Kidneys messed up?

[John in NY]

I'm 62 and on TRT, my labs look good except for my kidneys.
What do you think of it?

 

[Guided_by_Voices]

I'm 62 and on TRT, my labs look good except for my kidneys.
What do you think of it?

There are apparently confounders that raise creatinine like creatine use and possibly recent hard exercise. eGFR is a calculated number IIRC and is based off of creatinine. I use the cystatin C test which is apparently much more accurate. There is another test I have forgotten the name of which is the real GFR (non- calculated) but you can start with cystatin C. IME kidney tests and health are far from obvious based on the tests. Avoiding high blood pressure is one of the biggest things to do, IIRC.

 

[Vince]

Also, if you use creatine it can make your kidneys look bad.. Even though they're good.

 

[gr8schott]

I went through something similar last year and can share my experience in hopes that it can put your mind at ease (I'm 63). I'm not a doctor, yada yada, but I think I can help clarify some things based on what I learned.

(1) Doctors seem to pay the most attention to the eGFR number, which is derived from the creatinine measured value. My labwork last year showed an eGFR of 53, which was quite a bit lower than the result from the previous year (70). Looking back at years before that, I saw that the GFR always hovered somewhere right around 58-62. Note that the bottom end of "normal" is considered to be 60, so I could be "normal" one year (in which case the doctor wouldn't have said a word) and below that the next.
(2) My regular doctor looked at the reduction from 70 to 53 and requested that the test be rerun. Guided by Voices is right. The normal hepatic function tests are sensitive to diet and exercise (particularly high protein diets and creatine supplements). The Cystatin-C kidney function test is not, so if I were you, I would request one of those as confirmation of the results you received. In my case, the GFR still came back somewhat low with the Cystatin C test, so my doctor bundled me up and sent me off to a specialist, "out of an abundance of caution," he kept reassuring me as I pulled myself off the ceiling.
(3) The specialist ran scads of blood tests I had never even heard of before and came back with "it's blood pressure." He also had me do an ultrasound, which came back completely "unremarkable" (their term). I have always had somewhat high blood pressure, even when I was much younger. Although it's being aggressively treated now (the specialist asked me to start taking Amlodipine, in addition to the BP pills I was already taking), that wasn't always the case. I remember doctors sometimes remarking on it when the top number was hovering around 140 or so in my 20s but then did absolutely nothing about it. It wasn't quite to the point where they considered it to be hypertension at that time. My dad was the same way, and my regular doctor confirmed that my tendency to high blood pressure was almost certainly hereditary. (I'm not overweight and I do exercise.)
(4) My most recent set of blood labs showed an eGFR right back at 59. At my physical, my regular doctor said everything was fine, and that the improvement in kidney function may well be a result of better blood pressure control. He said that at an eGFR of 60, he wouldn't even say anything to the patient--everything would be considered normal.
(5) Both the specialist and my regular doctor told me basically the same thing: the most important thing I can do to protect my kidneys is to keep my blood pressure under control. The specialist said that he didn't think anything more would happen as long as I do that. I know I have always tended toward high blood pressure. I read the newspapers and I teach in the public schools, neither of which has helped in that regard in the past, but now I monitor blood pressure religiously and try to drink lots of fluids. My regular doctor says overall I'm fine and should only live another 30 or 40 years or so.

Note to younger readers: If your blood pressure tends toward the high side (ask your doctor what that is), get in front of it NOW. Don't wait until you're in your 50s and 60s. Even slightly elevated blood pressure over a long time affects kidney health down the line. Keeping your blood pressure well controlled from a young age is about the biggest favor you can do for yourself in preparation for good health in later life.

I hope this helps some.