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What Does Altered Serum Creatinine, BUN Ratio And Leukocyte Esterase Indicate?

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Posted on Mon, 5 May 2014
Question: My identical twin sister had bloodwork and urine test done, part of her yearly physical. Her bloodwork was very good. Total cholesterol 196 HDK 89 LDL 93 and tryglyserides 69. The only thing that was highlighlighted was creatinine which was 0.57 and the bun/creatinine ratio which was 26. In the urine testing it showed in the Leukocyte esterase (small +1) (Negative A). She is freaking out big time, and so am I, as I said we are identical twin. Her doctor did a repeat of her urine test, but she didn't hear anything yet, but of cause she is a nervous wreck. She called her doctor today and the results didn't come back yet and it is 2 weeks. She is freaking out why is it taking so long. In the meantime she is going to get a nervous breakdown and so am I, and also the stress is getting the best part of her. She feels great physically, but not mentally. Here are the urine analysis: Color..Yellow, Appearance …clear, Glucose, QL…Negative, bilirubin, urine…negative, key tones…negative specific gravity..1.013, blood..negative, PH..7.0, Protein,total,QL..negative, Nitrate.. negative, Leukocyte esterase..small(1+)(Negative)A, squamous epithelial cells.. 0.5, wbc..0.5, bacteria..none, RBC..0.3, hyaline casts ..none seen
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Answered by Dr. Chobufo Ditah (3 hours later)
Brief Answer: The results are normal and reassuring! Detailed Answer: Hi ad thank you so much for this query. I am so sorry to hear about these laboratory investigations and all the inconveniences that this has caused you. I guess the creatinine and the BUN creatinine ratio is what is causing you to freak out. Maybe the positive leucocyte esterase as well. We would take a look at these. The serum creatinine is on the low side. This, though not normal, in no way suggest a pathological process. Decreased muscle mass can be responsible for this as muscle mass determines how much creatinine the body produces. If the levels are very low, then there would be lower concentrations in the body as well. The higher BUN/creatinine ratio is explained by a low creatinine wich drives higher the ratio as a normal value(BUN) divided by a smaller value(creatinine) would produce a bigger number. it is no way suggest kidney damage but rather a reflection of the smaller value of the creatinine. There is just no point in getting concerned here. Leucocyte esterase is very non specific and may suggest an infection. With borderline positive results, this is very unlikely. If something abnormal were found on repeat testing, you would be inform immediately for action and no news actually means good news. Because the standard of practice requires that results with concerns be communicated directly to client for management. Why freak out? i found just no reason for. Stay relaxed and be reassured that there is no red flag at this time on the results. I hope this helps. i wish you well. Thank you so much for using our services and feel free to ask for more information if need be. Thanks! Dr. Ditah, MD.
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6323 Questions

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What Does Altered Serum Creatinine, BUN Ratio And Leukocyte Esterase Indicate?

Brief Answer: The results are normal and reassuring! Detailed Answer: Hi ad thank you so much for this query. I am so sorry to hear about these laboratory investigations and all the inconveniences that this has caused you. I guess the creatinine and the BUN creatinine ratio is what is causing you to freak out. Maybe the positive leucocyte esterase as well. We would take a look at these. The serum creatinine is on the low side. This, though not normal, in no way suggest a pathological process. Decreased muscle mass can be responsible for this as muscle mass determines how much creatinine the body produces. If the levels are very low, then there would be lower concentrations in the body as well. The higher BUN/creatinine ratio is explained by a low creatinine wich drives higher the ratio as a normal value(BUN) divided by a smaller value(creatinine) would produce a bigger number. it is no way suggest kidney damage but rather a reflection of the smaller value of the creatinine. There is just no point in getting concerned here. Leucocyte esterase is very non specific and may suggest an infection. With borderline positive results, this is very unlikely. If something abnormal were found on repeat testing, you would be inform immediately for action and no news actually means good news. Because the standard of practice requires that results with concerns be communicated directly to client for management. Why freak out? i found just no reason for. Stay relaxed and be reassured that there is no red flag at this time on the results. I hope this helps. i wish you well. Thank you so much for using our services and feel free to ask for more information if need be. Thanks! Dr. Ditah, MD.