How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr Khan Your Own Question
Dr Khan
Dr Khan, Doctor
Category: Medical
Satisfied Customers: 1183
Experience:  MB, MRCP(UK), MCPS(Medicine)
Type Your Medical Question Here...
Dr Khan is online now
A new question is answered every 9 seconds

what does a gfr of 40 exactly mean and is there anything I

Resolved Question:

what does a gfr of 40 exactly mean and is there anything I can do to reverse this? I am a type 2 diabetic and use 7u/night of lantus and also take lisinopril to coat the linings of my vessels. Thank you, XXXXX XXXXX Montana
Submitted: 5 years ago.
Category: Medical
Expert:  Dr Khan replied 5 years ago.



Thank you for your question and welcome to just answer


I shall try my best to assist you while you are working with me


Why was your GFR measured?


How is your kidney function? if checked?


How is your over all blood sugar control?


How is your blood pressure? Is it controlled? Average readings?

Customer: replied 5 years ago.

My gfr was calculated as i had to go emergently to the er and the dr. told me it was at 40 and could not have the contrast they use to see if I had a blood clot in my heart, he told me it would put me into immediate kidney failure and then dialysis or a kidney transplant.

I have not had my kidney function checked.

My blood sugar is about 109 each morning up to 130 about 2 hrs after eating.

My blood pressure is controlled, the lisinopril is to protect the linings of my vessels from the diabetes. I exercise about 20 minutes/day (and I live on a ranch, so am busy) and I try very hard to stick to a diabetic diet, but once in awhile i do "fudge" with 2 scoops of low fat ice cream, but that is only about twice a week, when I am weak! Thank you for your help

Expert:  Dr Khan replied 5 years ago.

Thank you very much for your reply.


GFR is the flow rate of filtered fluid through kidneys and overall a good measure of kidney function.


Well according to GFR of 40 means decline in your kidney function of moderate severity..which is clinically taken as Chronic Kidney Disease Stage III. It is fairly common among Diabetic patients to have silent decline in kidney function so regular kidney function evaluation with protein check in urine and creatinine is recommended.


Now what i can suggest is that your Diabetic control seems quite reasonable from readings but to be more precise i would suggest to check your HbA1C levels and keep around 6.5%. This is ideal level recommended to avoid complications.


Second your blood pressure should be below 125/75 and titrate your medication to achieve this target. Lisinopril is excellent in protecting kidney from Diabetic effects and continue it but dose should be adjusted to achieve this recommended level.


Rest your routine sounds OK. Above mentioned suggestions will not reverse kidney damage already done but FOR SURE will slow down further deterioration in kidney function.


Last thing that even at this level of GFR you can have contrast tests of heart with low osmolar or iso-osmolar dyes and using minimum possible dye dose like 20-30 ml in which test can be performed. Pre-procedure preparation with good hydration and N-Acetylcystein and soda bicarb will further have protective effect against contrast.This is something which you can discuss with your doctor in case that dye test is absolutely essential.


This conversation is open till you feel satisfied. Let me know if you have any further query. I will be glad to answer those



Customer: replied 5 years ago.

Thank you for this answer, it really helps my "head" to know it is common yet silent!

When I was first diagnosed, 4 yrs ago, my Ha1c was at 14 but now it is at 6.1. My blood glucose was 599, but that was as high as the meter could read! Yes, it put me into the lose weight mode and exercise and eat better! I have lost 55 pounds (165) with about 30 more to go (just my goal). Your answer about using the osmolar dye really helps me be able to speak more intelligently should i need some contrast for a test.

Thank you and I am very satisfied with your answer! We need someone like you here in Livingston, MT! Just 50 miles north of Yellowstone Park and our 6 acre ranch is for sale, come on and visit!! Thanks again, Carole simms in Montana

Expert:  Dr Khan replied 5 years ago.

Thank you very much for your appreciation.


I will definitely consider your offer...Smile


My pleasure if i could make your query clear

Dr Khan and 3 other Medical Specialists are ready to help you
Customer: replied 5 years ago.

Dear Dr. Khan~

Thank you for your information about my gfr, I was totally satisfied with the answers you gave me, you rock!!

Expert:  Dr Khan replied 5 years ago.

Its my pleasure

Thank you for your great feedback


Warm Regards