Kidney function goes down with age
Dear Dr. Roach: Each year when I receive results from my yearly bloodwork I notice that my GFR score keeps going down. This year is the first year that my score dropped below 60, with a score of 57. I am 66 years old. Should I be concerned?
A.S.
Answer: GFR, the glomerular filtration rate, is a measure of kidney function, with the higher the number meaning the greater the kidney function. It’s calculated using a person’s age and sex, and the measured creatinine in the blood.
Kidney function slowly goes down as we age, but the rate of decline is important. The average GFR for a person in their 60s is about 85, but you are on a medication (benazepril) that lowers the GFR number.
Your regular doctor can tell you whether your rate of GFR decline is worth worrying about. If not, a kidney specialist will certainly do so.
Dear Dr. Roach: I’d like your advice on a new prescription drug, vibegron, for reducing prostate enlargement when taken along with tamsulosin. Should I be concerned about any side effects that you might be aware of ? I’m considering participating in the study since I’m currently taking tamsulosin with no side effects.
A.T.
Answer: Vibegron (Gemtesa) is a newer drug used for symptoms of overactive bladder. It doesn’t affect the prostate at all. However, men with lower urinary tract symptoms are often assumed to have prostate enlargement as the underlying cause, when in fact, they may have overactive bladder in addition to (or even instead of ) an enlarged prostate.
A study published just last year showed that adding vibegron to a prostate treatment such as tamsulosin improved some symptoms of overactive bladder. Often, patients get incomplete relief from treatment of enlarged prostate before seeing a urologist to treat overactive bladder with great improvement.
Side effects of vibegron, like other beta-3 agonists, are generally mild. Some men have had an increase in the blood pressure with mirabegron (the other available beta-3 agonist), so that is worth keeping an eye on.