The glomerular filtration rate (GFR) is a measure of how much blood passes through the kidneys each minute. If the GFR is too low, it means that your kidneys are not working properly and your body is storing toxins. Depending on the situation, you can increase your GFR by making changes to your diet and lifestyle, although prescription medication and professional medical care may be needed for some people with very low GFR.
Part 1 of 3: Before You Begin: Knowing Your GFR
Step 1. Run the test
The doctor will test the GFR with several creatinine blood tests. Creatinine is a waste product in the blood. If the amount of creatinine in the sample is too high, it is likely that the filtering ability of the kidneys is very low.
Alternatively, your doctor may order a creatinine clearance test, which measures the amount of creatinine in your blood and urine
Step 2. Understand the numbers
Test results are only one factor in calculating GFR. Your doctor will also consider your age, race, body size, and gender when determining your actual GFR.
- If your GFR is 90 ml/min/1.73m2 or higher, your kidneys are considered healthy.
- GFR between 60 and 89 ml/min/1.73m2 included in stage two chronic kidney disease. Rate between 30 and 59 ml/min/1.73m2 is in stage three, and the rate is between 15 and 29 ml/min/1.73m2 included in stage four.
- Once the GFR drops below 15 ml/min/1.73m2, you are in stage five of chronic kidney disease, meaning kidney failure.
Step 3. Talk to a doctor
Your doctor can provide additional details about your GFR number and its impact on your life. If the GFR is lower than it should be, the doctor may suggest several types of treatment, but the specifics vary depending on the patient.
- You should make certain changes to your diet and overall lifestyle regardless of any stage of chronic kidney disease. However, in the early stages, diet and lifestyle changes are enough to improve GFR, especially if you have no previous history of kidney disease.
- In the final stages, the doctor will prescribe several types of drugs to help improve kidney function. The drug should be used in conjunction with lifestyle changes and should not be considered a substitute for treatment.
- In the late stages, doctors almost always do dialysis or recommend a kidney transplant.
Part 2 of 3: Part One: Diet and Lifestyle Changes
Step 1. Increase consumption of vegetables and reduce meat
Elevated creatinine and low GFR are related. If one problem, generally the other is also a problem. Animal products contain creatine and creatinine. So, you need to limit the consumption of animal protein.
On the other hand, foods from plant sources do not contain creatine or creatinine. A vegetarian diet can also help reduce other risk factors for chronic kidney disease, including diabetes and high blood pressure
Step 2. Quit smoking
Smoking will increase the amount of toxins in the body, even though these toxins must pass through the kidneys. Quitting this habit will lighten the load on the kidneys and improve their ability to filter waste.
In addition, smoking can also cause or worsen high blood pressure. High blood pressure is associated with chronic kidney disease. So, healthy blood pressure can improve GFR
Step 3. Try a low salt diet
Damaged kidneys have a hard time filtering sodium, so a high-salt diet can worsen the condition and lower GFR.
- Avoid salty foods and choose low-sodium alternatives if available. Try seasoning your food with other spices and herbs instead of relying on salt alone.
- You should also eat a lot of home cooking and reduce fast food. Foods cooked from fresh ingredients generally don't contain a lot of sodium, while fast foods use salt to make them last longer.
Step 4. Cut down on potassium and phosphorus
Phosphorus and potassium are two other minerals that interfere with the filtering of the kidneys, especially those that are already weak or damaged. Avoid foods that are high in potassium or phosphorus, and avoid supplements that contain these minerals.
- Foods rich in potassium are radishes, sweet potatoes, white beans, yogurt, halibut, orange juice, broccoli, cantaloupe, bananas, pork, lentils, milk, salmon, pistachios, raisins, chicken, and tuna.
- Phosphorus-rich foods are milk, yogurt, hard cheese, cottage cheese, ice cream, lentils, whole grains, dried peas, nuts, seeds, sardines, pollock, cola, and flavored water.
Step 5. Drink nettle leaf tea
Drinking 250 ml of nettle leaf tea 1 to 2 times daily can help reduce creatinine levels in the body and, as a result, increase GFR.
- Make sure first with your doctor whether nettle leaf tea is safe with your medical history.
- To make nettle leaf tea, steep two fresh nettle leaves in 250 ml of boiling water for 10 to 20 minutes. Strain and discard the leaves, then drink the water while it is still hot.
Step 6. Exercise regularly
In particular, do cardiovascular exercises to help improve blood circulation. The more blood pumped throughout the body, the more effective the removal of toxins through the kidneys so that the GFR will improve.
- However, note that strenuous physical activity can increase the breakdown of creatine into creatinine, which can increase the burden on the kidneys and cause a decrease in GFR.
- The best option is to do moderate-intensity exercise on a regular basis. For example, you might consider cycling or brisk walking for 30 minutes a day, three to five days a week.
Step 7. Take care of your weight
Usually, the ideal body weight is the result that naturally comes from a healthy diet and regular exercise. You should avoid risky diets or trendy diets unless specifically recommended by your doctor or renal dietitian.
Maintaining weight also facilitates blood circulation in the body and helps regulate blood pressure. Circulating blood can easily remove toxins and fluids through the kidneys, and you will see an increase in GFR
Part 3 of 3: Part Two: Medical Treatment
Step 1. Talk to a renal dietitian
In the late stages of kidney disease, doctors refer patients to specialists who can suggest the best diet for your condition. This specialist is called a "renal dietitian".
- A renal dietitian will help you reduce stress on your kidneys while maintaining a balance between fluids and minerals in your body.
- A special diet includes elements similar to those described in this article. For example, you may be instructed to reduce your intake of sodium, potassium, phosphorus, and protein.
Step 2. Find out if there are other conditions
Most cases of chronic kidney disease and low GFR are caused or influenced by other conditions. In such cases, you must treat the disease first before increasing the GFR.
- The two most common causes are high blood pressure and diabetes.
- When the cause of kidney disease cannot be easily identified, the doctor will perform additional tests to diagnose the problem. These tests include urine tests, ultrasounds, and CT scans. In some cases, the doctor will suggest a biopsy to take and evaluate a small sample of kidney tissue.
Step 3. Get kidney treatment
If kidney disease is caused by another condition, or when kidney disease causes related problems, your doctor will prescribe certain medications to treat your overall condition.
- High blood pressure is often associated with a low GFR, so you may need several types of blood pressure medication. Options include angiotensin converting enzyme inhibitors (captopril, enalapril, etc.) or angiotensin receptor blockers (losartan, valsartan, etc.). These drugs can maintain blood pressure and also reduce protein levels in the urine which in turn reduces the work of the kidneys.
- During the late stages of kidney disease, the kidneys can't produce a hormone called erythropoietin, so your doctor will prescribe medication to help treat the problem.
- You may need vitamin D supplements or other medications to control phosphorus levels, as your kidneys will have a hard time filtering phosphorus from your body.
Step 4. Discuss other medications with your doctor
All drugs are filtered through the kidneys so you should discuss with your doctor about which drugs to use when the GFR is low. This includes prescription drugs as well as over-the-counter medications.
- You should also avoid NSAIDs and COX-II inhibitors. Common NSAIDs are ibuprofen and naproxen. A commonly used COX-II inhibitor is celecoxib. Both classes of drugs are associated with an increased incidence of kidney disease.
- Talk to your doctor before trying herbal or alternative treatments. "Natural" treatments aren't necessarily better, and if you're not careful, your GFR can go down even more.
Step 5. Check GFR periodically
Even if the GFR is successfully raised, you should still check regularly. This is especially important if your GFR has been below average or if your risk of kidney disease is increasing.
GFR and kidney function will decline with age so the doctor may recommend ongoing tests to help monitor the decline in GFR. The doctor will change medications or dietary recommendations based on changes in GFR
Step 6. Go on dialysis
If your GFR is very low and you're in the phase of kidney failure, you'll need dialysis to filter waste products and excess fluid from your body.
- The hemodialysis procedure involves the use of an artificial kidney machine with a mechanical filter.
- Peritoneal dialysis procedures use the lining of the abdomen to help filter and clean waste products from the blood.
Step 7. Wait if you need a kidney transplant
Kidney transplantation is an option for severe kidney disease and very low GFR. You must be matched with the right donor before a transplant can be performed. Usually, the kidney donor is a relative, but in many cases it can also be a stranger.
- However, not everyone with severe kidney disease is eligible for a transplant. These treatment options are also determined by age and medical history
- After receiving a transplant, you should still monitor your diet and kidney health to avoid a drop in GFR.