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Thursday, September 1, 2016
136 BUN 4.6 Creatinine Prospects
An end stage 90yo female on palliative care, has congestive heart failure, pulmonary hypertension, is bedridden and difficult to awaken, ingests minimal liquid and solid foods. Blood test reveals high potassium level and 136 BUN, 4.6 creatinine levels. Are such levels physiologically sustainable? How long?
It sounds like things are coming to an end for this patient. In a person who is very debilitated, a creatinine of 4.6 is very high, indicating kidney failure. The high BUN also indicates kidney failure and in addition suggests dehydration from lack of intake. The high potassium level also probably results from kidney failure and may result in the heart stopping.
Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University