Brief Answer:
Chronic kidney disease

Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. Your creatinine is elevated at 2.5, with a GFR around 25, which, assuming your creatinine has been like this for longer than a few weeks, most likely shows stage 4 chronic kidney disease, which is quite advanced. There are many components of care for this, and ideally you should be under the care of a kidney doctor.

First, perhaps the most important thing is to be on an ACE inhibitor such as lisinopril to protect your kidneys from further damage. Your blood pressure should be kept below 130/80. Your potassium should be watched, which right now it looks like it is not too high. You would be considered for treatment with sodium bicarbonate to increase your bicarbonate a little. Your hemoglobin is low and may need treatment with a medication such as erythropoetin. You would also need your PTH and phosphate checked to see at what levels they are at, and may need medication to control the amount of phosphate in your blood.

At this point you should probably stop Metformin, as there is a risk of side effects with kidney disease at your level.

I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.

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