From the Guidelines
A GFR of 43 mL/min/1.73m² indicates moderate kidney disease, specifically Stage 3B chronic kidney disease (CKD), which requires medical attention and management to prevent further kidney damage and reduce the risk of complications 1.
Key Considerations
- This level of kidney function is considered moderate kidney disease, with the kidneys functioning at about 43% of normal capacity, as healthy kidneys typically filter at rates above 90 mL/min/1.73m² 1.
- Management of CKD typically includes blood pressure control with medications like ACE inhibitors or ARBs, dietary modifications, and regular monitoring of kidney function, electrolytes, and urinary protein 1.
- Controlling other conditions like diabetes and high cholesterol is crucial to prevent further kidney damage 1.
Recommendations
- Consult with a nephrologist to develop a personalized treatment plan.
- Limit sodium, potassium, and phosphorus intake.
- Avoid nephrotoxic medications like NSAIDs and certain antibiotics when possible.
- Regularly monitor kidney function, electrolytes, and urinary protein, typically every 3-6 months.
- Maintain HbA1c below 7% if diabetic, and control high cholesterol to prevent further kidney damage.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
GFR 43 Overview
- A GFR (Glomerular Filtration Rate) of 43 mL/min/1.73 m2 indicates a reduced kidney function, which is a sign of chronic kidney disease (CKD) stage 3b 2.
- CKD is a condition where the kidneys lose their ability to filter waste and excess fluids from the blood, leading to various complications such as cardiovascular disease, end-stage kidney disease, and death.
Diagnosis and Management
- The diagnosis of CKD is based on the presence of a persistent abnormality in kidney structure or function, such as a GFR <60 mL/min/1.73 m2 or albuminuria ≥30 mg per 24 hours, for more than 3 months 2.
- Management of CKD includes cardiovascular risk reduction, treatment of albuminuria, avoidance of potential nephrotoxins, and adjustments to drug dosing 2.
- Patients with CKD require monitoring for complications such as hyperkalemia, metabolic acidosis, hyperphosphatemia, vitamin D deficiency, secondary hyperparathyroidism, and anemia.
Treatment Options
- Angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are commonly used to treat CKD, as they can help reduce albuminuria and slow the progression of kidney disease 3, 4.
- Mineralocorticoid receptor antagonists (MRAs) may also be used in combination with ACEi or ARB to provide additional benefits in reducing cardiovascular and kidney disease risk 5.
Monitoring and Referral
- Patients with CKD should be monitored regularly for changes in kidney function, albuminuria, and other complications 2.
- Those at high risk of CKD progression, such as patients with an estimated GFR <30 mL/min/1.73 m2, albuminuria ≥300 mg per 24 hours, or rapid decline in estimated GFR, should be promptly referred to a nephrologist 2.