From the Guidelines
Elevated eGFR indicates that your kidneys are filtering blood at a higher rate than expected for your age, sex, and body size, and is generally not concerning, but may require regular monitoring if you have risk factors like diabetes or hypertension. While a normal eGFR typically ranges from 90-120 mL/min/1.73m², an elevated value may exceed this range. This finding often represents excellent kidney function, particularly in young, healthy individuals or athletes. Some key points to consider when evaluating elevated eGFR include:
- Small fluctuations in GFR are common and do not necessarily indicate progression, as noted in the 2012 clinical practice guideline for the evaluation and management of chronic kidney disease 1.
- The eGFR calculation has limitations and can be influenced by muscle mass, diet, and certain medications, so interpretation should always be done in the context of your overall health status and other laboratory values.
- Elevated eGFR might be caused by hyperfiltration, which can occur in early diabetes, pregnancy, high-protein diets, or after consuming a large protein meal, and can sometimes precede kidney damage in certain conditions.
- Regular monitoring of kidney function is advisable if you have risk factors like diabetes or hypertension, as recommended in the guideline for monitoring CKD 1.
- No specific treatment is needed for elevated eGFR alone, but management of underlying conditions and regular monitoring can help prevent progression of kidney disease.
From the Research
Definition of Elevated eGFR
Elevated eGFR, or estimated glomerular filtration rate, refers to a higher than normal rate of blood filtration by the kidneys.
- This can be an indicator of renal hyperfiltration, a condition where the kidneys filter more blood than normal, which can be a risk factor for cardiovascular disease and mortality 2.
- Renal hyperfiltration is often associated with early phases of kidney disease, particularly in individuals with conditions such as obesity and diabetes.
Implications of Elevated eGFR
The implications of having an elevated eGFR are not fully understood, but research suggests that it may be associated with:
- A higher risk of cardiovascular disease and all-cause mortality 2
- Early phases of kidney disease, particularly in individuals with conditions such as obesity and diabetes
- The need for careful management of blood pressure and proteinuria to prevent or retard the progression of diabetic nephropathy 3, 4, 5, 6
Management of Elevated eGFR
Management of elevated eGFR typically involves:
- Control of blood pressure, with a target blood pressure of <130/80 mm Hg in all patients with type 2 diabetes 4
- Reduction of proteinuria, which can help to retard the progression of nephropathy 4, 6
- Use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) to control hypertension and reduce proteinuria 3, 4, 5, 6