Mrs Ibrahim had been on blood pressure tablets for 12 years and had never had a kidney function test. Her kidneys were functioning at 28% of normal capacity. Caught at Stage 3b — before Stage 4 or 5 requiring dialysis — she had time to slow the progression with optimised treatment.
Retired teacher, Agege. Known hypertensive for 12 years, on amlodipine. Presented for a general check — mild ankle swelling noted. Creatinine: 198 μmol/L (elevated). eGFR: 28 mL/min/1.73m² — CKD Stage 3b confirmed. Urine ACR: 85 mg/g (significantly elevated — proteinuria). Had never had a kidney function test despite 12 years of hypertension.
Kidney Function Test (U&E, Creatinine, eGFR)Mrs Ibrahim had been on amlodipine for her blood pressure since age 49. She took it faithfully. Her blood pressure was reasonably controlled — usually around 138/86 mmHg at her pharmacy checks. She felt well, apart from some ankle swelling she attributed to standing all day as a teacher (now retired). She had never been told to have her kidneys checked.
She came to Mascot Healthcare for what she described as a "general check — I haven't done a proper check in years." The doctor reviewed her history: 12 years of hypertension, amlodipine alone, no other medications, no kidney function tests ever. Ankle oedema on examination. The doctor ordered a full metabolic panel including urea, electrolytes, creatinine, and a urine ACR.
The results came back: creatinine 198 μmol/L — more than double the upper limit of normal for her age. eGFR calculated at 28 mL/min/1.73m². Urine ACR 85 mg/g — indicating significant protein leakage. "Mrs Ibrahim," the doctor said, "your kidneys are working at approximately 28% capacity. This is chronic kidney disease, Stage 3b. It has been developing silently from your blood pressure — for years."
The kidneys filter waste from the blood, regulate blood pressure, and maintain fluid balance. Kidney function tests measure the waste products that accumulate when the kidneys are failing and estimate the remaining filtration capacity.
A waste product filtered by the kidneys. Elevated creatinine = reduced filtration. Normal: 45–90 μmol/L (women). Mrs Ibrahim's: 198.
Calculated from creatinine, age, and sex — estimates the percentage of kidney function remaining. Normal: > 90. CKD Stage 3b: 29–44. Mrs Ibrahim's: 28 (Stage 3b/4 borderline).
Another waste product — rises with declining kidney function and high-protein diet. Useful alongside creatinine.
Protein in the urine — a sign of kidney damage. Normal: < 3 mg/g. Severely elevated > 30 mg/g. Mrs Ibrahim's: 85.
Sodium, potassium, and bicarbonate regulation is maintained by the kidneys. Abnormal levels indicate renal dysfunction.
Hypertension is the second most common cause of chronic kidney disease in Nigeria (after diabetes). Sustained high blood pressure damages the glomeruli — the tiny filtering units of the kidney — gradually and silently over years. Annual kidney function testing is standard care for any hypertensive patient.
Mrs Ibrahim had 12 years of suboptimally controlled hypertension without a single kidney function check. During those 12 years, her eGFR had likely declined from the normal range to 28 — a reduction that, had it been tracked annually, would have prompted earlier and more aggressive blood pressure management before significant loss of function occurred.
A kidney-protecting blood pressure medication was added to her existing treatment (this type reduces protein leak and slows CKD progression — the cornerstone of CKD management). Her usual blood pressure medication was continued. Blood pressure target changed to < 120/80 mmHg (stricter target for CKD with proteinuria). Potassium monitoring commenced (ACE inhibitor risk in CKD).
Nephrology referral arranged. Dietary advice: low-salt diet; moderate protein restriction; avoid NSAIDs and nephrotoxic medications. Annual flu vaccination offered (infections worsen CKD). Hepatitis B vaccination (unvaccinated — kidneys are at risk from HBV).
Repeat kidney function at 3 months on the new medication: creatinine 184 μmol/L (slight improvement), eGFR 31, ACR 42 mg/g (significant reduction in proteinuria — the medication working). Blood pressure 118/76 on optimised regimen.
CKD Stage 3b — eGFR 28, creatinine 198, ACR 85. Cause: hypertensive nephropathy. Ramipril added. Nephrology referral.
A kidney-protecting medication added; stricter BP target < 120/80; nephrology referral; dietary counselling; potassium monitoring; annual flu vaccine; avoidance of nephrotoxins.
3-month creatinine 184, eGFR 31, ACR 42 — stabilising. BP 118/76. At 12 months: eGFR 33 (stable/slight improvement). No dialysis required.
Mrs Ibrahim's kidney function has stabilised at eGFR 32–34 at 18-month follow-up. No further significant decline. She is under nephrology review and understands what CKD Stage 3b means — and what she is doing to prevent progression.
Hypertension silently damages the kidneys over years. Every hypertensive patient needs an annual kidney function test — creatinine, eGFR, and urine ACR. A result at Stage 3 enables intervention. A result at Stage 5 means dialysis.
A kidney-protecting blood pressure medication added to standard antihypertensive therapy reduces proteinuria, slows CKD progression, and protects the kidneys — but it must be started before severe damage occurs. Annual testing finds the window.
High blood pressure for years without a kidney test is a missed opportunity. Your kidneys could be working at 30% capacity while you feel fine. An affordable annual test catches it before dialysis becomes the only option.
Book via WhatsApp — fast results on most tests, transparent pricing.