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Kidney Diseases

High BUN, HIgh creatinine, normal ratio

06/09/2010

Question:

I am a 65 y.o. male, and was diagnosed with congestive cardiac failure, IHD, and chronic renal failure two years ago and had bypass done. Since then my serum creatinine has been monitored but recently its shooting up. My urea nitogen is 49mg/dl, creatinine 4.17mg/dl and BUN: creatinine ratio is 12. Potassium is 5.6 mmol/L and alkaline phosphatse is 34 u/l, with EGFR of 14. Please advise if I need dialysis or any further treatment.I am currently under physicians care, but have been advised to watch and eat a low protein diet.Thank You.

Answer:

Based on your eGFR you would not yet need dialysis but there are other factors that go into making a decision about need for dialysis and it is not based solely on a single lab result. I think you should be seen by a nephrologist (kidney specialist) in order to determine if there is anything reversible and to review your medications and diet and BP control. The kidney specialist can also decide with you the need and timing of dialysis if it comes to that. Good Luck!

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Response by:

Thomas   Zipp, MD Thomas Zipp, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University