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Drugs That Distort eGFR: Medications That Falsify Your Kidney Function Test At a glance eGFR estimates how well your kidneys filter blood, reported in mL/min/1.73 m Normal eGFR is 90 mL/min/1.73 m or above for most adults The 2021 CKD-EPI equation removed the race coefficient and relies on serum creatinine (or cystatin C) Trimethoprim can drop eGFR by 15 to 30% without real kidney injury Cobicistat (in Stribild, Genvoya) raises creatinine 0.1 to 0.15 mg/dL within the first four weeks SGLT2 inhibitors cause an initial eGFR dip of 3 to 5 mL/min/1.73 m that is hemodynamic, not toxic Cimetidine inhibits tubular creatinine secretion and falsely lowers eGFR NSAIDs, ACE inhibitors, and ARBs can reduce true GFR through hemodynamic changes Cystatin C-based eGFR avoids most creatinine-related drug artifacts Metformin and GLP-1 agonists have renal dosing thresholds that a falsely low eGFR could trigger prematurely What eGFR Actually Measures Estimated glomerular filtration rate (eGFR) is a calculation, not a direct measurement
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