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Nephrology Ask the Experts

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  Friday, 12 October 2018
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Hello
Three weeks ago I had bloodwork done and my creative level was 1.29 and non African level of 45 I had a follow up test done again and my creative rose again 1.33 and non African dropped to 44 it has been continuously dropping since the beginning of the year should I be worried
I completely understand.

I am a doctor and have lots of anxieties about my health too. I get it.

The test will likely be just fine. And if it isn't, ignoring it is not a great idea.

Jordan
3 years ago
·
#1247
Jordan,

Good morning. When they drew my blood yesterday, they also did a regular panel test. Below are the results:

Report Result Ref. Range Units Status
CALCIUM 9.6 8.6-10.3 mg/dL Final A
GLUCOSE 107 75-99 mg/dL High Final A
SODIUM 140 135-145 mEq/L Final A
POTASSIUM 4.2 3.5-5.1 mEq/L Final A
CHLORIDE 104 101-111 mEq/L Final A
CO2 29 21-31 mEq/L Final A
BUN 18 7-25 mg/dL Final A
CREATININE 1.24 0.70-1.30 mg/dL Final A

The family doctor said it looks like my kidneys are functioning fine and there are no long term concerns.His results just show a GFR >60. When I enter this 1.24 number into the GFR calculator on the National Kidney Foundation's website, with my height and weight, it puts me at GFR 93. And this number really isn't considering anything for lean muscle. Plus, I did workout like 2 hours before the blood was drawn. My last microalbumin test came back at <12.0 mg/L. What do you think? This puts me into a pretty good place in my mind with this last test. I'm still waiting on the Cystatin test to come back, but like I said I don't really even want to look at it. If those results are high then its going to put me right back in the mind frame I have had for the last couple years and its very hard for me to live daily life that way. Also, just as a question on the microalbumin test, the creatinine to albumin ratio result came back as "unable to calculate", what does that mean and is the result of <12.0 mg/L for the microalbumin good?
3 years ago
·
#1248
Also, I wanted to add. The doctor said my glucose number was not concerning because I didn't fast before the test. Here are my numbers again, less jarbled:

Report
CALCIUM 9.6
GLUCOSE 107
SODIUM 140
POTASSIUM 4.2
CHLORIDE 104
CO2 29
BUN 18
CREATININE 1.24
Jordan,

Good morning. When they drew my blood yesterday, they also did a regular panel test. Below are the results:

Report Result Ref. Range Units Status
CALCIUM 9.6 8.6-10.3 mg/dL Final A
GLUCOSE 107 75-99 mg/dL High Final A
SODIUM 140 135-145 mEq/L Final A
POTASSIUM 4.2 3.5-5.1 mEq/L Final A
CHLORIDE 104 101-111 mEq/L Final A
CO2 29 21-31 mEq/L Final A
BUN 18 7-25 mg/dL Final A
CREATININE 1.24 0.70-1.30 mg/dL Final A

The family doctor said it looks like my kidneys are functioning fine and there are no long term concerns.His results just show a GFR >60. When I enter this 1.24 number into the GFR calculator on the National Kidney Foundation's website, with my height and weight, it puts me at GFR 93. And this number really isn't considering anything for lean muscle. Plus, I did workout like 2 hours before the blood was drawn. My last microalbumin test came back at <12.0 mg/L. What do you think? This puts me into a pretty good place in my mind with this last test. I'm still waiting on the Cystatin test to come back, but like I said I don't really even want to look at it. If those results are high then its going to put me right back in the mind frame I have had for the last couple years and its very hard for me to live daily life that way. Also, just as a question on the microalbumin test, the creatinine to albumin ratio result came back as "unable to calculate", what does that mean and is the result of <12.0 mg/L for the microalbumin good?


That is great. No worries then. The microalbumin could not be calculated because the protein is so low in your urine that it cannot be detected. This is good!

Dr. Jordan Weinstein
3 years ago
·
#1250
Thanks. I know the Cystatin test are new and most people don't do them, but do you have any experience? If you did have to "bet", do you think my Cystatin results could still come back high and above the average range?
They are mostly research level tests and not widely used. But they perform well and I predict yours will be consistent with kidney function in the range of your current eGFR.

Dr. Jordan Weinstein
3 years ago
·
#1252
I appreciate the fast responses. I'm sure you already think I'm crazy so what the hell, I might as well ask one more question. I have attached my GFR calculations from the Kidney Foundation website. I enter 1.24, my age, my height, my weight. The National Kidney Foundation recommends using the CKD 2009 equation, and that gives me a GFR of 93. When you say "I predict they will consistent with kidney function in the range of your current eGFR", are you referring to just greater than 60 GFR? Or do you mean they will likely be consistent with the 93+ GFR I get when on the National Kidney Foundation website? I only ask this because just over 60 GFR is kind of a good thing and kind of a bad thing. Patient results will come back as normal on panel test, but being only 39 years old, a GFR of just over 60 isn't very good.
Attachments (1)
It will likely be in the 90 ml/min range

Dr. Jordan Weinstein
3 years ago
·
#1254
Dr. Weinstein,

I wanted to follow up with you on my Cystatin C tests. My result came back as 0.6 mg/L. When I enter that information into the National Kidney Foundation website along with my Creatinine numbers, weight,, height, etc. I get the following results:

CKD-EPI creatinine equation (2009) 93 mL/min

CKD-EPI creatinine-cystatin equation (2012) 131 mL/min

CKD-EPI cystatin C equation (2012) 168 mL/min

MDRD study equation 83 mL/min

What do you think? I had previously read that the general consensus is that the most accurate equation to use is the equation that accounts for both creatinine and Cystatin, instead of just using one equation alone. That would be the CKD-EPI creatinine-cystatin equation 2012 from above that gives me a GFR of 131. I would like to know your thoughts. Thanks
I would agree, that is the formula I would use. This is very reassuring.

I am now going to be closing this thread as it has gotten a bit too unruly with everyone posting responses to it. Any future questions on new issues can be made using a new post.
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