My labwork in reference to kidney function has been a bit screwy over the past few months and I'm wondering what the problem may be. I've been on TRT and lost over 30 lbs over the last 8 months and have been working out hard. My Dr. says he thinks it may be due to my weight reduction combined with my hard work outs. I don't think I work out harder than the next guy. He also thinks I need to drink more water(I drink about a gallon per day as it is). Any input would be helpful.
Received bloodwork back today and my Chemistry shakes out as follows: BUN = 14 (7-25) Creatinine = 1.6 HI (0.6-1.3) GFR = 45 LO (>60 mL/min/1.73m2) BUN / Creat Ratio = 8.8 LO (10-28)
Thanks KS, I appreciate the information, especially in referece to sore or bruised muscles. I don't drink alcohol, but find the insight regarding NSAIDS helpful DJ. Once again, thank you both very much for the information.
No problem DJ, no I'm not African American; I did do some research and read that kidney function values can be different for African Americans. I am scheduled to go back in about three months to get checked again (along with other testing). The Dr. did say that he does see these types of readings every so often and as KSman suggested, he said it can be due to sore muscles. I've had it checked twice in the last six weeks with readings that were closer to normal the first time, but today I received lab results that I posted earlier. In your opinion, can HCG cause problems with kidney function? I'll ask that of both you and KS if you guys don't mind.
BUN = 24 (6-24) Creatinine = 1.62 HI (0.7-1.27) eGFR = 46 LO (>60 mL/min/1.73m2) BUN / Creat Ratio = 15 LO (9-20)
My creatine consumption contributes to a higher creatinine measurement. eGFR is determined by creatinine. Both of those will drop when I test again without creatine consumed for a week. BUN is at the upper limit however it was 32 in 2010 so the trend is my friend.
Your BUN/Creat ratio (15) looks to be good, however you have it as LO; any reason? You also say that your levels will drop when you stop consumption of Creatine for a week, which is good for the Creatinine, but wouldn't you want your eGFR reading to go up? My concern is, how do I get my eGFR levels up to or over 60? In reference to my Creatinine, I don't supplement with Creatine, so I'm stumped as to what my options are? and, am I being Paranoid / over concerned?
Creatitine clearance is a measure of RBC destruction and other cellular death. Issues with this can result from tissue (Muscle tissue) destruction but also when the Renal (Kidney) Pressure gets so high that it ruptures the RBC's during the filtration process that the kidneys provide.
Now HCG results KSman could attest to cause he is very knowledgeable, however I do believe it will cause increased RBC production which could result in higher RBC destruction.
If it continues to run high ruling out Kidney damage is always the biggest concern.
RBC lysis affects bilirubin NOT SCr. There is no probable mechansism by which HCg would increase SCr on its own. Muscle mass, protein intake, and, yes potentially creatine intake, may affect SCr. But DJHT is very right on one point... you are taking a risk by interpreting this data on your own as the potential for serious renal issues is nothing to take lightly.
You said they are the same thing. I never said they are the same thing.
I am stating fact not assumptions. Creatinine is the direct metabolite of Creatine and is cleared by the kidneys.
Creatinine is a break-down product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). In chemical terms, creatinine is a spontaneously formed cyclic derivative of creatine. Creatinine is chiefly filtered out of the blood by the kidneys (glomerular filtration and proximal tubular secretion). There is little-to-no tubular reabsorption of creatinine. If the filtering of the kidney is deficient, creatinine blood levels rise. Therefore, creatinine levels in blood and urine may be used to calculate the creatinine clearance (CrCl), which reflects the glomerular filtration rate (GFR).
You want them to measure less Creatinine ? You stop dumping Creatine into the system and retake the test. Worked before, I will find out next week if it works again.
eGFR is simply our ( age and race / creatinine score ) so as Creatine input goes down, creatinine score goes down while eGFR the numerator remains the same, with smaller divisor ( creatinine ) so your eGFR goes up and back into the normal range.
If I was not taking Creatine I would stop working out for 72 hours and consume little meat and see if that would reverse the trend back toward the normal range and reassess from there.
No I am a consultant and charge a lot of money for the work I do. Anything related to my health I pay out of pocket for myself as the doctors are not interested in doing anything more than basic labs infrequently. ( Major medical covers 'Major' problems I try not to pay for that myself. ) I paid for 3 pages of labs with directlabs on the last go around. I paid $1500 for 10 pages of labs 2 years ago with many smaller collections in between. The kidney do-over is a narrow targeted metric which my doctor agreed to write the script for after I presented him with the directlabs results. I now summarize 10 years of bloodwork into a graph and present that to my Doctor. I have been 1.6 before and expect to nudge it back down again.
Fyi - my blood work basically matches those of his. I dropped the creatine and my creatinine levels got better.
As well, as KSman say to be aware of sore or bruised muscles if you are doing your testosterone im there is also some breakdown due to the needle injection and even moreso if you are doing more than one injection per week.
Thank you. Same result here. Plus the eGFR will go up which you want simply because it is calculated by dividing creatinine score into your age or age adjusted for race. eGFR is not a measure it is an estimate.
Once again, thanks for the information Hired Gun , I'm going to withhold from working out for at least 72 hours prior to my next blood work up based on your reccomendation, it makes sense due to the fact that my kidney function numbers were never an issue until I started hitting the weights hard again. I've also been on a high protein / low carb diet for quite some time so I will abstain from large amounts of protein intake prior to next blood draw as well. As I said, I don't supplement with creatine so that is N/A regarding my issue. George, good information, I'm doing twice per week injections, so I'll take that in to consideration along with soreness of muscles after workouts.
Its kinda timely that this GFR issue has come up as I too am trying to get my GFR above 60. It is now 52.
At first we felt I was chronically dehydrated. I drank a lot of coffee and not much outside water. I dropped the coffee to 1 cup in the am and starting consuming 1 gallon of water a day of which 1 quart was cranberry juice. Did this for one week. Retested my GFR and there was no change. Still 52.
My BUN/CR ratio did go from 20 to 16.4.
Serum creatinine remained the same - 1.4
Also, I did not train at all for 5 days prior to these tests. My ALT went from 165 to 107. AST went from 147 to 92. Still elevated but better and the conclusion was due to no training (and no im injection during the 5 day period)
My MD wants me to drop ALL supplemental protein and any other isolated amino acids and replace with whole food and retest in one week to see the effect on my GFR. I take in about 100 grams of supplemental protein and about another 110 from whole food. I have no idea whatsoever if this will matter to my GFR
George, It looks like your BUN/Creat ratio (although still in the good range), is going in the wrong direction. What is your eGFR reading? My Dr. basically stated the same as yours regarding dehydration, so I'm doing the same as far as taking in more water on a daily basis. Your Creatinine seems minimally high. What has your Dr. said the course of action would be if the numbers don't improve?