eGFR Gives Insight Into Your Kidney Health. Here's What It Is and How to Optimise It.

As an adult exploring more about health and longevity, you understand the importance of preventive care and early detection of health risks.

An estimated glomerular filtration rate, or eGFR, test should be part of your regular bloodwork to monitor kidney health and function. An eGFR score provides an estimate of how well your kidneys are filtering and gives your doctor insight into your kidney function to detect any issues early.

For optimal health and longevity, aim for an eGFR in the normal range and get tested regularly based on your doctor's recommendations. By monitoring and managing your eGFR, you are taking an important step in safeguarding your future health.

TLDR: eGFR stands for estimated glomerular filtration rate.

• An eGFR test measures kidney function through a blood test.
• Regular eGFR tests are important for early detection of kidney issues and monitoring kidney health.
• Healthy kidney function and eGFR levels contribute to overall health and longevity.

The Link Between eGFR, Kidney Health and Longevity

What Is eGFR ?

eGFR stands for estimated glomerular filtration rate. It is a measure of your kidney function and how well your kidneys are filtering waste and excess fluid from your blood.

Your eGFR is calculated from the results of a simple blood test that measures your creatinine level, which is a waste product made by your muscles and excreted through your kidney.

As you age, your eGFR naturally decreases over time. However, a rapid drop in eGFR can be an early indicator of kidney disease or damage. Knowing your eGFR and tracking it over time is one of the best ways to monitor your kidney health and catch any issues early.

Risk Factors for Kidney Disease

Some of the major risk factors for reduced eGFR and kidney disease include:

• Diabetes - which can damage the filters in your kidneys over time.
• High blood pressure - which puts extra strain on your kidneys.
• Heart disease - your kidneys and heart are closely connected, so issues with one organ can impact the other.
• Family history of kidney disease - some forms of kidney disease are hereditary.
• Obesity or being overweight - excess weight also strains your kidneys.
• Smoking - reduces blood flow to your kidneys and speeds up age-related decline in kidney function.

How Low eGFR Can Impact Your Health

A low eGFR indicated that your kidneys are not functioning properly. This can put strain on your kidneys and reduce their ability to filter waste and excess fluid from your blood.

When your kidneys cannot adequately filter your blood, toxins and waste products build up in your body. This toxic buildup can cause serious health issues over time, including:

• High blood pressure - Your kidneys help regulate blood pressure by controlling fluid balance and producing hormones. As kidney function declines, blood pressure often rises.
• Cardiovascular disease - Toxins that normally exit through urine can accumulate and damage blood vessels, raising risks for heart attacks and strokes.
• Bone disease - Kidney disease affects the body's balance of phosphorus, calcium and vitamin D, which can lead to weak and brittle bones.
• Anemia - Your kidneys produce hormones that help produce red blood cells. Anemia is common with kidney disease.
• Immune system dysfunction - Your kidneys help eliminate waste generated by your immune cells. Impaired kidney function can disrupt your body's defenses.

So keeping your eGFR level within a healthy range is crucial for avoiding these health issues and maintaining overall wellness and longevity.

Ideal eGFR Levels Across Ages

Ideal eGFR levels will vary depending on your age and overall health. As we age, our kidney function naturally decreases, so eGFR levels that are normal for a 30-year-old may indicate kidney disease in someone who is 70. The National Kidney Foundation provides the following guidelines for healthy eGFR levels:

Ages 18-29: ≥90 mL/min/1.73 m2

In young adults, an eGFR below 90 mL/min/1.73 m2 may indicate kidney disease and warrants follow-up testing. At this age, the kidneys are functioning at their peak, so eGFR levels should be high.

Ages 30-59: 60-89 mL/min/1.73 m2

For middle-aged adults, an eGFR between 60 to 89 mL/min/1.73 m2 is considered within the normal range. Levels at the higher end of this range are ideal, while levels in the 70s and 80s, though still normal, indicate your kidney function may have started to decrease slightly with age.

Ages 60 and older: ≥60 mL/min/1.73 m2

In seniors, an eGFR of at least 60 mL/min/1.73 m2 is considered normal, though levels in the 60s and 70s mean your kidney function has likely decreased significantly with age. Your doctor may order more frequent eGFR testing, such as every 6-12 months, to monitor for any rapid drops.

How Often Should eGFR Be Tested?

To properly monitor kidney health and function over time, regular testing of estimated glomerular filtration rate (eGFR) is essential. For most healthy adults, eGFR should be checked at least once every 1-2 years after age 50, and potentially more frequently after age 65 or if any risk factors for kidney disease are present.

Annual Testing After Age 50

Once individuals enter middle age, the risk of developing chronic kidney disease (CKD) starts to increase. Getting eGFR tested annually after age 50, even for those without symptoms or known risk factors, allows for early detection of any decline in kidney function.

More Frequent Testing For At-Risk Groups

Certain individuals are at higher risk of developing kidney disease and should be tested more often. This includes those with diabetes, high blood pressure, obesity, or a family history of kidney failure. For these at-risk groups, eGFR should be checked at least once every 6-12 months to closely monitor for any changes. Frequent testing, along with proper management of any underlying conditions, can help avoid progression to more serious stages of CKD or even kidney failure.

Changes Over Time

While a single eGFR result may be in the normal range, monitoring how it changes over months and years provides the most useful information about kidney health.

A decrease of more than 4-6 mL/min/1.73m2 per year could indicate progressive loss of kidney function even if the eGFR remains normal.

On the other hand, stable or even improving eGFR over time with treatment and lifestyle changes confirms that kidney health is being well-maintained.

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Lifestyle Changes to Improve eGFR

To maintain or improve your eGFR, making healthy lifestyle changes is critical. Several factors within your control can positively impact your kidney health and longevity.

Diet

Following a balanced diet low in salt, sugar, and red meat is key. Aim for a diet high in whole grains, fresh fruits and vegetables, legumes, and lean proteins like fish and chicken.

Limit processed foods, fast food, and sugary beverages which are high in phosphorus, potassium and acid and can tax your kidneys. Staying hydrated, especially with water, will help your kidneys function properly.

Exercise

Engaging in regular exercise has significant benefits for overall health and kidney function. Aerobic exercise like walking, swimming or biking 3-4 times a week for 30 minutes helps control blood pressure and blood sugar, increases circulation, and promotes weight loss — all of which support healthy kidneys.

Strength or resistance training using weights a few times a week builds muscle and bone density. However, avoid high-intensity interval training as it may temporarily raise creatinine levels.

Weight Management

Maintaining a healthy weight reduces excess strain on your kidneys and provides other health benefits like lower blood pressure and blood sugar. Losing excess pounds through a balanced diet and exercise is the ideal approach.

Fad diets should be avoided as they can be unsafe and the weight loss is often not sustainable.

Smoking Cessation

Quitting smoking is one of the best things you can do for your health and to preserve kidney function. Smoking accelerates kidney damage and aging, and is a leading cause of CKD. Speak to your doctor about medications and strategies to help you quit for good.

Making healthy lifestyle changes and working closely with your doctor to properly manage any chronic conditions provides the best opportunity to maintain or boost your eGFR and support kidney health and longevity. Through balanced diet, exercise, weight loss, smoking cessation, and medication compliance, you have the power to positively impact your eGFR and overall wellness.

Medications for Managing eGFR

To properly manage an eGFR below 60 mL/min/1.73 m2, certain medications may be prescribed by your doctor. These aim to slow the progression of chronic kidney disease (CKD) and reduce complications.

Angiotensin-Converting Enzyme Inhibitors

Angiotensin-converting enzyme (ACE) inhibitors are commonly used to manage high blood pressure in CKD patients. Drugs like lisinopril and enalapril work by blocking ACE, an enzyme involved in raising blood pressure.

By inhibiting ACE, these medications lower blood pressure and reduce protein in the urine, both of which help slow CKD progression.

Angiotensin Receptor Blockers

Angiotensin receptor blockers (ARBs) like losartan and valsartan are alternative blood pressure medications for CKD patients. They work similarly to ACE inhibitors but have fewer side effects.

ARBs block angiotensin receptors to prevent angiotensin from narrowing blood vessels and raising blood pressure. They also help decrease protein in the urine to slow kidney function decline.

Diuretics

Diuretics, or “water pills,” may be used along with ACE inhibitors or ARBs to help lower blood pressure in CKD patients. Common diuretics include furosemide and hydrochlorothiazide, which work in the kidneys to flush excess sodium and water from the body through increased urination.

Reducing excess fluid helps lower blood pressure. Diuretics can cause dehydration and electrolyte imbalance, so potassium and blood levels may need monitoring.

Statins

Statins like atorvastatin and simvastatin may be prescribed to lower high cholesterol, which can damage blood vessels and further reduce kidney function. By decreasing “bad” LDL cholesterol and raising “good” HDL cholesterol, statins help prevent and slow the progression of atherosclerosis and subsequent kidney damage.

Statin use may slightly increase the risk of kidney damage, so kidney function tests are typically performed before starting or changing statin treatment.

Lifestyle changes in combination with these medications provide the best opportunity to maintain kidney health and longevity when eGFR starts to decline. Follow-up testing every 3-6 months allows your doctor to assess how well the treatment plan is working and make adjustments as needed to support lifelong kidney function.

Conclusion

In summary, getting your estimated glomerular filtration rate (eGFR) checked regularly should be an important part of your health and wellness plan, especially as you age. An eGFR test is a simple blood test that provides insight into your kidney function and overall health. Maintaining kidney health and optimal eGFR levels has been linked to increased longevity and vitality.

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