eGFR (Estimated Glomerular Filtration Rate)
eGFR estimates the volume of blood filtered by the kidneys each minute, calculated from creatinine (and sometimes cystatin C) adjusted for age and sex. Values above 90 mL/min/1.73m2 are generally normal, and values under 60 for three months or longer define chronic kidney disease. eGFR is used to stage kidney disease and adjust medication dosing.
Units: mL/min/1.73 m². Check the units on your report before comparing to any range here.
Optimal range: who says what
Institutions, researchers and practitioners draw the line in different places. Each position is listed with who holds it and, where a document states it, a link. How we verify ranges.
- Institution or study≥90 mL/min/1.73m² normal or high (G1)KDIGO 2024 CKD guidelineCKD is diagnosed at a GFR below 60 for more than 3 months, or with kidney damage such as albuminuria at any GFR
- Institution or study90-104 mL/min/1.73m² (reference band)CKD Prognosis Consortium meta-analysis (2023, 27.5 million people)Lower eGFR was linked to higher risk of all 10 outcomes studied, including in the mildest CKD categories
- Institution or studyAge-adapted: <75 in younger adults, <45 in the elderlyDelanaye et al. 2019 (J Am Soc Nephrol)Mortality rises below 75 mL/min/1.73m² in younger people but only below 45 in the elderly, so the authors propose age-specific CKD thresholds
- Lab reference interval>60 mL/min/1.73m², Normal: >90 mL/min/1.73m²What a lab report flags against. A lab interval is not an optimal target.
20 of 21 itemized panels
Kidney Function
What is eGFR (Estimated Glomerular Filtration Rate)?
eGFR (estimated Glomerular Filtration Rate) is the best overall measure of kidney function, estimating how much blood your kidneys filter per minute. GFR represents the volume of plasma your glomeruli (kidney filtering units) can clear of creatinine in one minute, adjusted for body surface area. Normal healthy kidneys filter about 90-120 mL of blood per minute per 1.73 m² of body surface area.
eGFR is calculated using serum creatinine, age, sex, and race through equations like CKD-EPI (most accurate) or MDRD. The calculation accounts for the fact that creatinine levels vary with muscle mass, age, and sex. eGFR is more accurate than creatinine alone for assessing kidney function because it normalizes for these variables. However, it can be inaccurate in extremes of muscle mass, rapidly changing kidney function, or certain ethnicities.
eGFR is used to stage chronic kidney disease (CKD) from Stage 1 (>90, normal or high) through Stage 5 (<15, kidney failure requiring dialysis). It guides treatment decisions, medication dosing, and timing of dialysis or transplant. Declining eGFR over time indicates progressive kidney disease, while stable eGFR suggests well-controlled kidney function or non-progressive disease.
Why eGFR Is the Gold Standard for Kidney Function
- Most accurate assessment: More accurate than creatinine alone by accounting for age, sex, and muscle mass
- CKD staging: Defines chronic kidney disease stages from 1-5, guiding treatment intensity and specialist referral
- Early detection: Can detect moderate kidney disease (eGFR 60-89) that may not be apparent from creatinine alone
- Medication dosing: Many drugs require dose adjustment based on eGFR to prevent toxicity from reduced clearance
- Prognosis: Lower eGFR predicts higher risk of cardiovascular events, mortality, and progression to dialysis
- Dialysis timing: eGFR <15 mL/min (Stage 5) indicates need to plan for dialysis or transplant
- Monitoring progression: Serial eGFR measurements track kidney function trajectory—rapid decline requires urgent intervention
Interpretation bands (curated, PMID-backed)
Holder: OptimizeBiomarkers editorial synthesis of: Relation between kidney function, proteinuria, and adverse outcomes (Hemmelgarn et al., 2010); Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis (Matsushita et al., 2010); Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data (Matsushita et al., 2015). No single paper sets these cutoffs; for attributed targets see who says what.
Normal Kidney Function>90 mL/min/1.73m²▼
- Normal kidney function (CKD Stage 1 if kidney damage present, or normal if no damage markers)
- Kidneys filtering efficiently
- However, some decline with age is normal—healthy 70-year-olds may have eGFR 60-80 without disease
- If >90 with proteinuria or structural abnormalities, still classified as CKD Stage 1 requiring monitoring
Mild Reduction (Stage 2 CKD)60-89 mL/min/1.73m²▼
- Mild kidney dysfunction (CKD Stage 2)
- May be normal aging in elderly without other kidney damage
- If under age 60 or accompanied by proteinuria, hypertension, or diabetes, indicates early CKD requiring treatment to prevent progression
- Check urinalysis for protein/blood
- Optimize blood pressure, glycemic control
- Monitor every 6-12 months
- Address cardiovascular risk factors aggressively
Moderate Reduction (Stage 3 CKD)30-59 mL/min/1.73m²▼
- Moderate kidney disease (Stage 3A if 45-59, Stage 3B if 30-44)
- Requires nephrology evaluation and active management
- Start ACE inhibitor or ARB if proteinuria present
- SGLT2 inhibitor if diabetic or high proteinuria
- Adjust medication doses
- Screen for anemia, bone disease, metabolic acidosis
- Monitor every 3-6 months
- Cardiovascular risk is significantly elevated—aggressive CV risk reduction essential
- eGFR 30-45 (Stage 3B) requires preparation for potential dialysis/transplant
Severe Reduction (Stage 4-5 CKD)<30 mL/min/1.73m²▼
- Advanced kidney disease
- Stage 4 (eGFR 15-29): Severe CKD requiring urgent nephrology care, dialysis access planning, transplant evaluation
- Manage complications (anemia, bone disease, acidosis, hyperkalemia)
- Protein restriction 0.6-0.8 g/kg
- Monitor monthly
- Stage 5 (eGFR <15): Kidney failure
- Initiate dialysis when uremic symptoms develop or eGFR <10
- Urgent transplant evaluation if candidate
- Requires nephrologist management
- Relation between kidney function, proteinuria, and adverse outcomes.
- Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis.
- Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data.
What raises or lowers eGFR
Causes of high eGFR
eGFR decline causes:
- Diabetes: Leading cause of CKD (40% of cases). Hyperglycemia damages glomeruli over years
- Hypertension: Second leading cause (30% of cases). Uncontrolled BP damages kidney vasculature
- Glomerulonephritis: Autoimmune or infectious inflammation of glomeruli (lupus nephritis, IgA nephropathy, post-strep GN)
- Polycystic kidney disease: Genetic condition with kidney cysts progressively replacing tissue
- Chronic interstitial nephritis: From chronic NSAID use, reflux nephropathy, analgesic abuse
- Obstruction: Prolonged urinary obstruction from stones, BPH, tumors causes hydronephrosis
- Nephrotoxic drugs: NSAIDs, aminoglycosides, lithium, chronic high-dose PPIs, chemotherapy
- Vascular disease: Renal artery stenosis, atheroembolic disease, scleroderma renal crisis
- Acute kidney injury: Severe AKI can progress to CKD
Causes of low eGFR
High eGFR (>120-150) causes:
- Pregnancy: Blood volume and GFR rise
- Diabetic hyperfiltration: Early diabetes increases GFR before kidney damage apparent
- High protein diet: Transient GFR increase from protein load
- Young age and high muscle mass: Athletes may have eGFR >120
- False elevation: Laboratory error or creatinine-lowering factors (low muscle mass person with formula assuming average muscle)
Symptoms when eGFR is high or low
When high
- eGFR 60-89 (Stage 2): Usually asymptomatic. Fatigue may occur but is nonspecific
- eGFR 30-59 (Stage 3): Fatigue and low energy, mild nausea, sleep disturbances, mild loss of appetite, often still asymptomatic
- eGFR 15-29 (Stage 4): Noticeable fatigue and weakness, poor appetite and weight loss, nausea and metallic taste, sleep disturbances and restless legs, swelling (edema) of legs/feet, shortness of breath (fluid, anemia, acidosis), foamy urine if proteinuria
- eGFR <15 (Stage 5): Severe nausea and vomiting, confusion and difficulty concentrating (uremic encephalopathy), severe itching (uremic pruritus), muscle cramps, chest pain (pericarditis—urgent), seizures (severe uremia), decreased or no urine output
Symptoms correlate with eGFR but vary by individual. Some tolerate eGFR 15-20 well; others symptomatic at 25-30. Uremic symptoms mandate dialysis regardless of eGFR. Monitor for hyperkalemia, acidosis, and fluid overload which are life-threatening.
When low
Low eGFR itself (hyperfiltration >120) rarely occurs and usually indicates:
- Young age, high muscle mass, pregnancy (increased GFR is normal)
- Diabetic hyperfiltration (early diabetes increases GFR before damage sets in—actually predicts future kidney disease)
- Generally not concerning unless extremely elevated (>150)
- May need cystatin C-based eGFR for accuracy if very high creatinine-based eGFR
Paradoxically, hyperfiltration in early diabetes predicts future kidney decline. If eGFR >120 in diabetic, intensify glycemic control and start ACE/ARB to prevent progression.
How to move eGFR
Effect sizes (how much something moves the marker) appear only where the paper cited under the item states them. Talk to your clinician before starting or changing any medication or supplement.
Slow CKD Progression with Evidence-Based Therapies
- ACE inhibitors or ARBs: First-line if proteinuria or diabetes. Slow progression. A small initial eGFR dip is expected; a drop over 30% or high potassium needs review. Continue long-term
- SGLT2 inhibitors: In DAPA-CKD (4304 people, eGFR 25-75), dapagliflozin cut the combined risk of a sustained eGFR decline of at least 50%, end-stage kidney disease, or kidney or cardiovascular death by 39% (hazard ratio 0.61), with similar effects with and without type 2 diabetes (Heerspink 2020). Now standard of care for CKD with proteinuria
- Blood pressure control: Treat to the blood pressure target your clinician sets. Lower BP slows GFR decline significantly
- Glycemic control: If diabetic, keep HbA1c at the target your clinician sets. Poor control speeds kidney decline
- Treat underlying cause: Address glomerulonephritis, obstruction, medication toxicity, autoimmune disease
Source: Dapagliflozin in Patients with Chronic Kidney Disease.
Dietary Modifications for CKD
- Protein restriction: EGFR 30-60: limit to 0.8-1.0 g/kg daily. eGFR <30: restrict to 0.6-0.8 g/kg daily. Reduces uremic toxins and may delay dialysis
- Sodium restriction: <2300 mg daily (<2000 mg if significant proteinuria or fluid retention). Reduces BP and proteinuria
- Phosphate restriction: EGFR <45: limit to 800-1000 mg daily. Avoid processed foods, cola, dairy. Phosphate binders (calcium acetate, sevelamer) with meals
- Potassium management: EGFR <30: often need to restrict high-K foods (bananas, oranges, tomatoes, potatoes) to prevent dangerous hyperkalemia
- Adequate calories: Ensure 30-35 kcal/kg daily to prevent malnutrition during protein restriction
- Dietitian consultation: Essential for CKD Stage 3-5 to balance restrictions with nutritional needs
Manage CKD Complications
- Anemia (Hemoglobin <10 g/dL): Iron supplementation (oral or IV). ESAs (erythropoietin-stimulating agents) if iron-replete and Hgb <10. Your nephrologist sets the hemoglobin target
- Bone and mineral disorder: Monitor calcium, phosphate, PTH, vitamin D. Vitamin D supplementation (cholecalciferol or active forms). Phosphate binders. Calcimimetics (cinacalcet) if high PTH
- Metabolic acidosis (Bicarb <22): Sodium bicarbonate as prescribed may slow CKD progression and muscle wasting
- Hyperkalemia (K+ >5.0): Low-potassium diet, patiromer or sodium zirconium cyclosilicate if persistent. Stop ACE/ARB only if severe (>6.0)
- Fluid retention: Diuretics (furosemide for eGFR <30) for edema. Restrict sodium and fluids if necessary
Cardiovascular Risk Reduction
CKD raises cardiovascular risk, and more so as eGFR falls. Aggressive risk factor management is critical:
- Statin therapy: High-intensity statin for all CKD patients age 40-75. Reduces cardiovascular events
- Aspirin: Consider low-dose (81 mg) if established CV disease, though bleeding risk higher in CKD
- Blood pressure: Treat to your clinician's target, with ACE/ARB as first-line
- Lifestyle: Smoking cessation (critical), regular exercise (30+ min most days), Mediterranean diet
- Diabetes control: Tight glycemic control reduces both kidney and cardiovascular complications
Prepare for Kidney Replacement Therapy (if eGFR <30)
- Nephrology referral: All patients with eGFR <30 need nephrology co-management. eGFR <20 requires urgent transplant/dialysis planning
- Dialysis access: Place fistula or graft when eGFR 15-20 (takes 3-6 months to mature before use). Avoid peripherally inserted central catheters (PICCs) in non-dominant arm to preserve vessels
- Transplant evaluation: Refer when eGFR <30 (or earlier if rapidly declining). Living donor transplant is ideal—can occur pre-emptively before dialysis
- Dialysis education: Choose modality (hemodialysis vs peritoneal dialysis) based on lifestyle, access, and medical factors
- Initiate dialysis: When eGFR <15 with uremic symptoms, volume overload, or refractory hyperkalemia/acidosis. Symptom-driven rather than eGFR-driven initiation is preferred
When to retest
- Initial staging: If first finding of low eGFR, repeat in 3 months to confirm chronic (not acute) kidney disease
- eGFR >60 with risk factors: Annual monitoring if diabetes, hypertension, or proteinuria present
- eGFR 45-60 (Stage 3A): Every 6-12 months. More frequent if proteinuria or declining trend
- eGFR 30-45 (Stage 3B): Every 3-6 months. Monitor closely for complications (anemia, bone disease, acidosis)
- eGFR 15-30 (Stage 4): Every 1-3 months. Requires nephrologist co-management. Prepare for dialysis/transplant
- eGFR <15 (Stage 5): Monthly until dialysis initiated. Watch for urgent dialysis indications (hyperkalemia, acidosis, uremia, volume overload)
- Rapid decline: If eGFR drops >5 mL/min/year or >10 mL/min over 3 months, urgent nephrology referral to identify reversible causes
- After medication changes: Recheck 1-2 weeks after starting ACE/ARB (a small drop is expected; a large one needs review)
Scientific Evidence
CKD-EPI Equation Beats MDRD
Validated against measured GFR in 3,896 people, the CKD-EPI creatinine equation had less bias than the MDRD equation (median difference 2.5 vs 5.5 mL/min/1.73 m2), especially at higher GFR, and more estimates within 30% of measured GFR (84.1% vs 80.6%). Applied to NHANES, it lowered estimated CKD prevalence from 13.1% to 11.5%.
Source: A new equation to estimate glomerular filtration rate.
KDIGO Guidelines for CKD
The KDIGO 2012 guideline on chronic kidney disease has 110 recommendations covering the definition, classification, monitoring and management of CKD in adults and children not on dialysis or a transplant.
SGLT2 Inhibitor Slows CKD Progression
In 4,304 patients with eGFR 25-75 and albuminuria, dapagliflozin reduced the composite of a 50% eGFR decline, end-stage kidney disease, or renal or cardiovascular death (9.2% vs 14.5%; HR 0.61) over 2.4 years, with similar effects with and without type 2 diabetes. Deaths fell from 6.8% to 4.7%.
Source: Dapagliflozin in Patients with Chronic Kidney Disease.
Which Providers Test eGFR (Estimated Glomerular Filtration Rate)?
Cheapest: Oura Health Panels at $99/year. Most comprehensive: Function Health, 160+ biomarkers for $365/year.
20 panels that include it, cheapest first
| Provider | Annual Cost | Total Biomarkers | $/Biomarker |
|---|---|---|---|
| $99 | 50 | $1.98 | |
| $190 | 100+ | $1.90 | |
| $250 | 65 | $3.85 | |
| $297 | 100+ | $2.97 | |
 Labcorp OnDemand | $338 | 50+ | $6.76 |
 Superpower | $349 | 100+ | $3.49 |
| $349 | 75+ | $4.65 | |
 WHOOP Advanced Labs | $349 | 65 | $5.37 |
 Function Health | $365 | 160+ | $2.28 |
| $365 | 100+ | $3.65 | |
| $375 | 108 | $3.47 | |
| $449 | 83 | $5.41 | |
| $495 | 80+ | $6.19 | |
| $499 | 100+ | $4.99 | |
| $700 | 138 | $5.07 | |
| $895 | 100+ | $8.95 | |
| $996 | 59 | $16.88 | |
| $1188 | 70+ | $16.97 | |
| $1198 | 40+ | $29.95 | |
| $1950 | 130+ | $15.00 |
$/Biomarker is annual cost divided by the panel's advertised biomarker count, not the price of this one test. We track 23 blood test providers (32 plans); 21 of those plans are itemized marker by marker. Compare all of them.
1 itemized panel does not include eGFR (Estimated Glomerular Filtration Rate)
11 providers not itemized in our matrix
We have not itemized these marker by marker (some sell tests one at a time), so this page cannot say whether they offer eGFR (Estimated Glomerular Filtration Rate). Check with them directly.
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Experts discussing eGFR (Estimated Glomerular Filtration Rate)
Podcast episodes where clinicians and researchers cover this marker in depth. Curated by hand; an episode is listed only when the marker is a substantial topic, not a passing mention.
Frequently Asked Questions
What is the optimal range for eGFR (Estimated Glomerular Filtration Rate)?
Published positions differ: ≥90 mL/min/1.73m² normal or high (G1) (KDIGO 2024 CKD guideline); 90-104 mL/min/1.73m² (reference band) (CKD Prognosis Consortium meta-analysis (2023, 27.5 million people)); Age-adapted: <75 in younger adults, <45 in the elderly (Delanaye et al. 2019 (J Am Soc Nephrol)). Lab reference interval: >60 mL/min/1.73m², Normal: >90 mL/min/1.73m². That is what a lab report flags against, not an optimal target.
Which blood test providers include eGFR (Estimated Glomerular Filtration Rate)?
20 of the 21 blood testing panels we itemize marker by marker include eGFR (Estimated Glomerular Filtration Rate) in their panels. This biomarker is widely available across major providers.
Related: YouBoost rates lifestyle and supplement interventions by evidence.
Medical Disclaimer
This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.
Last reviewed Sep 23, 2026 · First published Sep 30, 2025