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Kidney Diseases

Bun/Creat Ratio

05/27/2010

Question:

My bun/creat ratio is 34.3. I just want to know why would it be high and also why my hgb is low 10.6, platelet count is 482 high, and in my urinanalyis my wbc in urine is high 5-10. Also my small ldl-p is high 728. Please help me and tell me what can be wrong with me. I am 69 years old. Thank you in advance.

Answer:

I would say that what you need is a primary-care physician -- or, if you already have one, you should sit down with them and go over these results.  Without knowing more about you, such as your gender, medical history, family history, and what meds you take, I cannot be of much specific help, but here are some comments that may be useful:

1) Your BUN/creat ratio should be of no concern as long as both the BUN and creatinine levels themselves fall into the normal range.  The ratio can be affected by such things as whether or not you were fasting at the time of the blood test, how much meat you eat, whether you are a man or a woman, and how much muscle mass you have.

2) A small number of white blood cells in the urine is not necessarily abnormal, especially if you are a woman (because vaginal secretions may contaminate the urine).  In order to minimize such contamination, a urine sample should be collected as a "clean-catch" -- you need to urinate a small amount in the toilet first, then into the cup.  If you have symptoms of burning on urination, or if blood or protein or bacteria showed up on the urinalysis, the test should be repeated and further evaluation may be needed.

3) Your small LDL-P level is slightly elevated and may indicate a moderate risk for cardiovascular disease.  Remember that there are other blood lipid tests that are important too, such as the amount of HDL ("good") cholesterol and triglycerides.  Your primary doctor and/or cardiologist should be able to work with you to optimize your blood lipid levels and other factors (weight, blood pressure, smoking) to minimize your cardiovascular disease risk. 

4) The low hemoglobin and high platelet levels are of some concern.  They may indicate bleeding somewhere (possibly in your stomach or intestines), or some problem with your bone marrow.  These need to be repeated and followed up.

Best of luck to you, and please get yourself a primary physician soon -- and if you already have one, don't hesitate to ask about these results: it is your physician's job to address these.

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University