Could an eGFR of 30 mL/min or less be normal in advanced age?
The GFR falls progressively with age, even in the absence of specific kidney disease. Whether this is “normal” or reflects cumulative damage by various insults during life is unclear. But, in recent work by Dr. Pierre Douville and colleagues at the Hotel Dieu Hospital in Quebec City (published ahead of print by Nephrology Dialysis Transplantation in September) eGFR values calculated by several methods indicate that the normal range for persons in their eighth and ninth decade is not less than 60 mL/min. When the eGFR falls below the expected level for age, something has gone wrong with the kidney, even if we cannot identify the culprit and even if there is no proteinuria. I would not agree that an eGFR of 30 mL/min is ever just “normal.” But, it is also clear that many patients with an eGFR of less than 30 mL/min will never need dialysis and will not die because of kidney failure. Currently the Canadian Society of Nephrology advocates referral of these patients to a specialist. If ther
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