Is Your eGFR Low? Why Your Kidneys Are Filtering Slowly & Medically Approved Next Steps

If you've been told your eGFR is low, it's normal to feel concerned. eGFR is one of the most important numbers used to understand kidney health. But a low result does not automatically mean kidney failure. It does mean you need to understand what's happening and what to do next.

Let's break it down clearly and calmly.

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What Is eGFR?

eGFR stands for estimated glomerular filtration rate. It measures how well your kidneys filter waste and extra fluid from your blood.

Your kidneys contain tiny filters called glomeruli. When they're healthy, they remove waste efficiently. The eGFR is calculated using:

• Your blood creatinine level
• Your age
• Your sex
• Sometimes your race (though this is being phased out in many labs)

The result is reported as milliliters per minute per 1.73 m² (mL/min/1.73m²).

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What Is a Normal eGFR?

In general:

• 90 or higher → Normal kidney function (if no other signs of kidney damage)
• 60–89 → Mildly decreased kidney function (may be normal in older adults)
• 45–59 → Mild to moderate decrease
• 30–44 → Moderate to severe decrease
• 15–29 → Severe decrease
• Below 15 → Kidney failure (requires urgent specialist care)

An important detail:
A single low eGFR does not automatically mean chronic kidney disease (CKD). To diagnose CKD, kidney function must be reduced for at least three months or there must be other signs of kidney damage (like protein in the urine).

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Why Is Your eGFR Low?

A low eGFR means your kidneys are filtering more slowly than expected. There are many possible reasons.

1. Chronic Kidney Disease (CKD)

The most common cause of a persistently low eGFR is chronic kidney disease. The leading causes include:

• Diabetes
• High blood pressure
• Heart disease
• Long-term inflammation of the kidneys
• Polycystic kidney disease

CKD often develops slowly and may not cause symptoms in early stages.

If you're experiencing symptoms and want to understand whether they could be related to Chronic Kidney Disease, a free AI-powered symptom checker can help you assess your risk in just a few minutes.

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2. Dehydration

Not drinking enough fluids can temporarily lower your eGFR. When blood flow to the kidneys drops, filtration slows.

This is often reversible with proper hydration.

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3. Medications

Certain medications can reduce kidney function, including:

• NSAIDs (like ibuprofen or naproxen)
• Some antibiotics
• Certain blood pressure medications
• Contrast dye used in imaging tests

Always review medications with your doctor if your eGFR changes.

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4. Acute Kidney Injury (AKI)

A sudden drop in eGFR may indicate acute kidney injury, which can occur due to:

• Severe infection
• Major surgery
• Severe dehydration
• Blocked urinary tract
• Certain medications

AKI can sometimes be reversed if treated quickly.

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5. Age-Related Decline

It's normal for eGFR to gradually decrease with age. Many older adults have an eGFR between 60–89 without having true kidney disease.

The key question is whether the decline is stable or progressive.

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Symptoms of Low eGFR

Early stages of reduced kidney function often cause no symptoms. That's why blood tests are so important.

As kidney function declines further, symptoms may include:

• Fatigue
• Swelling in legs, ankles, or face
• Foamy urine (protein in urine)
• Changes in urination (more or less frequent)
• Nausea
• Muscle cramps
• Shortness of breath
• Confusion (in advanced stages)

If you experience severe symptoms like chest pain, confusion, or difficulty breathing, seek immediate medical care.

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What Happens If eGFR Stays Low?

If your eGFR remains below 60 for three months or longer, you may be diagnosed with chronic kidney disease.

CKD increases the risk of:

• Heart disease
• Stroke
• Anemia
• Bone disease
• Fluid overload
• Electrolyte imbalances

Advanced kidney disease can eventually lead to dialysis or transplant. However, many people with early CKD never progress to kidney failure, especially when treated early.

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Medically Approved Next Steps

If your eGFR is low, here are evidence-based steps doctors typically recommend:

1. Repeat Testing

A single low eGFR may not mean much. Your doctor will likely:

• Repeat blood tests in a few weeks or months
• Check urine for protein (albumin-to-creatinine ratio)
• Monitor trends over time

Trends matter more than one number.

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2. Control Blood Pressure

High blood pressure damages kidney filters.

Target blood pressure is often:

• Below 130/80 mmHg (depending on individual risk)

Medications such as ACE inhibitors or ARBs may both lower blood pressure and protect kidney function.

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3. Manage Blood Sugar (If Diabetic)

Tight glucose control significantly slows CKD progression.

Medications such as:

• SGLT2 inhibitors
• GLP-1 receptor agonists

have been shown to protect kidney function in appropriate patients.

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4. Adjust Medications

Your doctor may:

• Stop or reduce NSAIDs
• Adjust medication doses based on eGFR
• Avoid contrast dye if possible

Never stop medications without medical guidance.

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5. Improve Lifestyle Factors

Evidence strongly supports:

• Limiting sodium (usually under 2,300 mg/day)
• Maintaining a healthy weight
• Regular physical activity
• Quitting smoking
• Moderating alcohol intake

These steps help both kidney and heart health.

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6. Consider Referral to a Nephrologist

You may be referred to a kidney specialist if:

• eGFR drops below 30
• Kidney function declines rapidly
• There's significant protein in urine
• The cause is unclear

Early specialist care improves long-term outcomes.

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Can eGFR Improve?

Sometimes, yes.

If low eGFR is caused by:

• Dehydration
• Medication effects
• Acute illness

Kidney function may partially or fully recover.

If caused by chronic kidney disease, improvement is less common, but slowing or stopping progression is very possible with proper treatment.

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When to Seek Immediate Care

Seek urgent medical attention if you have:

• Severe shortness of breath
• Chest pain
• Sudden confusion
• Very little urine output
• Severe swelling

These can indicate serious complications.

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The Bottom Line

A low eGFR means your kidneys are filtering more slowly than expected. It is a signal — not a sentence.

Key points to remember:

• One low result doesn't confirm chronic kidney disease.
• Trends over time matter.
• Early stages often have no symptoms.
• Many causes are treatable.
• Lifestyle and medication changes can significantly slow progression.

If you're concerned about your kidney health and want to better understand your symptoms, you can check for signs of Chronic Kidney Disease using a free, AI-powered assessment tool that takes just minutes to complete.

Most importantly, speak to a doctor about your results. Kidney disease can become serious if ignored, but early evaluation and treatment dramatically improve outcomes. If you have severe or life-threatening symptoms, seek emergency medical care immediately.

Taking action early gives you the best chance of protecting your kidney health for years to come.