Daily Archives: January 29, 2019

I recently had some labs done. My BUN was 20, which was slightly higher than its usual 14 or 16. My creatinine level was .67, which also was a fraction lower than a year ago at .71. Those were all within the lab’s normal range. However, my bun-creatinine ratio was 30 and the lab’s normal range tops out at 28. The ratio is higher than it was last year when it was 20. Should I see a doctor? Is the ratio meaningless if the numbers themselves are within normal range, even though they have changed since my last test. My GFR is 95. My A/G ratio is 1.8, which is also in the normal range. I have not had any kidney issues other than kidney stones 20 years ago. I do have primary biliary cholangitis but take medication for that. I have been trying to eat more protein and likely had no liquid other than coffee and a small glass of water on the day of my test. Thank you very much.

A high protein diet will cause a elevated blood urea nitrogen (BUN). This may be the cause of the elevated BUN that you describe. Otherwise, I am unable to make a diagnosis of kidney disease based on the information that … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Serum Creatinine

I am trying to understand the way CKD is staged but it is confusing. eGFR of 60 and above is set as the normal level but kidney function also declines with age at about 1% a year. So individuals with a eGFR of 65-70 are called normal. But due to aging decline does this mean that in 5-10 years their eGFR will fall below 60 and will then be classified as having CKD? How is it possible to go from normal to stage 3 of a disease?

The Stages of chronic kidney disease require two pieces of information. What is the the estimated glomerular filtration rate (eGFR)?  And what is the urine testing that includes blood, protein and infection in the urine? These two pieces of information … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, GFR, Kidney-Related Health Questions

My daughter recently saw a nephrologist who was stumped as to why her erythropoietin is at 6 (expected to be close to 100 with a hematocrit of 30 and hemoglobin about 9.5) yet kidney function studies are all within range such as creatinine .5, BUN 12, etc. What might account for an epo-deficiency without obvious CKD? As we pursue further evaluation, any lab recommendations?

I am unable to make a specific diagnosis based on the information that you present. In the absence of kidney disease, a deficiency of erythropoietin would suggest a failure of the kidney to make erythropoietin or an autoimmune reaction against … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions

I had a partial nephrectomy on Nov 12. Since then I feel like I am about 4 months pregnant, but only on the left side. My doctor tells me this is normal and I should be patient; which is probably true. But what exactly is happening? Is it swollen organs (from being assaulted during the surgery), is it a kind of lymphedema? Is there anything that will reduce the swelling as in hot or cold compresses, massage or is the only solution the “tincture of time”? I find that when I start to walk my daily route the swelling gets more pronounced and “harder”…in the morning it is soft. If I sit at my desk it also gets harder. I am going for an ultrasound in 3 weeks which will be the 3 month mark. AND I went through airport security to pick up my grandchildren from a plane at Christmas and the body scan showed a big yellow box where the swelling is, so they gave me an intense pat down; looking for contraband I suppose. Have you heard of that before?

I am a nephrologist do not have any surgical expertise. I’m not sure if you had an open partial nephrectomy or a laparoscopic partial nephrectomy. The edema after surgery can take several months to completely resolve and the muscular injury … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrectomy / One kidney, Nephrologist