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Thursday, December 5, 2013
Concern of elevated bun and creatine?
I am a 73 year old female, weighing 230 pounds, just started a weight reduction plan, lost 22 pounds, intend to continue. Have arthritis, removed breast cancer both breasts with lumpectomys.
Bun 25 April 2007 Bun 40 Jan. 2008 Creat. 1.4 April 2007 Creat. 1.7 Jan. 2008
Bun 29 Oct. 2007 Concerned of these numbers for Creat. 1.3 Oct. 2007 Bun and Creatinine.
Your thoughts please?
You appear to have progressive renal disease, and there are a number of possible causes. These include: diabetes, hypertension, atherosclerosis (hardening of the arteries), medications (including arthritis meds), autoimmune disease (such as lupus), and cancer (either of the kidneys, or of other organs).
The blood tests that you mention, BUN (blood urea nitrogen) and creatinine, are measures of kidney function. Urea and creatinine are waste products that are generated in the course of normal body metabolism. They are excreted by the kidneys; and in kidney disease, they accumulate in the body and can be detected at higher-than-normal levels in the blood.
Judging by your BUN and creatinine levels, you have already lost over half of your kidney function. While many people your age can live long and trouble-free lives with this level of function, it is of concern that your kidney function has declined even in the last 3 months. Your doctor should immediately refer you to a nephrologist (kidney specialist). When you are seen by the nephrologist, you should be prepared to provide the following information:
- a thorough description of any other diseases or conditions that you have (such as diabetes or hypertension), as well as past hospitalizations and surgery.
- a description of any kidney-related symptoms or problems that you have (either currently or in the past), such as blood in the urine, excessive urination (including at night), burning on urination, and kidney stones.
- a list of all of your current and recent medications (including dosages), including over-the-counter and herbal medications.
- a medical history of your family members, especially with regard to kidney disease and diseases with a hereditary tendency such as hypertension, diabetes, and cancer.
- past lab tests (bring copies of the ones that you mentioned above).
- reports from past kidney imaging studies (including ultrasound, CT scan).
It is important for you to be seen within the next days to weeks. If the cause of your kidney disease can be determined, it may be possible to reverse the damage or at least to prevent more damage from occurring. Please do not delay!
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University