My egfr is 46 and creatinine of 1.3, a year ago my egfr was 60 and creatinine was 1.2. should i be worried?

24 hour urine: The GFR is only an estimation of kidney function based on creatinine, age, and race. But it is less reliable with normal or nearly normal kidney function and in patients with a lot or little muscle mass. The most reliable measurement of kidney function would be a creatinine clearance based on a 24 hour urine collection. You could talk to your doctor about getting this test if there is concern.

No. : This is probably a random fluctuation in creatinine; everybody's varies like this. Many pathologists and nephrologists consider the current fad for guesstimating GFR from a spot creatinne to be subscientific. These are normal creatinines for a man in my book; level correlates with muscularity; i work out and run a creatinine of 1.4 or even 1.6 in my glory days & have great kidneys.

Estimated GFR: Your egfr means "estimated" glomerular filtration rate. The key word here is "estimated". It seems unusual that a .1 increase of creatinine (c) could lower your egfr by over 20%. See a nephrologist and get a 24 hour urine for c clearance and protein and get an exact result of your gfr, rather than an estimated one. You may be surprised by the answer.