Low eGFR but no action by Doctor

[amy_c_78]

I am a 30 year old female. Height 6'0" and 180lbs, exercise 3-4 times a week, don't smoke, don't drink, normal blood pressure and blood sugar levels but my eGFR according to lab results is 53 and from what I can tell that means stage 3 kidney disease. Dr. said not to worry but keeps repeating the blood test (4 times in three months) without taking any other action. I am horribly exhausted lately and finding it difficult to stick with exercise routine. I have fairly severe flank pain. In 2004, I was diagnosed with endometriosis. The surgeon said he found scar tissue growing on my bladder and kidney's. Could this be the causing decreased kidney function? What should I do? I am very scared!

[Dr. Safaa Mahmoud]

Hello,
It true the result of your estimated glomerular infiltration rate indicate moderate kidney damage. If your other kidney functions are normal (creatinine and urea), physicians usually keep patients on follow up and make sure they avoid situations that may deteriorate their kidney function like frequent use of medications that affect the kideny or contrast dyes during radiologic exams.
Physicians seek nephrologist consultation when eGFR is 30ml/min or below.

This surely a concerning situation that mandates proper investigations. However, keeping in mind that this is a calculated way to estimate the GFR and not the most accurate way to test for the GFR. The best way to do so is by measuring the 24 hours urine chemical concentrates (24 hour Creatinine Clearance).

You have mentioned that during the surgical treatment of the endometriotic pelvic lesions, the physician observed some sort of fibrosis around the bladder and possibly the lower part of the ureter. This may cause obstruction in the urine flow from the kidney into the bladder. Consequently back pressure will cause deterioration of kidney function and possibly formation of renal cysts.

If this is the case, you better consult a nephrologist who would evaluate the proper therapeutic intervention before the situation is worsened. An US abdomen is helpful. Other investigations are based on your physician’s evaluation of the situation.

I would advise you to follow up with your physician and to discuss with him your concerns.

Please keep us updated.
Best regards.