How to Increase GFR

Co-authored by Scott Tobis, MD and Dan Hickey

Last Updated: September 18, 2024 Fact Checked

Your glomerular filtration rate (GFR) is a measurement of how much blood passes through your kidneys each minute. If your GFR is too low, it means that your kidneys aren't working well and your body is retaining toxins. Depending on the circumstances, you can usually increase your GFR by making changes to your diet and lifestyle, though prescription medication and other professional medical treatment might be necessary for some individuals with an exceptionally low GFR.

Part 1

Part 1 of 3:

Before You Begin: Finding Your GFR

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Take the test. Your doctor can test your GFR by administering a creatinine blood test. Creatinine is a waste product present in your blood. If the amount of creatinine contained within a sample is too high, your kidneys' filtering ability (GFR) is likely too low.^{[1]
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- Alternatively, your doctor might administer a creatinine clearance test, which measures the amount of creatinine in both your blood and urine.
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Understand your numbers. Your test results are only one factor involved in calculating your GFR. Doctors also take into consideration your age, race, body size, and gender when determining your actual GFR.
- If your GFR is 90 mL/min/1.73m² or greater, your kidneys are considered to be in good health.^{[2]
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- A GFR between 60 and 89 mL/min/1.73m² puts you into stage 2 chronic kidney disease (CKD). A rate between 30 and 59 mL/min/1.73m² puts you into stage 3 CKD, and rates between 15 and 29 mL/min/1.73m² are considered stage 4 CKD.
- Once your GFR dips below 15 mL/min/1.73m², you are in stage 5 CKD, which means your kidneys have failed.
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3
Talk with your doctor. Your doctor can provide you with additional details regarding your GFR score and how it impacts your life. If your numbers are lower than they should be, your physician will probably recommend some type of treatment, but the specifics may vary from patient to patient.
- You'll need to make certain changes to your diet and overall lifestyle regardless of which stage of CKD you've entered. During the early stages, however, these changes might be enough to improve your GFR. This is especially true if you've had no prior history of kidney problems.
- During the later stages of CKD, your doctor will likely prescribe some form of medication to help improve your kidney function. This medication should be used alongside lifestyle changes and should not be thought of as a substitute treatment.
- In the final stages of CKD, your doctor will almost always put you on dialysis or recommend a kidney transplant.

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Diet and Lifestyle Changes

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Eat more fruits and vegetables and less meat or animal protein. Increased creatinine and a low GFR go hand-in-hand; one issue generally won't be present without the other. Animal products contain creatine and creatinine, so you may need to restrict the amount of animal-based protein you consume.^{[4]
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- Plant-based sources of food, on the other hand, do not contain creatine or creatinine. Maintaining a largely vegetarian diet can also help reduce other risk factors of CKD, including diabetes and high blood pressure.
In addition to other health issues, smoking can also cause or aggravate high blood pressure. High blood pressure is linked to CKD, so maintaining healthy blood pressure can further improve your GFR.^{[5]
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Try a low salt diet. Damaged kidneys have difficulty excreting sodium and diets high in salt can cause hypertension, which aggravates your condition and causes your GFR to worsen.^{[6]
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- Eliminate salty foods from your diet and opt for low-sodium alternatives when offered. Try seasoning your food with other spices and herbs instead of relying strictly on salt.
- You should also eat more home-cooked meals and fewer boxed dinners. Meals made from scratch generally contain less sodium since many boxed meals use salt for its preservative qualities.
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Consume less potassium and phosphorus. Both phosphorus and potassium are minerals your kidneys may have difficulty filtering, especially once they've already been weakened or damaged. Stay away from foods high in either mineral and don't take any supplement that contains them.
- Potassium-rich foods include winter squash, sweet potatoes, potatoes, white beans, yogurt, halibut, orange juice, broccoli, cantaloupe, bananas, pork, lentils, milk, salmon, pistachios, raisins, chicken, and tuna.^{[7]
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- Phosphorus-rich foods include fast food, milk, yogurt, hard cheeses, cottage cheese, ice cream, quick breads, processed meats, chocolate or caramel, colas, and flavored waters.^{[8]
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Exercise regularly. Exercise can improve diabetes symptoms, dialysis efficiency, and lower blood pressure and cholesterol. ^{[9]
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- Note that strenuous physical activity can increase the breakdown of creatine into creatinine, which can increase the burden on your kidneys and cause your GFR to drop further.
- Your best option is to engage in regular moderate exercise. For instance, you might consider cycling or walking at a brisk pace for 30 minutes a day, three to five days a week.
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Manage your weight. In most cases, weight management will be the natural result of a healthy diet and regular exercise. You should avoid risky diets or fad diets unless they are specifically recommended by a physician or renal dietician.
- Maintaining a healthy weight makes it easier for blood to pass through your body and may help regulate your blood pressure as a result. Once blood can flow through your body more readily, it will be more able to flush toxins and fluids through your kidneys, and you should see an improvement in your GFR.

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Medical Treatment

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Speak with a renal dietitian. During later stages of kidney disease, your doctor may recommend you to a specialist capable of devising the best diet for your condition. These specialists are known as renal dieticians.^{[10]
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- Your renal dietician will work with you to reduce the stress on your kidneys while maintaining a balance between the fluids and minerals in your body.
- Most specialized diets will include elements similar to those described in this article. For instance, you might be instructed to reduce your intake of sodium, potassium, phosphorus, and protein.
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Identify any underlying causes of low GFR. Most CKD and low GFR rates are caused or influenced by other underlying conditions. In such cases, you'll need to get these other ailments under control before you can raise your GFR.^{[11]
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- High blood pressure and diabetes are the two most common causes.
- When the cause of kidney disease isn't easily identifiable, your doctor may administer additional tests to diagnose the issue. These may include urine tests, ultrasounds, and CT scans. In some cases, your doctor may recommend a biopsy to remove and evaluate a small sample of kidney tissue.
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Take prescription kidney medication. When another condition causes kidney disease or when kidney disease causes related problems, your doctor may prescribe certain medications to help treat your overall condition.^{[12]
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- High blood pressure is often linked to low GFR, so you may need some type of blood pressure medication. Options include angiotensin-converting enzyme inhibitors (captopril, enalapril, and others) or angiotensin receptor blockers (losartan, valsartan, and others). These drugs maintain your blood pressure while also reducing protein levels in your urine, allowing your kidneys to work less hard as a result.
- During late stages of kidney disease, your kidneys may not be able to produce an important hormone called erythropoietin, so your doctor may need to prescribe drugs that can help remedy the problem.
- You may also need vitamin D supplements or other drugs to help control phosphorus levels since your kidneys will have difficulty filtering phosphorus in the body.
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Discuss other medications with your doctor. All drugs are filtered through the kidneys, so you should discuss any medication you plan to use with your doctor while your GFR levels are low. This includes both prescription and non-prescription drugs.
- You may need to completely avoid NSAID and COX-II inhibitor drugs. Common NSAID drugs include ibuprofen and naproxen. One common COX-II inhibitor is celecoxib. Both drug classes have been linked to increased incidents of kidney disease.
- Talk with your doctor before trying any herbal remedy or alternative treatment. "Natural" treatments are not necessarily better for you, and if you aren't careful, you could take something that may make your GFR levels dip lower.
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Periodically check your GFR. Even if you successfully increase your GFR, you should continue to check your GFR throughout your lifetime. This is especially true if you've ever had lower than average rates or if you face an elevated risk of kidney disease.
- GFR and kidney function naturally decline with age, so your doctor will likely recommend continued exams to help monitor the rate of decline. They may need to adjust your medications or dietary recommendations based on any changes to your GFR.
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Go on dialysis. If your GFR is extremely low and you've entered renal failure, you'll need to go on dialysis to filter waste products and excess fluid from your system.^{[13]
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- Hemodialysis involves the use of an artificial kidney machine with a mechanical filter.
- Peritoneal dialysis uses the lining of the abdomen to help filter and clean waste products from your blood.
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Wait for a kidney transplant. Kidney transplants are another option for people with advanced kidney disease and exceptionally low GFR. You'll need to be matched with the right donor before a transplant can take place. Oftentimes, the donor is a relative, but in many cases, it may also be a stranger.^{[14]
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- Not everyone with advanced kidney disease qualifies as a candidate for a transplant, however. Age and medical history may rule out this treatment option.
- After receiving a transplant, you'll still need to carefully monitor your diet and overall kidney health to prevent your GFR rate from dropping too low again.