eGFR of 115 mL/min/1.73 m² in a 56-Year-Old Female
An eGFR of 115 mL/min/1.73 m² represents excellent kidney function that is well above normal thresholds and indicates no chronic kidney disease, even in the context of previous renal concerns. 1
Understanding This Value in Context
Normal adult GFR ranges from 120-130 mL/min/1.73 m² in young adults, with physiologic decline beginning in the third or fourth decade of life at approximately 1% per year. 1
At age 56, an eGFR of 115 is exceptional and actually exceeds what would be expected for age-related decline, suggesting robust kidney function. 1
This value places the patient in Stage 1 kidney function (GFR ≥90 mL/min/1.73 m²), which is the highest functional category and only constitutes chronic kidney disease if markers of kidney damage are present (such as albuminuria, structural abnormalities, or pathological findings). 2
Clinical Significance and Risk Assessment
No increased cardiovascular or mortality risk exists from kidney function at this level. The threshold for increased risk begins at eGFR <60 mL/min/1.73 m², with moderate risk at 45-59 mL/min/1.73 m² and substantial risk only below 45 mL/min/1.73 m². 1
The patient retains full normal kidney function with no reduction in glomerular filtration capacity that would warrant concern or intervention. 2
Previous concerns about impaired renal function are not supported by this result, which demonstrates kidney function in the normal-to-excellent range for any age group. 1
Essential Next Steps
Verify absence of kidney damage markers to confirm truly normal kidney status:
Measure urinary albumin-to-creatinine ratio (UACR) on a random spot urine sample. Normal is <30 mg/g creatinine. 1
Albuminuria (UACR ≥30 mg/g) would be the only finding that could indicate kidney disease despite the excellent eGFR, as it dramatically increases cardiovascular and kidney disease progression risk even with preserved filtration. 1
Review urinalysis for hematuria, proteinuria, or cellular casts that might indicate glomerular or tubular damage not reflected in the eGFR. 2
Assess for structural abnormalities if previous imaging suggested kidney damage (such as cysts, scarring, or size discrepancies). 2
Important Caveats About eGFR Interpretation
eGFR equations (MDRD, CKD-EPI) tend to underestimate true GFR in the normal range, meaning actual kidney function may be even higher than 115 mL/min/1.73 m². 2, 3
A single eGFR value provides limited information—serial measurements over time are more informative for detecting trends or decline. 1
eGFR reflects only filtration function, not other kidney functions such as tubular secretion, acid-base regulation, or endocrine functions. 4, 5
Factors that can artificially elevate eGFR include high protein intake, hyperfiltration states, and certain medications, though these are unlikely to produce values this high without underlying excellent kidney reserve. 5
Monitoring Recommendations
No specific kidney-related interventions are needed, but establish baseline monitoring:
Repeat eGFR and UACR annually to detect any future decline, particularly watching for rates of decline >4-8 mL/min per year which would suggest accelerated kidney disease. 1
Maintain blood pressure control (target <140/90 mmHg, or <130/80 mmHg if diabetic or albuminuric) as uncontrolled hypertension accelerates GFR deterioration. 1
No medication dose adjustments are required at this level of kidney function—drug dosing modifications only become necessary when eGFR falls below 60 mL/min/1.73 m². 2, 1