Might a low EGFR indicate a serious condition?

Written by: Dr David Game
Edited by: Conor Lynch

In our latest article, we speak to revered London-based consultant nephrologist, Dr David Game, to find out what a low EGFR indicates in a typical blood test, and whether or not a low EGFR may indicate a more severe medical condition.

What does a low EGFR mean in a typical blood test?

EGFR simply refers to estimated glomerular filtration rate. So, here, we are talking about an estimate of someone’s kidney function on a blood test. The estimate of kidney function is based on the creatinine level in the blood. If your EGFR is low, then the suspicion is you may have a kidney problem.


However, this is not always the case. There are other causes of a low EGFR, such as increased muscle bulk and increased muscle turnover. If the EGFR is very low, then this suggests that kidney function is very low, which is very serious.


What are the main causes of a low EGFR?

If one’s low EGFR is kidney-related, the most common causes for this typically include hypertension, diabetes, and other conditions that can cause vascular disease. Inflammatory conditions such as lupus, and structural problems with the kidneys, such as polycystic kidney disease, can also cause a reduced kidney function.


Might it indicate a potentially severe condition?

It can be very serious, especially if the EFFR levels are very low, as this indicates a very low kidney function.


How exactly is a low EGFR detected?

It is usually detected on a routine blood test, that is often carried out for a different reason altogether. A referral is then made.


Other deeper investigations can then be carried out to find out whether the high levels of creatinine truly indicate a decreased kidney function, and patients should discuss what these may be with an experienced nephrologist.


Once a low EFGR has been detected, what is the next step?

It obviously depends on the magnitude of the decrease. We typically categorise chronic kidney disease according to how low the EGFR is. If it is more than 60 and is not changing, this is not something of an immediate concern.


If a EFGR is lower than 60, then a patient can expect to undergo a blood test, followed by a urine test, followed by an ultrasound scan. A kidney biopsy may be needed, depending on the results of the previous tests.


Dr David Game is a highly experienced London-based consultant nephrologist. Consult with him today via his Top Doctors profile if you are worried about your EFGR levels and a potential decreased kidney function

By Dr David Game

Dr David Game is a leading consultant nephrologist based in London who specialises in transplantation, dialysis and chronic disease of the kidney. He is additionally expert in hypertension as well as acute kidney injuries and kidney stones.

Dr Game studied for a bachelor’s degree in pharmacology at the University of Cambridge before qualifying in medicine at the University of Oxford in 1996. He was later awarded the prestigious Medical Reserve Corps (MRC) fellowship and additionally completed a PhD in transplant immunology at Imperial College London. Following further specialist training on the esteemed North Thames rotation, he was appointed as a consultant at Guy's Hospital in 2009, where he continues to see private patients. He additionally sees private patients at HCA at the Shard and the Lister Hospital in central London.

Dr Game is a leading name in medical education and has been an honorary senior lecturer at King’s College London since 2015. Prior to this, he was a clinical lecturer at Imperial College London, based at the Hammersmith Hospital for several years and was also voted Guy's Teacher of the Year by the establishment’s junior doctor trainees. Additional to his teaching roles, Dr Game continues to be an active researcher in transplant immunology. He was the principal investigator in a highly anticipated €14 million clinical trial of cell therapy for transplant tolerance which was funded by the EU.

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