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Have multiple kidney stones. BUN result is 21.0 and creatinine serum 0.8. What does this indicate?

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i have lab results that I am wondering if I should be concerned. I do have multiple kidney stones in both kidneys. My BUN result is 21.0 my creatinine serum is 0.8, my bun/creatinine ratio is 26.3 (High). I also show a low reading of 3 for Anion Gap which I do not know what that is. There is a notation on the bottom of the page for the sults that mentions GFR which I do not believe it has a result. It only says Chronic Kidney Disease: less than 60ml/min/1.73 m2
and Kidney Failure: less that 15ml/min/1.73/ m2. Does that notation of GFR mean anything? I cannot see a physician for another 2 months when I am covered by health insurance. I do have pain in rt leg (entire leg) from back area down leg. Thank You
Posted Thu, 25 Jul 2013 in Kidney Conditions
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Hi and thanks for the query,

The normal BUN (Blood Urea Nitrogen) level ranges between 7 to 20. At 21, you really need not be worried. A raised BUN/CReatinine Ratio with a Normal BUN level usually requires another test to be done again. A GFR (Glomerular Filtration Rate, a measure of the purification capacity of kidney with respect to blood contents) is needed. A GFR of greater than 90ml/min/1.73 is considered within the normal range, for your age and cormobidities (diabetes/hypertension) but need supervision. An ultrasound might be needed to detect the size of the stones. Stones greater than 6mm and if bilateral might require surgical removal.

Less than 90 becomes a problem, and the more it gets lower, the more the patient approaches chronic kidney disease stages.

A GFR of less than 60 requires strict followup is needed from a nephrologist.

It would be interesting to know how your glucose control and blood pressure control is within the last months. Diabetes is a major contributor to chronic kidney disease, especially in the presence of hypertension. Blood pressures at advised to be less than 125mmHg for the systolic and the glycated hemoglobin levels, HbA1c, a major marker for effectiveness of glucose level control to be less than 7% or 6.5% if possible. Specific drugs for hypertension are advised especially when coupled with diabetes. These are Angiotension Converting Enzyme Inhibitors or Angiotensin 2. Control of these risk factors for chronic kidney disease are of utmost importance. Exercise, diet, reduced salt intake and intake of saturated fats and positive life style changes do have their place.

You will certainly need to book an appointment with a nephrologist, and a more stricter control for diabetes and hypertension are particularly needed at this point in time.

This pain starting from the back down to the led is probably a sciatic pain. This usually arises from the compression of the sciatic nerve that innervates the lower limbs. Causes could range from disc compression, degeneration, tumors or trauma. An X XXXXXXX of the lumbo sacra spine and at times an MRI scan might needed to appreciate the cause and orient treatment. A proper clinical examination by a doctor is needed. Treatment ranges from rest with the back on a straight flat surface, analgesics, non steroidal anti inflammatory drugs, steroid infiltration in some cases and and surgery.

I suggest you have to book an appointment with a nephrologist, an d you might start with a family physician for a proper clinical review and work up for your back pain. Thanks and hope this helps. In case you got any specific questions, I shall be very glad to answer. Kind regards and wishing you good health.

Bain LE, MD.
Above answer was peer-reviewed by
Follow-up: Have multiple kidney stones. BUN result is 21.0 and creatinine serum 0.8. What does this indicate? 9 hours later
Thank you kindly for the thorough informative answer. Yes, my stones are bilateral and are small. I did have lipotripsy in the past for 1 large stone that was creating a blockage. My A1C was 6.2. My confusion is actually that GFR notation if it was an actual reading for me, I thought it was just information. If so, it looks like it is belowe 60 ml. Truthfully these lab results are from Dec. 13, 2012, I requested them by mail from my former physician as I am getting ready to see a new physician when I get my health insurance. I did not know these results until now, I did not see my former physician for the results as I lost my job right after these labs were done. I am experiencing pushing downs pains (probably the stones) but I have atributed it to the leg pain. I do have frequent urination. I am taking Glucophage 500 mg tid. Right now I am very uncomfotable with the pushing down feeling (like very mild labor pains). I actually received my health insurance card today, should I see my knew physician now? I was financially going to wait for 2 more months due to my high deductible, however I do not want to jepordize my health. Thank you very much

so sorry....I just reviewed the lab results again and there was an actual result for the GFR, I somehow missed it, it does say >60. Looks like I need to follow up with this.
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Hi and thanks for the update,

I strongly feel you really need to see a physician for a proper clinical review once again. It s better to know the actual state of the kidney function, which to me, is urgent to know and intervene early enough in case of any thing.

Glycated hemoglobin (HbA1c) to monitor blood glucose control effectiveness, blood pressure monitoring, Repeating serum Creatinine, BUN, BUN/Creatinine ratios, Glomerular Filtration Rate (GFR), Serum electrolytes (especially blood calcium and potassium levels). are key informants with respect to kidney function. A complete blood count is important in search of anemia, generally present in kidney disease. It might be necessary to do another abdominal ultrasound to check for kidney stone sizes and number, and also the nature of the urine collecting system and kidney tissue size and architecture.

I suggest you book an appointment first with a nephrologist (or internist) for a proper clinical review. Doing it as soon as now possible, starting is my advice. Thanks and kind regards as I wish you the best of health.

Bain LE, MD.

Above answer was peer-reviewed by
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