I am a 44 year old active duty military officer and in my most recent deployment, I had labs drawn and I had high creatinine and high-normal BUN levels (or vice versa). Neither one was that much out of tolerance and I likely was dehydrated at the time so I didn't give it much thought. In November 2012, my creatinine came back at 1.4 and my BUN was high-normal and then in December, my creatinine was 1.6 and my BUN was lower than either of the two previous labs.
After meeting with an internist yesterday, I now have more labs and a renal ultrasound scheduled and there is talk of a nephrology consult. With this tentative Stage 3 CKD diagnosis, I've been in a funk for the last 36 hours but I just looked at my medical records and I see that I've always run high on both creatinine and BUN. Nine years ago, my creatinine levels hovered between 1.3 and 1.4. I have normal BP, no diabetes, BMI of 26, and I am otherwise in good health. I do not drink or smoke and obviously I exercise regularly.
How likely is it that I really do not have CKD and just have always had a low eGFR with the latest lab as just an outlier?
Kidney disease is diagnosed when the combination of the values you have mentioned is aligned as you have noted.
I would encourage you to have the consultation with the nephrologist (kidney specialist) if it has been recommended by your doctor.
I have a history of kidney disease that stems from extreme high blood pressures, resulting in strokes. The good news is that kidney disease is a very slow moving disease, that can be greatly affected by life style changes, and medication.
If you are subject to CKD, knowing as soon as possible gives you the greatest chance of finding a great way to live that spares you the outcome that ignorance can never prepare you for.
Our kidney function is one that does slowly fall as we age, so most of us are born at approximately 100%. By our older years, many of us have lost our kidney function naturally. For those of us who loose our early due to other illnesses, heredity, or other causes can do our best to cut our losses by adopting a kidney friendly diet and living with awareness.
just for reference, my eGFR is about 23, and I am considered stage 4. I have maintained this number for about 10 years now, with no fall into end stage failure and the need for dialysis. I am so grateful for that, and I do rely on my doctor to manage and monitor my health with great success.
Best of luck to you...
Last edited by growagourd; 02-02-2013 at 06:58 PM.
My eGFR was around 52 in November and 47 in December. Hopefully, it didn't really drop that much in 30 days. Like I said, my creatinine levels have been 1.3-1.4 for the last 10 years or so. This is the first time it's been this high. We'll see if it was outlier with this next set of labs. I'm eager to get the ultrasound and see if there's something there other than a couple of prematurely failing kidneys.
There could be a couple of things going on that do not mean kidney disease. If you have a lot of muscle mass, this could raise your creatinine (cr. is a byproduct of muscle metabolism). Add in a bit of dehydration and some exercise the day before the labs and you could get some out of range results. On the other hand, the decreasing GFR could be an issue. So for your next labs, make sure you keep yourself tanked up with fluid and don't do any excess exercise the day before.
Ultrasound came back normal but labs confirmed I'm in Stage 3 (eGFR slightly higher, BUN quite a bit lower) and, per some old labs I dug up, I have been for over 9 years. When I mentioned this to the internist, she said that means that I am stable. As such, when she said I could get a nephrology consult but that I probably don't need one right now, I declined the invitation. I just read that people at Stage 3 should have new labs drawn every 3 months. Does that sound right?
What's the best way to keep from slipping into Stage 4? Low-protein diet, lots of fluids, etc?
I would definitely see the neph. The earlier the better and the more up to date will be any kidney info you get. In the meantime, you are correct that keeping hydrated and cutting back on animal protein is a good idea. Also cut back on salt and processed foods. Don't worry about cutting back on other things yet. I imagine that currently all your electrolytes are normal and you can basically eat as you please. How is your bp? That needs to be monitored too. You are also right in that you should be getting labs drawn every 3 - 6 months to keep track of things. You will probably only need to see the neph once or twice per year.
If you have more questions, don't be afraid to ask.