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