a different condition that is not related to glomerular filtration rate and is a term used in lung diseases that develop with EGFR gene mutation. The abbreviation of EGFR used in this sense is epidermal growth factor receptor.

How is EGFR Tested?

EGFR calculation is a practical and rapid diagnostic test that can be applied in any situation where kidney diseases are investigated. However, this test is not suitable for use alone, as EGFR may be outside normal ranges for those under 18 years of age, pregnant women, those with a lot of muscle mass or obesity. In individuals other than these, the estimated glomerular filtration rate can be used in the screening, detection and follow-up of early stage kidney damage. EGFR is calculated using creatine or cystatin C levels.

Generally, different parameters such as creatine and BUN are included in the blood results along with the EGFR test. The GFR test, a simple blood test, can be performed with a small amount of blood taken from the arm veins, and the results are usually available on the same day or the next day. When evaluated together with different conditions such as EGFR protein leakage, creatinine or BUN elevation, important information can be obtained about the patient’s kidney functions.

What is EGFR Normal Value?

Many symptoms such as edema and swelling in the body, blood or color difference in the urine, decrease in urine output, pain and burning during urination, pain in the waist and back area, itching in the body, high blood pressure, nausea and vomiting are among the symptoms that indicate kidney diseases.

In these patients, the EGFR test and some other kidney function tests are usually performed in the form of blood tests and urine tests. EGFR is calculated with the help of a special GFR formula called MDRD. Then, based on the results obtained, it can be determined whether there is kidney damage and, if so, at what stage it is. The results obtained in EGFR calculation are united as ml/min/1.73m2 and express the minute filtration rate of the kidneys.

The EGFR reference value can be specified as 90 and above for adults. Glomerular filtration rates in the range of 90-122 ml/min can be considered normal, taking into account age. As an answer to the question of what the EGFR should be, it can be stated that the range of 90-122 ml is the normal GFR value. The EGFR test reference range, which shows the level of kidney damage according to the test results, is as follows:

  • EGFR>90: Minimal kidney damage compared to normal GFR or urine test results
  • EGFR between 60-89: slight decrease in GFR
  • EGFR between 30-59: moderate decrease in GFR
  • EGFR between 15-29: Severe decrease in GFR
  • EGFR<15: Kidney failure

In order to determine that the GFR value is decreased, an individual must have a low EGFR level of 60 or below for at least 3 months. However, when the findings obtained as a result of urine tests are evaluated in individuals with a GFR measurement level between 60-90, minimal damage to the kidneys can be diagnosed. Therefore, if GFR is outside the normal value, it should be evaluated by a physician and, if deemed necessary, more detailed diagnostic tests should be performed.

Causes of Elevated EGFR

Many people who see high EGFR results in their blood results; It seeks answers to questions such as how to lower EGFR, what does high GFR mean, and what are the factors affecting GFR. A glomerular filtration rate above normal may indicate many conditions such as obstruction in the urinary tract, inability of the kidneys to retain urine, and inability of the kidneys to filter well.

If an elevated EGFR result is found during the follow-up of nephropathy, which is a common complication in diabetic patients, it can be concluded that the kidneys are damaged. In such cases, an increase in creatine values ​​usually occurs. In some cases, high GFR may be considered normal due to reasons such as pregnancy, growth and development.

Therefore, when an abnormal GFR value is seen in the test results, regardless of whether it is high or low, the results should be shown to the physician and action should be taken according to the physician’s opinion.

Causes of Low EGFR

On the contrary of high EGFR, questions frequently asked by patients with low filtration rates include questions such as how to increase EGFR, what is low EGFR, what does low GFR mean. GFR is among the most important markers for kidney failure. Temporary decreases in EGFR value may occur due to acute diseases.

However, the possibility of kidney damage is high in cases of low GFR that persists for 3 months or longer. Common factors that can cause low EGFR include kidney failure, acute or chronic glomerulonephritis, cancers in the kidneys, and urinary tract infections. In individuals with low glomerular filtration rate, additional investigation should be conducted to determine whether there is protein leakage in the urine and infections.

In addition to creatine and BUN tests, blood levels of electrolytes such as sodium and potassium also provide information about the filtration ability of the kidneys. The stages of kidney failure according to GFR are as follows:

Stage 1 Kidney Failure: GFR may be over 90, protein leakage in the urine (proteinuria) may be observed, but the patient usually does not have any symptoms.

Stage 2 Renal Failure: GFR is in the range of 60-90, mild renal failure has developed, but there are usually still no symptoms.

Stage 3 Renal Failure: GFR is in the range of 30-59 and there is moderate renal failure. Symptoms such as swelling in the hands and feet, high blood pressure and decreased urine output may develop.

Stage 4 Renal Failure: GFR is in the range of 15-30. Attention should be paid to appropriate nutrition for kidney failure, and research on kidney transplantation or dialysis should be started.

Stage 5 Renal Failure: It is an advanced stage of renal failure with GFR<15 and the kidneys are almost inoperable. Severe symptoms develop and the patient must be connected to dialysis or receive a kidney transplant.

Medical imaging techniques are among the diagnostic tests used in individuals with suspected kidney diseases. With the help of these applications, many conditions such as kidney stones, duct obstructions and tumors in the kidneys can be detected. Once the problem causing decreased kidney function is fully identified, the treatment process is started.

Another issue that is wondered by patients who have results below the GFR limits is the answer to the question of what the GFR is, should they undergo dialysis. EGFR value is not used as a sole parameter when evaluating whether the patient needs to start dialysis. The necessity of dialysis is decided by evaluating many factors such as the patient’s current health status, electrolyte values ​​in the blood, creatine value and the presence of protein in the urine.

Generally, in adult individuals over 18 years of age and with GFR values ​​in the range of 10-15 ml/min/1.73m2, dialysis decision is made by taking other findings into consideration. Depending on the patient’s age and health condition, either hemodialysis or peritoneal dialysis may be preferred.

If you have recently had a blood test and found that your EGFR result is outside the normal range, it would be beneficial to consult your doctor and get information about the reasons for this situation. If you have any disease that may affect the kidneys, you can prevent permanent kidney damage by ensuring it is diagnosed and treated as early as possible.

Abbas Jahangir

I am a researcher and writer with a background in food and nutritional science. I am the founder of Foodstrend.com, our reputable online platform offering scientifically-backed articles on health, food, nutrition, kitchen tips, recipes, diet, and fitness. With a commitment to providing accurate and reliable information, we strive to empower our readers to make informed decisions about their health and lifestyle choices. Join us on Foodstrend.com's journey toward a healthier and happier lifestyle.

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