From the Guidelines
A GFR of 62 ml/min/1.73m² with a creatinine of 1.43 mg/dL indicates stage 2 chronic kidney disease (CKD), which represents mildly reduced kidney function, and requires monitoring and implementation of kidney-protective measures. This condition is characterized by a decline in kidney function, but not to the extent of requiring immediate intervention like dialysis or transplantation 1. According to the National Kidney Foundation practice guidelines, a GFR level less than 60 mL/min per 1.73 m² represents loss of half or more of the adult level of normal kidney function, and below this level, the prevalence of complications of chronic kidney disease increases 1.
Key Considerations
- The patient should schedule regular follow-up appointments with their healthcare provider every 6-12 months to track kidney function.
- Focus on kidney-protective measures including:
- Blood pressure control (target <130/80 mmHg)
- Diabetes management if applicable (target HbA1c <7%)
- Lifestyle modifications such as:
- Reducing sodium intake to less than 2 grams daily
- Maintaining adequate hydration
- Exercising regularly
- Avoiding nephrotoxic medications like NSAIDs (ibuprofen, naproxen)
- Medications like ACE inhibitors (e.g., lisinopril 10-40 mg daily) or ARBs may be prescribed if the patient has hypertension or diabetes to protect kidney function 1.
Implications
This level of kidney function represents about 50% of normal function, indicating some kidney damage has occurred. Early management can prevent progression to more advanced stages of kidney disease. It is essential to note that decreased GFR in the elderly is an independent predictor of adverse outcomes, such as death and cardiovascular disease, and requires adjustment in drug dosages 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Glomerular Filtration Rate (GFR) and Creatinine Levels
- A GFR of 62 mL/min/1.73 m2 and a creatinine level of 1.43 mg/dL indicate impaired kidney function, as a normal GFR is typically considered to be above 90 mL/min/1.73 m2 2.
- The National Kidney Foundation suggests that estimates of GFR are the best overall indices of the level of kidney function, and that the serum creatinine concentration should not be used alone to assess the level of kidney function 3.
Estimating GFR
- The Modification of Diet in Renal Disease (MDRD) study equation and the Cockcroft-Gault equation are useful for estimating GFR in adults, taking into account serum creatinine concentration, age, gender, race, and body size 3.
- The MDRD study equation and Rule's quadratic equation can be used to calculate eGFR values based on creatinine levels, with reference intervals of 63.5-124.6 mL/min/1.73 m2 and 78.3-139.2 mL/min/1.73 m2, respectively 2.
Chronic Kidney Disease (CKD) and Treatment
- CKD is a major public health problem, and angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been shown to slow down the progression of CKD 4, 5.
- The use of ACE inhibitors and ARBs in combination may provide greater renoprotection than either an ACE inhibitor-based or ARB-based regimen alone, although larger outcomes trials are needed to confirm this 4.
- Patients with proteinuria may benefit from ACE-I/ARB therapy, which can slow down the progression of renal insufficiency and provide cardio-protective effects 5.