cause of high bun & creatinine levels

[mamaw2ps]

my husband is 53 years old. He has had a lot of health problems. Testicular cancer, stroke, and 4 heart attacks. He has had numerous ct scans for the cancer, has had 4 heart caths. The last heart cath they had to admit him the day before and give iv hydration & mucomyst therapy to make sure his kidneys were flushed. He can no longer have the dye with his ct scans for the tumors because of abnormanl kidney levels. His last cath stated that he had chronic renal insufficiency. His labs last week said BUN 32, CREATININE 2.4. He is to do a 24 urine. He is a diabetic also. I am worried that his kidneys will worsen. How high does the bun and creatinine have to be before they look toward dialysis. I know when he had the 5 bypass surgery the kidneys were trying to shut down and at one point they discussed dialysis but then they picked up. Any help you be greatly appreciated. Thanks

[Dr. Chan Lowe]

Hi Mamaw2ps,

There are a number of things that can damage the kidneys causing the BUN and creatinine to increase. Diabetes is a definite possibility in your husband's case. Sometimes the actual cause is never identified.

The level of BUN or creatinine itself is not an indication for dialysis. Basically, when considering when to start dialysis one looks for symptoms related to the renal failure rather than the BUN or creatinine. Indications for dialysis include uremia (symptoms from a BUN that is dramatically elevated, which include itching and nausea/vomiting), elevations in potassium levels, too much acid in the blood or too much fluid in the body. Note that uremia is symptoms from the BUN so a BUN of 50 but with symptoms would be an indication for dialysis while a BUN of 75 without symptoms would not be an indication for dialysis.

Your husband needs close follow up with a nephrologist (kidney specialist). Hopefully, there will be some good treatments to help prevent renal failure and the need for dialysis.

Best wishes.