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c/bloodwork·posted 2 years ago by u/milos_trevino

reading eGFR threads from 2024 and half of it aged badly

Baseline Slow Clap ×5 Receipts ×1 Well Actually ×3

reading eGFR threads from 2024 and half of it aged badly. I have gone back and forth on this for months.

Different laboratories use different assay platforms with different calibration. Comparing across labs adds a systematic offset that is invisible on the report.

Reference intervals are typically the central 95% of a reference population. By construction one person in twenty falls outside one on any given test without anything being wrong.

ApoB counts atherogenic particles rather than the cholesterol they carry, which is why it can diverge from LDL-C and why it is the addition most worth making.

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

4,315 up / 149 down97% upvoted56 commentsid 11bgp329 Jul 2024

56 comments

27 in this archive, depth 4

best — the order this archive was captured in

u/rekha_mwangi-14 points·1 year ago

Repeat testing before acting is standard practice for a reason: regression to the mean does a lot of work on single outlying values.

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u/tidy_vialdrawer_watch1 point·1 year ago

How many weeks between the two measurements?

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u/emil_agyeman1 point·1 year ago

Correction: that marker is reported in different units by different labs, which explains the tenfold difference you are seeing.

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u/milos_trevinoOP1 point·1 year ago

the trend line matters more than any single value

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u/chidi_abubakar419 points·2 years ago

That comparison crosses two labs with different assays. The difference you are describing may be the method.

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u/janek_ferrari129 points·1 year ago

Yes — same lab, same fasting state, same rough time of day, or the comparison is doing nothing.

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u/micro_bump_mick189 points·2 years ago

Nobody here can interpret your panel and this comment is not doing so. What a board can usefully do is help you ask better questions of somebody who can.

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u/ismael_eriksen101 points·2 years ago

Time of day, fasting state, hydration and recent exercise all move common markers. Standardising the draw conditions is free and it removes most of the apparent variability.

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u/skip_week_sceptic62 points·1 year ago

Agreed. The trend is the signal. A single value is a snapshot of one morning.

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u/milos_trevinoOP0 points·1 year ago

Did anything else change in that window — training, intake, hydration?

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u/milos_trevinoOP1 point·1 year ago

Small fix — a reference interval is not a treatment target, and the post above uses them interchangeably.

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[removed]1 point·1 year ago

[removed by moderator]

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u/amara_dziedzic38 points·1 year ago

Agreed.

Agreed — and standardising the draw conditions is the cheapest improvement available.

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u/emil_agyeman125 points·1 year ago

Fasting or not, and what time of day?

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u/cormac_erdogan86 points·1 year ago

Same lab as the previous draw?

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u/nnt_nate136 points·1 year ago

Substantial weight loss independently moves lipids, liver enzymes and several other markers. Attributing a change to a compound while losing weight is confounded by design.

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u/constipation_clubside effects38 points·1 year ago

Agreed on assay changes. A lab switching platforms between your draws is invisible unless you ask.

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u/karl_fischer_kev17 points·1 year ago·edited

Agreed on assay changes.

Adding the obvious one — take it to whoever ordered the panel. This board cannot read it for you.

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u/gentle_correctionnice about it63 points·1 year ago

hydration status moves a surprising number of markers

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u/neha_rahimi43 points·1 year ago

ask whether the lab changed its assay between your two draws

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u/santiago_rasmussen21 points·1 year ago

Disagree with reading anything into that. One value, one morning, and you changed two other things in the same window.

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u/emeka_chowdhury9 points·1 year ago

one measurement is a point, two is a line, three is a trend

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u/emil_agyeman17 points·1 year ago

Careful — that is a question for whoever ordered the panel, and nobody in this thread can answer it responsibly.

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u/a1c_arcMOD30 points·1 year ago

Left up. It is a question about how to compare panels, not a request for interpretation.

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u/heart_rate_bump21 points·1 year ago

nothing on this board interprets your results for you

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u/elin_varga23 points·1 year ago

My ApoB moved and I spent a fortnight convinced I knew why. The repeat six weeks later was back in range and I had changed nothing.

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u/osman_eriksen12 points·1 year ago

Push back: a value just outside a reference interval is a common finding in healthy people. It is a reason to repeat.

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About c/bloodwork

What to measure before you start, what to re-measure, and how to interpret movement without panicking. ApoB over LDL-C, HOMA-IR as a crude free tool, ALT and the fatty-liver story, eGFR noise during rapid loss, and the deficiencies that a 1,100-calorie appetite will hand you.

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