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RE: [IP] Kidney failure, maybe?



Hi Christene,

I'll skip the OK stuff:

 > Urea Nitrogen    31 H  mg/dl  2.0-28.0

Urea is a chemical that binds excess nitrogen and is excreted by
the kidneys. The result here will cause your doctor to give your
kidneys some thought -- or, more likely, he has been aware of the
potential and is already keeping an eye on your kidney panel.

 > Microalbumnin, Urine Random
 > microalbumin  42.2   H mg/l   (range 2.0-20.0

The lab report says this was a random sample. If your doctor is
worried, the next step will either be an eight-hour overnight
urine collection, or a 24-hour collection. (In case you are
concerned -- assuming 2 litres of urine per day, this comes out to
~85 mg/day of albumin. That is called microalbuminuria;
frown-inducing frank proteinuria requires (a) bigger molecules
than albuimin, and (b) more than 300 mg/day.)

Oh, and consider the variation: Albumin excretion during the day
is higher than at night (at night, it's ~80% or the daytime rate);
exertion or high blood pressure can massively skew the result; and
the day-to-day variation is +- 25% and more. A diagnosis therefore
usually calls for three samples over a few months.

 > M-Alb/Creat   62.0  H  mcg/mgCr  (range 0.0-30.0

The ratio of microalbumin to creatinine indicates whether your
microalbumin was high because your kidneys were generally in high
gear at the time -- in that case, there would also be much more
creatinine, so the overall ration would be normal. This result
also says that your kidneys need keeping an eye on.

 > U Creat  65    (range not est)

Without a unit, this number makes no sense (unless it is an
estimated creatinine clearance).
 
 > B Typ Naturitc Peptide
 > BNP   81   pg/ml     (range 5-100)
 > A BNP value of greater than 100pg/ml
 > is a strong overal indictor of (then
 > blank)

Beta-natriuretic peptide, when high, indicates congestive heart
failure (Wikipedia will tell you more about CHF than you ever
wanted to know, but it doesn't apply to you). It (and its
precursor, Pro-BNP) is used to distinguish asthma from CHF-induced
breathing trouble.

Overall, I would be mildly concerned, and I would discuss these
results with my GP. There is no need to run to a nephrologist yet;
depending on how long you have had microalbuminuria and diabetes,
your GP will likely consult one.

Oh, and one of our regulars here often recommends starting
dialysis at 15% remaining kidney function, not at 12% -- if you
receive that advice, don't panic. You are years and years,
decades, really, away from dialysis, and with a little care you
will never need it at all.

Cheers,
Felix.
.
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