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Lab results explained

Low eGFR: what your result means

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Short answer: eGFR estimates how well your kidneys filter blood. A result of 90 or more is normal, 60 to 89 is mildly reduced, and below 60 mL/min/1.73m² for at least three months is a sign of chronic kidney disease. Below 15 is the kidney failure range. One low result can be temporary, so doctors repeat it.

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Typical adult range

Your lab may print a slightly different range. Use the one on your report when there is one.

Typical adult ranges
TestMenWomen
eGFR (kidney filtering)Stage G5 (kidney failure range): under 15 mL/min/1.73m² Stage G4 (severely decreased): 15–30 mL/min/1.73m² Stage G3b (moderately to severely decreased): 30–45 mL/min/1.73m² Stage G3a (mildly to moderately decreased): 45–60 mL/min/1.73m² Stage G2 (mildly decreased): 60–90 mL/min/1.73m² Normal (G1): 90 or more mL/min/1.73m²
Creatinine0.74–1.35 mg/dL65.4–119 µmol/L0.59–1.04 mg/dL52.2–91.9 µmol/L
Urine albumin/creatinine ratio (ACR)Normal (A1): under 30 mg/g Moderately increased (A2): 30–300 mg/g Severely increased (A3): 300 or more mg/g

What eGFR measures

eGFR stands for estimated glomerular filtration rate. It is worked out from your blood creatinine, age and sex, rather than measured directly. A higher number means better filtering. Doctors group results into stages: G1 is 90 or more, G2 is 60 to 89, G3a is 45 to 59, G3b is 30 to 44, G4 is 15 to 29 and G5 is below 15. Kidney filtering slowly declines with age, so a mildly reduced eGFR is common in older adults. A G2 result alone, with no other sign of kidney damage, is not chronic kidney disease.

Why eGFR can read low

A single low eGFR does not always mean lasting kidney damage. Short-term factors can push creatinine up and eGFR down, which is why guidelines ask for a repeat test before a diagnosis. Long-term causes are mostly conditions that harm the small blood vessels in the kidneys over many years. Muscle mass also matters, because very muscular people can have a lower eGFR on paper, while frail people can look better than they are.

  • Dehydration, vomiting or diarrhoea
  • A large meat meal or creatine supplements before the test
  • Some medicines, including certain painkillers and blood pressure tablets
  • Diabetes and high blood pressure, the most common long-term causes
  • Kidney infections, kidney stones or inherited kidney disease

Symptoms and the role of urine ACR

Early kidney disease usually causes no symptoms, which is why blood and urine tests matter. Later signs can include swollen ankles, tiredness, itching, poor appetite, and passing more or less urine than usual. The urine albumin to creatinine ratio (ACR) checks for protein leaking into urine. An ACR of 30 mg/g or more is raised, and 300 or more is severely raised. Kidney disease is staged using both eGFR and ACR, and a raised ACR can show kidney damage even when eGFR is normal.

What usually happens next

Your doctor will usually repeat your eGFR and urine ACR, often within about three months, to see whether the change lasts. They may check your blood pressure, blood sugar, potassium and medicines, and sometimes order a kidney ultrasound or a cystatin C test, which can estimate kidney function more accurately in some people. Managing blood pressure and diabetes well is the main way to protect the kidneys. Your doctor may change the dose of some medicines if your eGFR is low. Referral to a kidney specialist is advised at lower stages.

When to get help the same day

Get same-day medical care if your eGFR is below 15, if it has dropped sharply since your last test, or if you are passing very little urine. Call your local emergency number for severe breathlessness, chest pain, confusion, a seizure, or swelling of the legs with trouble breathing.

Questions to ask your doctor

  • Is this result new, and should we repeat it before drawing conclusions?
  • What stage am I in when you include my urine ACR?
  • What is the likely cause of my reduced kidney function?
  • Do any of my medicines need a dose change or should be avoided?
  • Do I need to see a kidney specialist?

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mL/min/1.73m²
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Frequently asked questions

Is an eGFR of 75 bad?

An eGFR of 75 is stage G2, mildly reduced. On its own, without protein in the urine or other signs of kidney damage, it is not called chronic kidney disease. It is common in older adults. Your doctor may simply recheck it from time to time.

Can eGFR go back up?

Yes, if the low result was caused by something short-term, such as dehydration or a medicine. In chronic kidney disease the aim is usually to slow or stop further decline. Good control of blood pressure and blood sugar helps.

Does drinking more water raise eGFR?

If you were dehydrated, rehydrating can bring eGFR back up. Drinking large extra amounts beyond normal needs does not improve kidney function. People with advanced kidney disease may need to limit fluids, so ask your doctor what is right for you.

What is the difference between eGFR and creatinine?

Creatinine is the measured waste product in your blood. eGFR is calculated from creatinine, age and sex to estimate filtering. When creatinine rises, eGFR falls.

Sources

This page explains what results usually mean. It isn't a diagnosis or medical advice; your doctor interprets results with your symptoms, history and medicines. Medical disclaimer

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