GFR, or glomerular filtration rate, is an estimate of how efficiently the kidneys filter blood. An estimated GFR (eGFR) is commonly calculated from blood-test results and is one of the main measurements used to assess kidney function.

A low eGFR does not automatically mean that permanent kidney failure has occurred.

The significance of a low result depends on:

• The actual eGFR value

• Whether the result is persistent

• Previous eGFR results

• Urine albumin or protein levels

• The underlying cause

• Age and other health conditions

• Whether there is an acute illness affecting kidney function

For example, a temporary decline in kidney function during dehydration or an acute illness may improve after the underlying problem is treated.

By contrast, persistent eGFR below 60 mL/min/1.73 m² for more than three months can indicate chronic kidney disease when appropriately evaluated.

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized assessment and treatment planning for patients with reduced kidney function.

Can a Low GFR Be Increased?

Sometimes kidney function can improve, but there is no universal medicine that simply raises GFR in every patient.

The first question is why the GFR is low.

A reduced eGFR may be related to:

• Chronic kidney disease

• Acute kidney injury

• Dehydration

• Low blood pressure

• Urinary obstruction

• Certain medicines

• Diabetes

• High blood pressure

• Glomerular diseases

• Other kidney conditions

If a reversible cause is responsible, kidney function may improve after appropriate treatment.

When chronic kidney damage is established, the treatment goal is usually to protect remaining kidney function and slow further decline, rather than attempting to force the eGFR back to a normal number.

Why Does GFR Become Low?

Diabetes

Diabetes can damage the kidney's filtering structures over time and is one of the major causes of CKD.

Treatment focuses on individualized blood-glucose management and kidney-protective strategies when appropriate.

High Blood Pressure

Long-term hypertension can damage kidney blood vessels and filtering units.

Blood-pressure control is therefore a central part of kidney disease management. NIDDK identifies blood-pressure control as one of the most important measures for treating CKD.

Acute Kidney Injury

A sudden fall in kidney function can occur with:

• Severe dehydration

• Infection

• Low blood pressure

• Certain medicines

• Urinary obstruction

• Major illness

Some cases of acute kidney injury can improve considerably after the underlying problem is corrected.

Glomerular Kidney Diseases

Diseases affecting the kidney's filtering units can cause proteinuria, blood in urine and reduced kidney function.

Specific treatment depends on the diagnosis and, in selected cases, may require additional blood tests or kidney biopsy.

Urinary Obstruction

Kidney stones, urinary narrowing, prostate-related obstruction and other conditions can interfere with urine drainage.

Relieving an obstruction may allow kidney function to recover when the damage is reversible.

How Is a Low GFR Evaluated?

A single eGFR result may not provide enough information to determine the cause or long-term outlook.

A nephrologist may assess several components.

1. Repeat Kidney Function Testing

Previous creatinine and eGFR results can help determine whether kidney function is:

• Stable

• Slowly declining

• Rapidly declining

• Temporarily reduced

Trends are often more informative than one isolated result.

2. Urine Albumin Testing

Urine albumin-to-creatinine ratio (UACR) can identify albumin leakage through the kidney filters.

eGFR and albuminuria are assessed together when evaluating CKD risk.

3. Blood Pressure

Blood-pressure measurement helps identify an important potentially modifiable contributor to kidney disease.

4. Blood Tests

Depending on the situation, testing may include:

• Creatinine

• Urea

• Sodium

• Potassium

• Bicarbonate

• Hemoglobin

• Calcium

• Phosphorus

• Blood glucose or HbA1c

5. Kidney Imaging

Ultrasound or other imaging may be recommended when obstruction, stones, structural abnormalities or another condition is suspected.

6. Additional Kidney Testing

If the cause remains unclear, selected patients may need immunological tests, genetic evaluation, specialized urine studies or kidney biopsy.

Low GFR Treatment Depends on the Cause

There is no single treatment for low GFR.

The management plan may look very different depending on the diagnosis.

If Dehydration Is Responsible

Appropriate fluid replacement may improve kidney filtration when dehydration has caused a temporary decline.

However, people with heart failure, advanced CKD or fluid restrictions should not increase their fluid intake without medical advice.

If a Medicine Is Affecting Kidney Function

Some medicines can worsen kidney function in susceptible individuals.

A doctor may review prescription medicines, over-the-counter drugs and supplements and make adjustments when necessary.

Do not stop prescribed medicines independently.

If Urinary Obstruction Is Present

Treatment may focus on restoring urine flow.

Depending on the cause, this could involve treatment of a stone, ureteral procedure, catheterization or another intervention.

If Diabetes Is Contributing

Blood-glucose management is an important component of CKD care.

For selected people with diabetes and CKD, kidney-protective medicines may be recommended according to eGFR, albuminuria, cardiovascular status and other factors.

If High Blood Pressure Is Contributing

Blood-pressure treatment can reduce the risk of further kidney damage.

In people with CKD and significant albuminuria, ACE inhibitors or ARBs are recommended or suggested in appropriate clinical situations.

These medicines require monitoring of blood pressure, creatinine and potassium.

If Albuminuria Is Present

Persistent albuminuria can be an important marker of kidney damage.

Depending on the cause and patient's clinical profile, treatment may include renin-angiotensin system blockers and other kidney-protective therapies.

If an Underlying Kidney Disease Is Identified

Some glomerular, autoimmune or other kidney diseases require disease-specific treatment.

The correct therapy may involve medicines that are not appropriate for other types of CKD, which is why diagnosis is important before treatment begins.

Medicines Used in Some Patients With Low GFR

Patients often search for a medicine to improve kidney function when their eGFR decreases.

The appropriate medicine depends on the underlying disease.

Depending on the patient's condition, treatment may include:

• ACE inhibitors or ARBs

• SGLT2 inhibitors

• Diabetes medicines

• Blood-pressure medicines

• Diuretics for fluid overload

• Medicines for specific glomerular or autoimmune diseases

• Treatments for anemia or mineral-bone complications when indicated

For example, current KDIGO guidance recommends SGLT2 inhibitors for several groups of adults with CKD, including selected patients with eGFR ≥20 and significant albuminuria or heart failure, as well as selected patients with type 2 diabetes and CKD.

These medicines are not suitable for everyone with a low GFR.

Medication choice should be based on kidney function, potassium, blood pressure, diabetes status, albuminuria, other illnesses and current medicines.

Can Low GFR Be Improved Naturally?

Searches for “how to increase GFR naturally” are common, but there is no guaranteed natural remedy that reverses established chronic kidney damage.

Healthy habits can nevertheless support kidney and cardiovascular health.

These may include:

• Avoiding tobacco

• Maintaining an appropriate body weight

• Following a kidney-appropriate diet

• Reducing excessive sodium

• Staying physically active when medically appropriate

• Managing diabetes

• Controlling blood pressure

• Avoiding unnecessary NSAID use

• Taking prescribed medicines correctly

• Attending kidney-function follow-ups

NIDDK recommends blood-pressure control, glucose management when appropriate, regular kidney monitoring, nutrition guidance, physical activity, healthy weight and smoking cessation as important components of CKD management.

What Diet Is Appropriate for Low GFR?

There is no single low-GFR diet for every patient.

Dietary recommendations depend on:

• eGFR

• Potassium level

• Phosphorus level

• Proteinuria

• Diabetes

• Blood pressure

• Nutritional status

• Dialysis status

Reduce Excess Sodium

Reducing excessive sodium can support blood-pressure and fluid management.

Protein Should Be Individualized

People with CKD should not automatically eliminate protein.

The appropriate amount depends on kidney function, nutritional status and whether the person is receiving dialysis.

Potassium May Need Individual Assessment

Not everyone with low GFR needs a low-potassium diet.

If blood potassium is elevated, dietary changes may be recommended based on laboratory results.

Phosphorus May Need Attention

Some patients with advanced CKD develop abnormalities in phosphorus metabolism and may need dietary or medication adjustments.

A renal dietitian can help create an individualized meal plan.

Does Drinking More Water Increase GFR?

Not necessarily.

Adequate hydration is important when dehydration is contributing to reduced kidney function.

But drinking excessive quantities of water does not repair chronic kidney damage and can be dangerous in people with fluid retention, heart failure, advanced CKD or kidney failure.

Fluid intake should therefore be individualized.

Can a Low GFR Return to Normal?

It depends on the cause.

A temporary reduction caused by dehydration, acute illness, obstruction or another reversible problem may improve significantly.

In established CKD, the eGFR may remain below the normal range even when treatment is successful.

A successful treatment plan may therefore mean:

• Stabilizing eGFR

• Slowing further decline

• Reducing albuminuria

• Controlling complications

• Treating the underlying disease

• Protecting cardiovascular health

Improvement should be judged using the overall clinical picture rather than one eGFR result.

What Does Different GFR Levels Mean?

CKD is categorized by GFR when the reduction is persistent and appropriately diagnosed.

GFR category	eGFR range	General interpretation
G1	≥90	Normal or high
G2	60–89	Mildly decreased
G3a	45–59	Mild to moderately decreased
G3b	30–44	Moderately to severely decreased
G4	15–29	Severely decreased
G5	<15	Kidney failure range

Importantly, an eGFR of 60–89 alone does not establish CKD. Evidence of kidney damage or another qualifying abnormality persisting for at least three months is needed.

What Happens if GFR Becomes Very Low?

As kidney function becomes severely reduced, complications may develop involving:

• Fluid balance

• Potassium

• Acid-base balance

• Anemia

• Bone and mineral metabolism

• Nutrition

• Blood pressure

• Uremic symptoms

When kidney failure develops, nephrologists may discuss kidney replacement options such as hemodialysis, peritoneal dialysis or kidney transplantation. Conservative kidney management may also be considered for selected patients.

Dialysis is not started simply because a single eGFR number is low. Symptoms, laboratory abnormalities and the overall clinical situation are considered.

How Can You Prevent GFR From Falling Further?

If you have reduced kidney function, protecting the remaining kidney function becomes important.

Keep Blood Pressure Controlled

Follow the blood-pressure target recommended by your healthcare professional.

Manage Diabetes

If you have diabetes, work with your medical team to achieve individualized glucose targets.

Avoid Unnecessary Kidney-Harming Medicines

Do not regularly use painkillers or supplements without checking whether they are appropriate for your kidney function.

Treat Urinary Problems

Stones, obstruction and recurrent urinary problems should be evaluated appropriately.

Monitor Kidney Function

Regular creatinine, eGFR and urine albumin testing can help identify changes.

Follow a Personalized Diet

Avoid extreme internet diets or unverified kidney detox programs.

When Should You See a Nephrologist for Low GFR?

A nephrologist may be particularly helpful when there is:

• Persistently reduced eGFR

• Rapidly falling eGFR

• Significant albuminuria

• Unexplained blood in urine

• Difficult-to-control hypertension

• Recurrent kidney stones or obstruction

• Electrolyte abnormalities

• Suspected glomerular disease

• Advanced CKD

• Kidney failure

NIDDK notes that nephrology involvement can be useful for diagnostic challenges, difficult treatment decisions and rapidly decreasing eGFR.

Low GFR Evaluation and Treatment at Prabhakar Bhurke Clinic

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized evaluation for patients with reduced kidney function.

Depending on the clinical situation, care may include:

• Reviewing previous creatinine and eGFR reports

• Identifying possible causes of reduced GFR

• Urine albumin and protein assessment

• Blood-pressure management

• Diabetes-related kidney care

• Medication review

• Evaluation for urinary obstruction

• Assessment of kidney stones

• Management of CKD complications

• Monitoring kidney-function trends

• Advanced kidney disease planning

• Dialysis assessment when clinically indicated

• Kidney transplant-related evaluation when appropriate

The treatment plan is based on the cause of reduced kidney function rather than the eGFR number alone.

Frequently Asked Questions

What is the best treatment for low GFR?

There is no single best treatment. Management depends on whether the low GFR is caused by CKD, acute kidney injury, obstruction, dehydration, diabetes, hypertension, medication effects or another condition.

Can medicine increase GFR?

Some medicines can protect kidney function and may slow CKD progression. In selected situations, treating a reversible cause can improve GFR. However, no universal medicine can permanently raise GFR in every patient.

Can low GFR improve?

Yes, if the reduction is caused by a reversible condition. Established chronic kidney damage may not return to normal, but treatment can sometimes stabilize kidney function or slow further decline.

What should I eat if my GFR is low?

Diet should be individualized. Sodium, protein, potassium, phosphorus and fluid intake may need adjustment depending on kidney function and laboratory results.

Does drinking more water improve GFR?

Only when dehydration is contributing to reduced kidney function may appropriate fluid replacement help. Excessive water intake is not a treatment for chronic low GFR and can be harmful in some patients.

Is a GFR below 60 always kidney failure?

No. Persistent eGFR below 60 can indicate CKD, but kidney failure is generally the G5 range, with eGFR below 15. The complete clinical picture must be considered.

Does low GFR always mean dialysis?

No. Dialysis is not automatically required because eGFR is low. The decision depends on kidney failure complications, symptoms, laboratory abnormalities and the overall clinical condition.

Can GFR improve after treating high blood pressure or diabetes?

Appropriate treatment can help protect kidney function and slow progression. Whether an existing low GFR rises depends on the underlying kidney damage and whether a reversible component is present.

Conclusion

Finding the right treatment for low GFR begins with determining why kidney filtration has decreased.

A low eGFR may reflect chronic kidney disease, but it can also occur temporarily because of dehydration, acute illness, medication effects or urinary obstruction. For this reason, one abnormal result should not be interpreted in isolation.

Treatment may involve blood-pressure control, diabetes management, kidney-protective medicines when appropriate, treatment of albuminuria, correction of reversible causes, dietary management and regular monitoring. Current CKD guidelines emphasize individualized treatment based on kidney function, albuminuria, cause and associated health risks.

If kidney function is progressively declining or the cause of a low GFR is unclear, specialist nephrology evaluation can help identify appropriate treatment and kidney-protection strategies.

For individualized assessment and kidney care, consult Dr. Sandip Prabhakar Bhurke at Prabhakar Bhurke Clinic.

Medical Disclaimer

This article is intended for general educational and informational purposes only and is not a substitute for medical diagnosis, treatment or individualized medical advice. A low GFR can have multiple causes, and the appropriate treatment depends on the underlying condition, kidney-function trend, urine findings, medications and overall health. There is no universal medicine, supplement, diet or home remedy that can permanently increase GFR in every patient. Do not start, stop or change prescription medicines, fluid intake, supplements or dietary restrictions based solely on this article. Seek prompt medical attention for very little or no urine, severe breathlessness, chest pain, confusion, persistent vomiting, rapidly worsening swelling or sudden deterioration in health. Consult Dr. Sandip Prabhakar Bhurke or another qualified nephrologist for personalized evaluation and treatment.