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Dehydration Question - Lab results

toadqueen
toadqueen Posts: 592 Member
edited December 2024 in Social Groups
I had some recent lab work that has me a little concerned. I will be seeing 2 doctors next week, including my primary care but I wanted to know if any one else has similar findings and get ideas on how to improve results. I think they mean that I am dehydrated. I started strict LCHF in early August.

May August
Urea Nitrogen 23 26 (High)
Creatinine 1.03 1.08 (High)
BUN/Creatinine Ratio N/A 24 (High)
EGFR Non Afr Amer 62 58 (Low)
HDL Cholesterol 60 38 (Low)
Ketones Negative 2+ (I think this is what I want?)
Hemoglobin A1C 6.6 6.4

A recent CT scan (Aug) showed no hydronephrosis or nephrolithiasis. No hydroureter or ureterolithiasis. Left parapelvic cyst noted. Could the cyst be having an impact?

I used to have similar kidney function results in years past when I ate LCHF and doctors always scared me into stopping. I can't stop because when I increase carbs, I get awful edema and bad digestive issues. Years ago when I had the similar results, I was drinking a much higher volume of water, about a gallon a day. Now, I am drinking to thirst and it is about a quart a day. I am going to increase my water, but is there anything else I could/should do?

I have intestinal absorption issues resulting from a major car accident surgery reducing my small intestines to less than 5 feet and am on a low FODMAP diet at the recommendation of a gastroenterologist which is helping my abdominal pain. I also have Hashimoto's Thyroiditis, a microprolactinoma, food sensitivities, and possible lymphedema. I eat meat (poultry, pork, beef, fish, lamb), fat, and salt and take Vitamin D, a probiotic, and Magnesium Citrate as supplements to thyroid and blood pressure (Lisinopril) medications.

TIA,

TQ

Replies

  • nvmomketo
    nvmomketo Posts: 12,019 Member
    I'm afraid I know very little about these issues but a bump may be in order. Hopefully someone else can help.
  • RalfLott
    RalfLott Posts: 5,036 Member
    I'm stumped, too, but I wonder if your kidney issues could be diabetes related.... How long have you had high blood glucose?

    In another recent thread, @nvmomketo recalled Dr. Bernstein writing about his kidney function improving dramatically after he switched to LC.
    http://www.diabetes-book.com/bernstein-life-with-diabetes/

    There's a recent discussion on the subject at tudiabetes.org:
    http://www.tudiabetes.org/forum/t/bernsteins-diet-with-kidney-disease/10060/12
  • nvmomketo
    nvmomketo Posts: 12,019 Member
    Bump
  • Riche120
    Riche120 Posts: 154 Member
    edited September 2016
    I don't have much experience with your exact issues, but do have problems with digestion do to low stomach acid. I've found that taking digestion enzymes helps quite a bit with stomach pain. In my case I also avoid meat, (it used to give me horrible stomach pain) but that does make this way of eating quite a bit more difficult and isn't for everyone.

    The supplements that you are taking sound like they should help quite a bit.
  • Cheesy567
    Cheesy567 Posts: 1,186 Member
    Sodium, potassium, osmolarity, and hematocrit are more telling for dehydration...
  • KarlaYP
    KarlaYP Posts: 4,436 Member
    Elevated BUN/Creatinine is a sign of dehydration, usually. But, can also be an indicator of strain on the kidneys from protein intake (yep!).

    My recommendation would be to increase hydration slowly. If edema occurs, you've got a problem beyond hydration. If urination increases, as it should normally, you should be good to continue increasing hydration to levels where your comfortable, and not having to urinate to the point that it's inconvenient.

    I assume you have labs drawn every three months? That should be enough time to see a change in BUN/Creatinine if it's hydration that's causing the highs. @KETOGENICGURL might have some information on the protein side of things if it's not just hydration.

    Best of luck with this! I'm sending good thoughts your way for this to be a simple fix!
  • RalfLott
    RalfLott Posts: 5,036 Member
    Cheesy567 wrote: »
    Sodium, potassium, osmolarity, and hematocrit are more telling for dehydration...

    What if you're taking sodium and potassium but just not much fluid?
  • RalfLott
    RalfLott Posts: 5,036 Member
    Karlottap wrote: »
    Elevated BUN/Creatinine is a sign of dehydration, usually. But, can also be an indicator of strain on the kidneys from protein intake (yep!).

    My recommendation would be to increase hydration slowly. If edema occurs, you've got a problem beyond hydration. If urination increases, as it should normally, you should be good to continue increasing hydration to levels where your comfortable, and not having to urinate to the point that it's inconvenient.

    I assume you have labs drawn every three months? That should be enough time to see a change in BUN/Creatinine if it's hydration that's causing the highs. @KETOGENICGURL might have some information on the protein side of things if it's not just hydration.

    Best of luck with this! I'm sending good thoughts your way for this to be a simple fix!

    Good tips, @Karlottap.

    @toadqueen - Grasping at straws here....

    Any possibility of meds or med-supplement interactions being involved? I'm sure you know that various meds can work a diuretic effect, and if you're not eating carbs due to edema and only drinking a quart a day, that combo alone does sound suspicious...

    Any improvement yesterday with more fluids?

    As I am learning with my father-in-law (just turned 90), your thirst batteries wear out over time. He's never thirsty, yet chronically dehydrated.

    Best of luck! Keep us posted, eh?
  • Cheesy567
    Cheesy567 Posts: 1,186 Member
    RalfLott wrote: »
    Cheesy567 wrote: »
    Sodium, potassium, osmolarity, and hematocrit are more telling for dehydration...

    What if you're taking sodium and potassium but just not much fluid?

    Determining hydration status from labs doesn't depend upon intake. It's a snapshot in time of electrolyte and water balance, but corrections to the lab values aren't made based upon intake. The OP could post these lab values and perhaps get better feedback.

    You can't base hydration status on creatinine alone. There's too much that plays into kidney function.
  • toadqueen
    toadqueen Posts: 592 Member
    Thanks for the bump and the input.

    @RalfLott The high blood glucose is recent. I had been in the 5.8 - 5.9 range since around 2010 until the bloodwork in May. I have a history of diabetes where my A1C was 13 at one point that was resolved in 2009 when I went very low carb (Atkins) and lost almost 100 lbs. I will probably have to go back on Metformin to get the numbers down.

    @Riche120 My stomach pain is three-fold according to a recent doctor visit. I am taking Betaine HCl after most meals (low FODMAP) and wearing a compression garment on my abdomen. I need surgery to alleviate the 3rd factor (adhesions) and I do not think I can.

    @Cheesy567 - Those areas tested within range

    @Karlottap I increased my water intake from less than 16 oz to 64 oz yesterday. It has only been one day, but I have not noticed any additional swelling nor more frequent urination. I am not going to increase above this level unless I am thirsty.

    @RalfLott I added a new medication earlier this month at the advice of a gastroenterologist that may be having a diuretic effect. That is the only change. I am seeing my primary care doctor this week and will get her input. I hope that is it. I'll toss them all gladly even though I was prescribed a 3-month supply.

    All - I really appreciate the input. I went through this in 2012 and stopped eating LCHF because I was scared by a nephrologist. I had also been taking Lasix for water retention problems which she had me stop. I gained so much weight and suffered from extreme water retention. Then I stopped eating entirely. It actually helped, but I will not do that again.

    My body is so messed up from hormones, trauma, digestive issues, etc. I am just concerned about messing up my kidneys too.
  • RalfLott
    RalfLott Posts: 5,036 Member
    @toadqueen - That has got to be a maddening burden to bear. My admiration for your dedication and tenacity!

    If you do go back on Metformin and your insurance co will work with you, see if you can get an override for name-brand Glucophage XR.
    More here: http://community.myfitnesspal.com/en/discussion/10394798/t2d-glucophage-name-brand-metformin-generic
  • Cheesy567
    Cheesy567 Posts: 1,186 Member
    toadqueen wrote: »

    @Cheesy567 - Those areas tested within range

    Then it's less likely to be due to dehydration. The variations shown in your kidney function are pretty minor, many docs would probably monitor it over time to see if it's a consistent elevation in creatinine or drop in GFR, or if there's a trend of any sort. I understand your concern, though-- I have autoimmune issues myself, and worry a bit about the 'overtime' my kidneys and liver do in processing the meds and everything else. I tend towards dehydration because the main AI disease affects my swallowing, making it difficult to drink most liquids, and lately I've been seeing drops in kidney function with each flare. I hope you get some answers at your next appointment.
  • KnitOrMiss
    KnitOrMiss Posts: 10,103 Member
    Bumping this back up, as I recently had similar labs indicating dehydration over several tests (6 months apart on average). My ratio was like 34:1 or something crazy. I'll have to come back and read tomorrow to see if I am missing anything...
This discussion has been closed.