Question: I had some labs done and would like a second opinion. I had two sets of labs done one in March and then one in April. Two days later in April I had a retest of potassium. In March I had what I thought was food poisoning--I was throwing up and having diarrhea. I had some rectal bleeding for two days. The doctor I saw strongly suggested that I had colon cancer and pushed me into having a colonoscopy. I had colitis of some sort which resolved on its own. No cancer, no polyps.

Notably the creatinine was high. 1.11. A second doctor who never saw me said that my "kidney function is chronic." He reviewed the labs because the first doctor was too worried about colon cancer to read my lab results.

I retested in a month and the creatinine was .97. However, the Potassium was then high In March it was 4.4. In April it was 5.3. I retested the potassium two days later and it was 3.6.

Question: Does it look from these results that I have chronic kidney problems? Also, why would the potassium drop down so much in two days (both lab tests were fasting)?

Thank you for your response. It seems as if I have had an unending stream of problems with this clinic and it has really affected my trust. Unfortunately I live in a small town and going somewhere else would involve a very long drive. So that is why I am here.

I'm not that worried about kidney disease after the second creatinine test came out normal. I was definitely dehydrated when I took the first creatinine test. I had food poisoning or something that caused a lot of vomiting. That was the only creatinine test I had had in years. It seemed odd to me that the doctor diagnosed me with "chronic" kidney disease after one test when I was sick.

I read that sometimes declining kidney function can show up as protein in the urine even before the creatinine levels drop. So I got that tested too and it was completely normal. I don't want an ultrasound right now.

I am more concerned/confused about the potassium.

Do you know much about lab procedures?

I was not sick and not at all dehydrated during the second and third blood test (the third was just potassium). During the second blood test (the one with the high potassium) there was a new person in the lab. They left the tourniquet on my arm for what seemed like a really long time while first one person and then another pushed at my veins trying to find them. It seemed like maybe 3-5 minutes, although that's just a guess. The potassium came out as 5.3 which was high in that lab.

My doctor acted very worried about it and she started talking about giving me a diuretic. My blood pressure had been moderately high 135/95 for about a month. Prior to that it was much lower, and I think that it was mostly due to anxiety. I have been very stressed out about all of the false diagnoses (colon cancer, then kidney disease and then high potassium). Instead she asked me to retest in a week. I got it retested 2 days after the first one and it came out 3.6.

I figured that the blood had slightly hemolyzed because they left the tourniquet on so long (I had read that could cause it) and the first reading was incorrect...my doctor (and you) came to the same conclusion--that it was a false high reading. However, I made the mistake of bringing up the issue with the lab. I wasn't mad really, I just thought I would let them know and save someone else the trouble if this was a procedure issue.

The lab said that the blood was absolutely not hemolyzed and that those levels can "shift hour by hour" based on diet. Is that true? For both potassium tests I had been fasting for about 12 hours prior to the test. I don't recall eating anything different than I usually do during the two days between tests. I don't take any supplements with potassium in them and never have.

Of course I could believe that they could shift some. But to go from high to almost low that quickly? Can they always tell if the blood is hemolyzed? It seems like they are trying to blame it on me...saying that I ate the wrong things. If that's true could I go eat a banana and make it go up high again? I do have mild to moderate hypertension, but it has been well controlled until the last month or two (since I started having panic attacks). I do not have diabetes, and it appears that my kidney function is ok.

Thank you,

XXXX

I'm sorry to keep perseverating on this. I just need to understand. Logically I know this high potassium isn't a danger to me and honestly I wasn't worried about it at all until my doctor acted quite concerned and wanted me to get retested as soon as possible.

I have been on lisinopril for at least five years. I was on the same dosage when I got the reading 4.4, when I got the reading 5.3 and when I got the reading of 3.6. And the 5.3 and 3.6 were two days apart, and I am absolutely sure I took my medication both days. As you can probably tell I'm pretty meticulous about medical stuff.

My fluid intake was lowest when I got the 4.4. I was sick. I am sure I was adequately hydrated when I got both the 5.3 and the 3.6. I understand that small variations are normal and not concerning, but is a difference between 5.3 and 3.6 in two days considered a small variation?

My suspicion is that the 5.3 was a false high because the blood was slightly hemolyzed. 3.6 is actually right at the bottom of normal...maybe not really concerning, but I am not on a diuretic or any other medication that should be lowering it. And in the last two months my average blood pressure has gone up about 20 points on both systolic and diastolic. Anxiety is certainly part of that. It is a very new thing because of a traumatic event. But I wonder if I might actually be not getting enough potassium in my diet. Does that seem reasonable? My understanding is that potassium is important in keeping blood pressure controlled and mine is not right now.

Would it be a good idea to increase fruits and vegetables that have potassium in them? Could that help me lower my blood pressure? Surely that would be safe anyway, right? It wouldn't make the potassium go too high. (I won't take supplements...just more fruits.) I already exercise about an hour a day.

I know lab results should be interpreted by a doctor. Unfortunately my trust in my doctor is at an all time low, which is a huge problem. That's the primary reason I'm consulting internet doctors.

Again I am sorry for being dense. I appreciate your time.