From the Guidelines
The patient's kidney function appears normal based on the provided laboratory values, with a GFR of 96 mL/min/1.73m² indicating excellent kidney function for her age. Her creatinine level of 0.69 mg/dL is within normal range, and while her BUN/creatinine ratio of 29 is slightly elevated, this finding alone doesn't indicate kidney disease when other parameters are normal 1. The elevated ratio could reflect mild dehydration, high protein diet, or use of certain medications rather than kidney dysfunction. According to the national kidney foundation practice guidelines for chronic kidney disease, 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 the patient's GFR is well above this threshold 1.
Key points to consider in this patient's kidney status include:
- Normal GFR values above 90 are considered normal, and this patient's GFR of 96 mL/min/1.73m² falls within this range 1
- The age-related decline in GFR is considered part of normal aging, but decreased GFR in the elderly is an independent predictor of adverse outcomes, such as death and cardiovascular disease 1
- The definition of chronic kidney disease is the same, regardless of age, and is defined as either kidney damage or decreased kidney function (decreased GFR) for 3 or more months 1
- Maintaining good hydration and following up with routine kidney function tests at regular intervals would be prudent for ongoing monitoring, especially given her age of 65 years when age-related changes in kidney function can begin to manifest.
From the Research
Kidney Status Indicators
The patient's kidney status can be indicated by several factors, including:
- Blood Urea Nitrogen (BUN) level: A BUN level of 20 is within the normal range [ 2 ]
- Creatinine level: A creatinine level of 0.69 is within the normal range [ 2 ]
- BUN/Creatinine ratio: A ratio of 29 is within the normal range [ 2 ]
- Glomerular Filtration Rate (GFR): A GFR of 96 is within the normal range, indicating good kidney function [ 3, 2 ]
Normal Kidney Function
The patient's kidney function appears to be normal, as indicated by the normal BUN, creatinine, and GFR levels [ 3, 2 ]. The BUN/Creatinine ratio is also within the normal range, which suggests that the patient's kidney function is not impaired [ 2 ].
Association with Other Conditions
It is worth noting that higher BUN levels have been associated with an increased risk of incident diabetes mellitus, even in patients with normal kidney function [ 4 ]. However, in this case, the patient's BUN level is within the normal range, and there is no indication of diabetes or other kidney-related conditions [ 4 ].