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Dr. Andrew Rynne
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What do my lab test reports indicate?

Answered by
Dr.
Dr. Rakesh Madhyastha

Nephrologist

Practicing since :2009

Answered : 4360 Questions

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Posted on Tue, 7 Jun 2016 in Kidney Conditions
Question: I am 45 years old male.i am hypertensive and my lipid profile remains high.i follow the advice of my cardiologist since 2006.at present I am taking sartel-40(half tab per day),rosavel10 and half tab of concorcor2.5.my cardiologist did echo twice and ecg in every year.according to him these are normal.moreover my family physician always do routine tests like urea,creatinine,Hba1c,albumin creatinine ratio,urine exam.i am attaching all these reports.
Now for few days I am noticing a swelling around my left ankle which is pitted in nature.it is found especially after a long sitting.a tight feeling is there in my lower feet which is removed after walking.this pitted edema is noticed in left leg but right leg appears almost normal(at least i could not found any such swelling).my frequency of urine is normal and i do not raise in night.
My question is what is the reason of such swelling?does it indicate kidney or heart problem?
doctor
Answered by Dr. Rakesh Madhyastha 59 minutes later
Brief Answer:
Most likely to be side effect of Concor

Detailed Answer:
Hello

Thanks for the query

Swelling of the ankles is very common with Tab Concor2.5mg. I have seen this many of the patients have this side effect. I have seen the reports attached by you and they are within normal limits .Please do not be worried.

Kidney and heart problems usually come other symptoms as well
1. Patients with kidney injury often have swellings of the both lower limbs, fatigue and loss of appetite
2. Patients with heart issues have swelling of both feet and breathlessness on exertion ( most often). As your ECHO is normal it is less likely to be the heart

I hope I was of help, please get back to me if you have any further queries

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Rakesh Madhyastha 53 minutes later
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Rakesh Madhyastha 10 hours later
Brief Answer:
ECG changes

Detailed Answer:
Hello

Thanks for attaching the reports

Here are my interpretations

1. You have slightly enlarged prostate. Mild enlargement of prostate need not be intervened until you have difficulty in voiding of urine or you get up more than once in the night to void urine. I suggest you to get post void ultrasound of the bladder next time to see if any urine is left behind after passing urine because of the enlarged prostate
2. One pus cell and few epithelial cells are normal. It does not require any treatment. All other urine reports are normal
3. Your ECG has mild increase in heart rate. It could be anxiety while taking the ECG or the cold environment causing the increase in heart rate. It also has a mild increase in the left ventricular size, it usually occurs when one's blood pressure is not under control for prolonged periods. Tab Sartel is the right tablet for the slight enlargement of the heart. Please attach the ECHO report so that I can go through it as well

Regards
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Rakesh Madhyastha 4 hours later
Doctor,i could not understand whether did you receive all my current reports or not? because I did not find all reports sent by me in ""my dashbord"' area of healthcaremagic.
actually I performed serum creatinine,HbA1c,Albumine creatinine ratio in December,2015.creatinine value is 1,HbA1c value is 5% and ACR value is 14.8 microgram per milligram creatinine.The ACR value was 4.6mcg per mg creatinine in September,2014.My body weight is 78kg and height is 5ft 8inch.Routine urine exam and usg KUB done in December 2015 remain normal.I am trying again to sent these reports to you.
I want to know why such enhancement in ACR value occurred? Does it indicate kidney disorder? what steps should I take at present?Is it related to my swelling of feet?

I did not have answers of my last question made on yesterday.please reply me as early as possible.
doctor
Answered by Dr. Rakesh Madhyastha 41 hours later
Brief Answer:
I have received the reports

Detailed Answer:
Hello

Thanks for getting back. I am sorry for the short delay in my reply there was deceased donor kidney transplantation in our unit. Yes, I did receive all your e XXXXXXX and thats how I could interpret them.

ACR is within normal limits. Please do not worry about it. Albumin excretion of upto 30 mg per day is considered normal. Our body excretes small amounts of protein routinely which includes tamm horsfall protein, blood products, globulins, etc. Your excretion has been within normal limits and need to be treated. Eventhough there is a rise it is still within normal limits and does not indicate kidney disorder

You are slightly overweight, I recommend you to lose about 5 kilos to be in ideal body weight range.

The swelling of the feet is most likely due to Concor 2.5 mg. I usually continue the tablet if the patients is not having too much trouble with it.I tell my patients to rise the leg a little while sitting or keep a pilow under the leg while sleeping, this reduces the swelling. However if it is bothering you then I suggest you to shift over to Tab Cilinidinpine 5 mg once daily ( please speak to your doctor before changing).

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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