high GFR

  1. Hello! I have a client with a critically high GFR (151.5). I've never seen a high GFR and have no info about it. What can it mean? The pt also has low Hemoglobbin, 6.3, low WBC, RBC. Kidney labs are fine. I am stumped!
  2. 4 Comments

  3. by   pharmgirl
    Typically impaired kidney function would show a low GFR. Our book says that GFR higher than 90 could indicate risk factors for kidney disease (diabetes, high BP, yadda yadda). Sickle cell Anemia would elevate GFR and decrease Hg and RBC. I dunno, can't wait for a knowledgeable person to answer. Are they on any meds? History of diabetes?
  4. by   NewNurseAlert
    They drink regularly and take methadone
  5. by   mama_d
    we just started adding gfr to our chem studies not long ago, and the emphasis has been on if the patient has a low gfr, so i did a little looking around since high gfr's have not been addressed in any of our inservices. honestly, i don't even think our lab has "high" or "low" or "panic" values associated w/gfr. we don't even get a range for it on our lab printouts, i'm assuming b/c there are so many variables which can affect it.

    anyways, poking around online a little bit, it appears that dietary protein intake, pregnancy, hyperglycemia, and ketoacidosis can lead to a high gfr. i'm assuming that having awesome kidney function can cause a high reading as well, although i'm not sure where the cut-off for that would be

    apparently drinking can lead to a high gfr as well: "subjects with alcohol consumption had significantly higher levels of serum triglycerides, high-density lipoprotein cholesterol, uric acid, estimated ccr and gfr values than non-drinkers." http://ndt.oxfordjournals.org/cgi/co...ract/20/8/1610

    apparently there has been some research into using gfr, both high and low, as a mortality indicator. i can only get to the abstract, but it states that "circulatory disease was the main cause of death in patients with low egfrs and respiratory disease/cancer, in patients with high egfrs. conclusions: as a marker of mortality, both low and high egfrs are equally predictive of increased mortality in community patients, exhibiting a 'u' shaped curve. thus, current ckd guidelines which recommend inaction or even the non-reporting of egfr values greater than 60-90 ml/min/1.73 m2 may not identify patients who are at an equally high risk of dying as those where intervention is recommended." http://content.karger.com/produktedb...1159/000151720

    all the tables that i have come across have been the same in regards to a gfr of >90 indicating normal kidney function or else kidney damage w/normal gfr. kidney damage w/normal gfr is determined based on other test results, such as proteinuria. http://www.labtestsonline.org/unders.../gfr/test.html

    if you can manage to get through it without frying your brain, there is an extremely detailed explanation about gfr at http://www.uhmc.sunysb.edu/internalm...ges/part_a.htm . personally, i started having my eyes cross and smoke coming out of my ears before i was a quarter of the way through it, but bookmarked it to come back to when i have the time to read it w/out kids screaming in the background.

    hope this helps out some; it was interesting reading for me to find it
  6. by   NewNurseAlert
    wow that's great (for me to know, not for the client to have) I wonder what the consequences are, I'm guessing poorly filtered blood, maybe fluid excess?