Question: I have had a low gfr (around 40) for a few years. Creatinine is around 1.55. I have had no symptoms, and no history of any kidney problems in my life. My MD brushes it off as dehydration, due to the large amt. of psyco tropic meds I take, including large doses of Effexor and Seroquel. when I force myself to drink a lot of water, my gfr and creatinine fall back in line but my gfr still stays in the 40's. My md says as long as my gfr goes up after forced liquid intake, I'm dehydrated. But, dehydration can harm the kidney's too, and I normally don't think about drinking plenty of water, because I'm not thirsty. I mentioned to her that I have severe gum disease with abcesses (treated), that has apparently be going on for about 5 years. Could an occult infection in my gums cause intersticial kidney inflammation? My md didn't think so and that was the end of my visit. No other labs were ordered, and I never had a UA done in 20 years. I got a urine dipstick kit and my urine is cloudy with high leukocytes. I have no symptoms of a uti. Does it sound like my kidneys are headed for outright failure? I belong to HMO, with access to specialists decided by primary MD

Dear Dr. Madhyastha, Thanks for your reply. How do they do a kidney biopsy? I don't tolerate pain well, and if sticking a needle into my kidney, and it hurt, I would probably go into shock, as I did when I had an amniocentesis done in 1979. This really scares me to death! When I asked about the gingivitis being a culprit, I didn't mention that due to flare ups with my gums over the last five years, in which I didn't know I had problems, My dentist told me that there was a lot of pus from the abcesses. I had been swallowing pus for a long time, without knowing it. I assume that pus was being filtered by my kidneys for years. Thanks, I will ask my MD about further tests.