What GFR is considered "good" post-transplant?

[Sax-O-Trix]

I am curious...  What should we expect or hope our GFR to be post-transplant?  6 weeks post-transplant, mine is 48-50% and that is much lower than I expected to achieve with a transplant for some reason.  My neph says 50 is good, to remember that it is only one kidney getting that result.  I guess I feel it should be higher because I was at about 15% going into the transplant.  Can you share your post-transplant GFR so I have a clearer idea of where I am?

[RichardMEL]

Mine's been bouncing around anything from 40-42% to 53-55%. Really it's variable and depends on a few things.

Around 50% makes sense given you're getting the benefit of one kidney doing all the work so I don't expect much more than that unless you have a) super kidney or b) some residual function in any original kidney(s) that are there.

Remember of course a GFR of 15 pre transplant would have been propped up somewhat by dialysis. Mine went as low as 3 at one stage.

At the end of the day it doesn't really matter IMHO. I've never had any of my tx team mention the gfr as either an issue or concern, or even the number - I just see it on the labs when I'm lucky enough to con someone into giving me a print of them. Their focus is more on the obvious indicators of concern of the creatanine of course.

I'm not going to worry if some lab report shows it at 40% one week. If I'm feeling good, and the other main numbers are in line that's the main thing. I don't think it's a number you should worry about. Anyway 50% I would say is, indeed, good.

[Sax-O-Trix]

Thanks for your thoughtful reply, Richard.  I wasn't on dialysis with the 15% function, my transplant was preemptive, so I was expecting a higher GFR for some reason.  I obsess over ALL of the numbers in my lab report every week (down from twice a week just this week.)  I only worried about GFR, K, Phos, calcium, BUN, urea, cholesterol and Hemo levels before the transplant and it seems now I have 10 times as many numbers to be concerned with.  I am hoping the numbers will level out and the "deer in the headlights" feeling I have will subside over time.

[Jie]

This really depends on what kind of kidney one gets. If a large man get a kidney from a small-sized, middle or old lady, it would be very lucky to get to 40%. In reverse, if a small lady gets a kidney from a healthy young man with a big body, the GFR could be 70% or higher. For living donors, the remaining kidney can enlarge and make up to 75% of kidney functions after the donation. For the donated kidney, I heard it does not enlarge, so it may be close to 50% function from the donor. Karol mentioned that a lady had a transplanted kidney with creat. 2.2 and the kidney lasted for 22 years. The more important matter is that the GFR can remain close to stable. As long as it does not have a declined trend, it is a good post-transplant. 

[Chris]

Mine fluctuates with each lab, if I am ill, and of course dehydrated. The highest mine has been is 65% with a Creat of 1.0, BUN I do not remember without looking at 10 years worth of lab papers. I would say my average is 52%, but would be higher if I did not have hospital stays late last year..
 
We are all different tho and will react differently to each individual kidney, medication, and lifestyle change. However this the GFR should not be a main concern if your transplant is doing well, labs are good, and your not rejecting unless your kidney is slow at waking up post transplant and then this level I would watch when you pick up your lab results to watch for improvements.

[Sunny]

My GFR post transplant, almost 7 months now, runs about 54% to 57%. The doctors at Stanford tell me this is the best possible outcome in all best possible scenerios and they are extremely pleased with the results. Apparantly this is far better than most cases. Believe me, this is plenty good and anything far lower would be plenty good to me since I felt so absolutely lousy prior to the transplant and feel so absolutely good after. I was told it is the rare event when a post transplant kidney funcitoned above 60%. If you are feeling good and your medical staff says you are doing well, I wouldn't worry too much about your GFR.

[kellyt]

Last time I was told of my GFR post transplant it was at 45 and that was three months post surgery.  My doctor never mentions my GFR, so I'm guessing it's the same or better.  I do labs for my next appointment Wednesday.  I'll be sure to ask.  Now I'm curious. 

[lawphi]

Hammett is running at 48%.  The surgeon expects that the kidney will grow a little over the next few months. 

Also, your prograf and other medication will be tapered overtime and decrease your creatinine. 

Hammett's second cadaver transplant lasted for three years with a creatinine of 3.3-3.6. 

[Chris]

Last time I was told of my GFR post transplant it was at 45 and that was three months post surgery.  My doctor never mentions my GFR, so I'm guessing it's the same or better.  I do labs for my next appointment Wednesday.  I'll be sure to ask.  Now I'm curious. 

Don't you get monthly lab results Kelly? Mine shows the GFR all the time.

[kellyt]

I don't do monthly labs anymore.  I see my doctor every 4-5 months and I do labs 1 week prior.  The GFR is on here, but he never mentions it, so I'm assuming it's good.  We go over other stuff and it's all good.  The visit usually ends up with us just catching up a bit.  I don't get a copy of my labs.  The only other times I do lab work is when they are doing a Prograf level.

[Chris]

How often do you get Prograf checked then Kelly?
Maybe just me finding it odd that they only check your kidney function every 4 to 5 months, but it also good in a way to. But if your getting Prograf checked once or every other month, then why not just add one more tube to check kidney function. Gues I'm sort of jalous, I have been doing once or more labs a month for over 10 years and this is the norm at my center.

[Jie]

Many centers require monthly lab, like mine, and some centers don't. If one is lucky and has no problems with the kidney, it is good to have lab every half years.  If unlucky, there are problems with the kidney, it is better to have monthly lab.

[kellyt]

I am able to kindof tell when my Prograf level is high, so when I start feeling that way i give them a call and they send me for a Prograf level the next morning.  If high, which it usually is, we reduce the Prograf and check labs again in one week.  By then it's a little lower than he wants, so we increase back to 2/2 and keep on trucking.  My level tends to get too high every two to three months.  That's one of the things I'm going to discuss with him on my visit on the  25th.  I'm starting to wonder if my body is reacting different to the Prograf somehow.  My creatinine has been consistently 1.1 and 1.2.

[RichardMEL]

I agree with Jie that the important thing is not so much the GFR or even the creat number per se (as long as it is lower enough) but the trend - if it's going down(creat I mean, not GFR) then that's great, but if it goes up over a number of labs, you have to question what's causing it. If it's stable at 1.1, 1.7 or even 2.0 the fact that it is stable would be the important thing. My TC has often said that they have patients with higher creat numbers (say 170-200 our scale) but it's not so much a concern as they're always stable, and that's just the baseline for what their kidney is doing, while it seems my baseline is in the 120-140 range.

I don't really worry about the GFR.

[Chris]

don't really worry about the GFR.

True, it's just an interesting side note in lab readout. The creat and BUN are the first things I look for when I pick up my labs because I then can call my doc who really do not look at them, it's just someone whowrites them down in the chart. Then I look at my potassium and Phos because they are the second things that tend to go high for me followed by Prograf and Rapamune levels.

[natnnnat]

I asked Gregory what his GFR is, and he said the same as Richard and Chris, without having read their posts (he's watching telly).  He said, "I don't worry about the GFR."  He said, "I just look after my kidney and look at my creatnine.   If there's a problem with GFR, they can tell me."  Because I kept asking if he had ever known what his GFR ever was, he must have thought I wanted him to find out his GFR, and said:  "You can worry too much about these things"  So I explained about the thread, but he is watching a show about planes nearly crashing, and I only got half an eye.  When he says he looks after his kidney, he means he watches his weight and goes for a walk every night.  He has a blood test before he sees his neph, which should happen about every three months.   He used to be once a month, for the first few years or so.  He says he had a lot of problems back then.  He used to have bone scans, GFRs, renal scans, blood tests... lots of testing at first.  "And they never told me what my GFR was."  He adds:   "I haven't had one in years,  fifteen years I reckon".    I think he means a GFR.  Plane has a hijacker.  Hope this helps.

[natnnnat]

I don't do monthly labs anymore.  I see my doctor every 4-5 months and I do labs 1 week prior.  The GFR is on here, but he never mentions it, so I'm assuming it's good.  We go over other stuff and it's all good.  The visit usually ends up with us just catching up a bit.  I don't get a copy of my labs.  The only other times I do lab work is when they are doing a Prograf level.

yes this sounds like Gregory's relationship with his doctors.   If "they" aren't worried, neither is he. 

[MomoMcSleepy]

mine got up to 64%, and I thought there'd be a continuing trend, but after a week of fasting/bland/liquid diet, my gfr was 52.  It was a pretty steady 58 for a month or so.  I am two months out on March 16th.  I was so scared, but you have made me feel better.  I was very sick to my stomach for two weeks, and my downward trend definitely started with my sickness.  I didn't realize my gfr would always bs low; I was born with one kidney, and my body adjusted--I had a "super kidney!" It's still in there, gfr pre-transplant was 12.  Have you guys had fluctuations like these?  My hospital posts labs I can log in and see, but it's always a week behind.  Frustrating, but I'm lucky to be able to log in!

[jeannea]

Over 20 years of kidney disease and 2 transplants later, I have never been told my GFR. I didn't even know the term until I joined this board. I don't know what to say. Doesn't mean they never measured it but none of my printouts had it.

[coravh]

My GFR and Cr. bounce around a lot. I agree with the other posters that what you want to worry about is the trends over time. I get monthly labs drawn because I am on steroid avoidance. These values vary with my hydration, exercise level, stress, and whether or not I am fighting some sort of infection. My GFR is usually around 40 and I am happy with that. My center doesn't even really care what it is. They are more concerned with my drug levels and my trends.

Cora

[sullidog]

being that I'm still fresh out of transplant I get labs twice a week. GFR has never once been mentioned, they just look at my creatnine, however I have put my labs into one of those online gfr calculators for what it's worth and depending on my cr level the GFR is in a different range every time. My cr has been as low as 1.21 which the calculator defines that as stage2, and as high as 1.59 which according to the calculator is stage 3. Basically the more I drink the lower my cr level and the less I drink the higher. I am also one of those if the doctor is not concerned, neither am I. Cr and GFR can also change do to the levels of your antirejection meds.

[DialysisGoneFOREVER]

I was shocked to see normal GFR for a healthy person is 90 to 120! But it's not measured in a percentage. It's ml/min.

Mine is 57 with a creatinine of 1.46. That's very good for a transplant patient but it's been gradually going up so hopefully I'll be over 60 soon!

[OneForTheBirds]

Mine is an amazing 81 ml/min! I really lucked out, my kidney is a valiant one.