eGFR · low result
Low eGFR: what it means, the stages of chronic kidney disease and what to do next
Short answer
eGFR estimates how much blood the kidneys filter per minute, from creatinine (and sometimes cystatin C), age and sex. Below 60 mL/min/1.73m² suggests reduced kidney function; if it stays below 60 for more than three months — or any eGFR is accompanied by persistent kidney damage markers such as albumin in the urine — it meets the definition of chronic kidney disease, staged from 3a (45–59) to 5 (under 15). A single low value is often not that: dehydration, a recent hard workout, creatine supplements or a large meat meal raise creatinine and lower the estimate, and NSAIDs, ACE inhibitors and some antibiotics do too. A repeat in two to four weeks, hydrated and rested, with a urine albumin-to-creatinine ratio, is the first step; eGFR 60–89 with no other markers is not kidney disease.
Medically reviewed by Youmna DiStefano, MD · Last reviewed November 2026
When does this result need same-day care?
- An eGFR below 15, or a fall of more than half from a recent value — same-day care (possible acute kidney injury)
- A low eGFR with very little urine, severe swelling, breathlessness, confusion or chest pain — emergency care
- A low eGFR with a potassium above 6.0 mmol/L — emergency care
What is the normal range for eGFR?
- age 18+: 60.0 – 120 mL/min/1.73m2
Sustained values below 60 can indicate chronic kidney disease and warrant follow-up.
Full reference table, citations and testing options: eGFR biomarker page.
What are the common causes of low eGFR?
- A transient creatinine rise — dehydration, strenuous exercise in the previous two days, creatine supplements, a large meat meal, a recent illness
- Medications — NSAIDs (ibuprofen, naproxen), ACE inhibitors and ARBs (a small expected fall), diuretics, trimethoprim and cimetidine (block creatinine secretion without harming the kidney), some antibiotics, contrast dye, lithium, calcineurin inhibitors
- Diabetes and high blood pressure — together the cause of most chronic kidney disease in the US
- Glomerular disease — IgA nephropathy, lupus nephritis, other glomerulonephritis; often with blood or protein in the urine
- Urinary obstruction — an enlarged prostate, stones, strictures
- Polycystic kidney disease and other inherited conditions; kidney stones with repeated infections
- Heart failure, cirrhosis and severe dehydration — reduced blood flow to the kidneys (acute and often reversible)
- Older age and high muscle mass — eGFR declines slowly with age, and very muscular people produce more creatinine, so their estimate reads low without any kidney problem
What symptoms go with low eGFR?
- None until kidney function is substantially reduced — most low eGFRs are found on routine blood work
- Swelling of the ankles, feet or around the eyes; foamy urine; waking at night to urinate
- Fatigue, poor appetite, nausea, itching, muscle cramps, trouble concentrating as function falls further
- High blood pressure that is new or harder to control
What do clinicians usually check next?
- Repeat in 2–4 weeks, well hydrated, 48 hours after any hard exercise, off creatine and after a normal diet
- A urine albumin-to-creatinine ratio — the second axis of kidney staging and the strongest predictor of progression; and a urinalysis for blood
- A cystatin C–based eGFR for confirmation when muscle mass is unusual (very muscular, frail, amputation) or the result is borderline
- Blood pressure, A1c and lipids; potassium, bicarbonate, calcium, phosphorus and a CBC as function falls
- Medication review — stop or avoid NSAIDs, adjust doses that depend on kidney function, check anything that blocks creatinine secretion
- A kidney ultrasound when eGFR is persistently below 60, when obstruction is possible, or when there is blood in the urine
- Nephrology referral for eGFR below 30, a fall of more than 25% or 5 mL/min per year, significant albuminuria, blood in the urine without infection, or an unclear cause
Follow-up tests available at TestWell: CBC with Differential Test ($17.99), Calcium Test ($16.99), Phosphorus Test ($16.99).
KDIGO recommends measuring eGFR (alongside urine albumin) at least once a year in people with chronic kidney disease, and more often at more advanced stages or higher risk — as frequently as every 1–3 months. Adults with diabetes or high blood pressure are generally checked yearly even with normal kidney function.
How do you recheck eGFR?
Prices are cash-pay; every order adds one $6 lab processing fee. Physician authorization is included; no insurance or referral needed.
| Test or panel | Type | Price | Fasting | Results |
|---|---|---|---|---|
| Kidney Health Panel | Panel · 4 tests | $64.99 | Yes | 2–4 business days |
| Total Body Essentials Panel | Panel · 39 tests | $399.99 | Yes | 3–7 business days |
| Total Body Panel | Panel · 49 tests | $599.99 | Yes | 5–10 business days |
| Renal Function Test (Renal Panel) | Test · 10 biomarkers | $22.99 | No | 2–4 business days |
Common questions
What eGFR is chronic kidney disease?
Below 60 mL/min/1.73m² for more than three months, or any eGFR with persistent kidney damage markers such as albuminuria. 60–89 with no other markers is not CKD.
Can eGFR go back up?
Yes if the cause was transient — dehydration, a drug, an obstruction. Chronic damage doesn't typically reverse, but its progression can be slowed.
What is a low eGFR?
Below 90 is 'mildly reduced' but normal for many adults, especially over 60, and is not kidney disease without other markers. Below 60 is reduced and, if it persists three months, is chronic kidney disease: 45–59 is stage 3a, 30–44 stage 3b, 15–29 stage 4, under 15 stage 5 (kidney failure).
Is an eGFR of 55 or 58 serious?
It is mildly reduced (stage 3a if it persists) and common after 65. On its own it is not an emergency, but it is a reason to confirm with a repeat, check urine albumin, control blood pressure and glucose, avoid NSAIDs and review medication doses. Most people at this level never progress to kidney failure.
Can exercise, creatine or a high-protein diet lower eGFR?
They raise creatinine, which lowers the estimate without harming the kidneys — a heavy workout can drop eGFR by 10–20 points for a day or two, and creatine supplements and large meat meals do the same. Repeat rested and off supplements; a cystatin C eGFR sidesteps the problem entirely.
How do you improve a low eGFR?
You protect what remains: blood pressure under control (ACE inhibitors or ARBs when there is albumin in the urine), glucose control in diabetes, SGLT2 inhibitors which slow CKD progression even without diabetes, avoiding NSAIDs and dehydration, not smoking, and treating any reversible cause. True kidney scarring does not regrow, but decline can often be slowed to near zero.
Educational content, not a diagnosis. Lab results are one input; a clinician interprets them with your history and exam.