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Have TB lymphadenitis. Test showed elevated urea and creatinine. Started swelling in legs. What should I do?

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Hi my age is 71 male. I have been diagnosed with TB lymphadenitis 2 months back. I have started anti TB medicines as prescribed by dr. I have also done CT scan and biopsy to confirm the TB. Anyways, after the CT scan my creatinine and urea level were 4.68 and BUN 54. Immediately after ct scan I started with extreme swelling in my both legs. Dr gave human albumin and started Cardace 5 as I am bp patient. The swelling went down temporarily but again came back around 35%. I did blood test again and creatinine came 1.2 and bun came 34. Please advise what should I do?
Posted Tue, 6 Nov 2012 in Infections
Answered by Dr. Michelle Gibson James 2 hours later
Hi, thanks for using healthcare magic

In the first set of results both the urea and creatinine are elevated. In the second set, the creatinine has essentially normalised (it is just at the upper limit) and the urea has remained high, though it the level has declined.

There is a ratio called the urea creatinine ratio, normal values for the ratio are 10:1 to 20:1, your present value is 28.
Elevated urea creatinine ratio can result from {a}increased urea production ([1] high protein intake,[2] bleeding in the gastrointestinal tract, [3]medications such as tetracycline, [4]steroid medication, [5]in a person who is septic)
{b} high urea can also result from decreased urea clearance ([1] dehydration [2] heart failure [3]kidney [4]kidney disease

If you are not using any of the above medication, no history or examination consistent with gastrointestinal bleeding or heart failure and not septic then the other causes must be considered.
Since both values declined after you repeated, you can consider - making sure that you use an adequate amount of fluids-at least 8 glasses (dehydration causes high urea), decrease your protein intake slightly and repeating the values in 1 to 2 weeks.
If the urea remains high then a 24 hr urine collection to assess kidney function and an ultrasound of the pelvis (will look at the kidneys and the blood supply) to also provide additional information may be considered.

I hope this helps, feel free to ask any other questions
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