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Kidney conditions and stones treatment - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Kidney Conditions
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   hi
Doctor :   DR.XXX here
Doctor :   please proceed with your health query.
User :   Yes I have a question regarding a Kidney issue
Doctor :   ok. please proceed. I am a General Practitioner, I believe I can help you within my expertise and If required I shall recommend a specialist.
User :   My doctors are not giving me clear answers and I want to know if some of my labs I'm looking at right now in front of me is an indicator of borderline Kidney disease or if its progessing as such.
Doctor :   ok. please share your lab results
Doctor :   you can send it to YYYY@YYYY
User :   Okay so I need to type what I'm looking at to that email address?
Doctor :   if you are typing it out, then you can type the results here itself in chat window
User :   Oh okay, well I'm a fast typer so it should be fine
Doctor :   if you are sending soft copy of report, then send to above mentioned e-mail ID
Doctor :   are you there?
User :   My Creatinine levels from June 2008-2010 have ranged from 1.5mg/dL to 1.2mg/dL My BUN levels have always been normal 14mg/dL is the norm for me. However, on 9-4-2010 they rose to 24 mg/dL which was noted as high. My GFR (MDRD) was at 60.7 the range stated anything above 60 ml/min/1.73 m2 was normal.
User :   But the range for someone my age should have a level of 107 ml/min/1.73 m2
Doctor :   ok. so your GFR is on lower side of normal range and the lab results do suggest functions abnormalities
Doctor :   were these done on a 24 hour urine sample or random urine sample?
User :   But BUN/Creatinine Ratio is 17.9 which is normal. These were done on a blood test
User :   Had a urine test done as well which are random urine sample.
Doctor :   ok. get your 24 hour urine protein and creatinine levels checked
Doctor :   if it shows abnormalities, then you will need further consultation with a Nephrologist.
User :   Did get a 24 hr urine test done back on 8-24-2008. That was my last 24 hr urine test.
Doctor :   2008 is a long time, please get it repeated.
Doctor :   to see the current status.
User :   Did have an CT Scan done at that time fram too and an Ultrasound done on 6-2010
Doctor :   ok, did the CT show any abnormalities?
User :   Total Protien showed just alittle low this last blood test which was at 6.3 g/dL
Doctor :   ok. if you are looking for kidney function, urine protein is more reliable
Doctor :   blood protein levels are measure of liver functions
User :   Yes. Says here I have 6 stones and tells of their locations. Two which measured 4mm, two were 3mm, and two measured 2mm.
Doctor :   ok. what are your current symptoms?
Doctor :   the GFR being less could be partly due to stones too.
User :   I have generalized itchy skin. I itch all the time. My potassium levels are low all the time. My muscles jerk if I don't take my prescription Potassium citrate suppluments.
Doctor :   yes, potassium is necessary for neuromuscular functioning, as it is essential part of smooth signal transmission
Doctor :   so do not miss your prescriptions.
Doctor :   have you had urine bile salts and pigments checked?
User :   Would kidney stones be associated with kidney disease? What I would like to know is if I get a health questionaire and it asks "Do you have kidney disease?" Do I answer "Yes" or "No"?
Doctor :   if they are raised, you can have itching
User :   I don't believe those have been checked.
Doctor :   since your BUN levels are increased, and stones are present, you should click on "yes".
Doctor :   it will ask you further questions
User :   Oh okay. Could something else raise BUN levels though? This was during an ER visit and they drew blood at about 3:00am, I don't believe it was enough time to be considered a fasting test.
Doctor :   asking your other symptoms and tests results etc
Doctor :   no, BUN levels are usually raised with altered kidney functions.
User :   Okay, so could those levels return to normal on their own? Or will they start showing the slight elevation that is similiar to my elevated Creatinine levels?
Doctor :   otherwise it is known to be raised with dehydration, increased meat intake
User :   I definetly was Dehydrated and I eat little meat.
Doctor :   ok
User :   Wasn't dehydrated sorry
Doctor :   ok
Doctor :   since you have history and evidence of stones in kidney, your results could be atttribute to them
User :   Okay makes sense. Someone mentioned once those stones are delt with my kidney numbers will return to normal. Is that so? BUT, I've also heard once the kidneys have been damaged that they continue to detteriorate.
Doctor :   if damage is more than mild damage, detioration can continue
Doctor :   if stones are removed soon it improves
Doctor :   go ahead with resolving the stones issue
User :   Oh okay. Mine isn't even to the mild stage yet, I imagine.
Doctor :   and with getting 24 hour urine protien and creatinine levels done
Doctor :   it will tel if you need to be worried about kidney damage or not
User :   I have another appointment with my primary care doctor to have blood drawn on Nov 2, 2010. And my CT Scan sometime in Nov. Then I have my Nephrologist appointment in Jan. 2011. The thing is no one has come out to say "Yes you have a kidney disease" or ever go over what my numbers mean. All I know about it is through research.
Doctor :   ok
Doctor :   try to prepone your appointment with Nephrologist
Doctor :   it is a long time till then
Doctor :   when you meet your primary physician
Doctor :   request for the tests I have suggeted
User :   Thats the problem though. I have to get approved by my primary care doctor to even be granted for an earlier appointment with my Nephrology doctor. The VA system really is bad.
Doctor :   on a 24 hour urine sample
Doctor :   if it comes abnormal, he/she has to refer you urgently to Nephrologist
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