A Glomerular Filtration Rate (GFR) is a measurement that indicates how well your kidneys are functioning. It estimates the volume of blood passing through the tiny filters in your kidneys, called glomeruli, each minute. This rate reflects the efficiency with which your kidneys remove waste products and excess fluid from your blood. A GFR result of 9 is significantly low, signaling that the kidneys are operating at less than 15% of their normal capacity. This level of function points to severe kidney failure.
What a GFR of 9 Means
A GFR of 9 corresponds to a diagnosis of Stage 5 Chronic Kidney Disease (CKD), also known as End-Stage Renal Disease (ESRD). This is the most advanced stage of long-term kidney disease, where the kidneys have lost nearly all ability to filter waste and fluids, making them unable to sustain the body’s needs.
This condition often results from health problems that gradually damage the kidneys. The most frequent causes of ESRD include long-term, uncontrolled diabetes and high blood pressure. Other conditions, such as polycystic kidney disease, glomerulonephritis, and autoimmune diseases like lupus, can also lead to this severe stage of kidney failure.
Symptoms and Complications of Severe Kidney Failure
When kidneys function at such a low level, waste products and excess fluid accumulate in the body, leading to a range of symptoms and complications. Many individuals experience persistent nausea and vomiting, along with a metallic taste in the mouth, due to the buildup of toxins. Severe fatigue is also common, as failing kidneys do not produce enough erythropoietin, a hormone necessary for red blood cell production, leading to anemia.
Fluid overload manifests as swelling, particularly in the legs, ankles, and around the eyes, and can lead to shortness of breath as fluid accumulates in the lungs. Other serious complications include mineral and bone disorder, where imbalances in calcium and phosphorus levels can weaken bones and affect heart health. Accumulated waste and fluid also increase the risk of cardiovascular disease.
Primary Treatment Pathways
When kidney function drops to a GFR of 9, treatments become necessary to replace the kidneys’ work and sustain life. The primary options include dialysis (hemodialysis or peritoneal dialysis) and kidney transplant. For some, conservative medical management is also an option.
Hemodialysis
This procedure filters blood using an external machine, typically performed several times a week at a clinic or sometimes at home.
Peritoneal Dialysis
This method uses the lining of the abdomen (peritoneum) to filter blood, with fluids exchanged through a catheter, often done daily at home.
Kidney Transplant
This involves a surgical procedure to place a healthy kidney from a deceased or living donor into the patient’s body. The transplanted kidney then takes over the functions of the failing kidneys.
Conservative Medical Management
In some situations, particularly for older or frail individuals, this approach focuses on managing symptoms and quality of life without dialysis or transplant.
Dietary and Lifestyle Management
Managing a GFR of 9 involves significant dietary and lifestyle adjustments to support overall health and manage symptoms. A specialized renal diet is recommended to reduce the burden on the kidneys. Working closely with a dietitian specializing in kidney disease helps tailor these dietary guidelines to individual needs.
Key dietary considerations include:
- Limiting sodium intake to help control fluid retention and high blood pressure, often less than 2,300 mg per day.
- Controlling potassium intake, as high levels can lead to dangerous heart rhythms.
- Restricting phosphorus to protect bones and blood vessels, as failing kidneys struggle to remove this mineral.
- Carefully monitoring and limiting fluid intake to prevent excessive fluid buildup.