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Forum Name: Renal Failure

Question: Diabetes and Renal Impairment.


 Emerald - Thu Dec 23, 2004 2:21 am

HI,
I am a Medical Student. I want to ask a question about my Mother. My Mother is 53 years old. She is Diabetic (Type-2) and Hypertensive. She also has Coronary Artery Disease with mild inferior wall ischemia. Her current drug therapy is:
Insulin NPH 16/14 units
Nitroglycerine 2.6 mg 2 times daily
Diltaizem 60 mg 2 times daily
Losartan 50mg 2 times daily.
Low Dose Aspirin 75mg daily.


She had UTI without any symptoms so was not recommended to take any medicine for that. However her Urine RE indicates that she is passing Albumin (+2) in urine.
To check the renal functions BUN and Creatinine were measured. The results are:

Blood Urea Nitrogen = 19 mg/dl
Serum Creatinine = 1 mg/dl

I want to ask:

1. Is her BUN and Creatinine levels within the normal range?
2. What is the normal range for the above?
3. Do these results indicate Renal Impariement?
4. Can passing albumin in urine be due to the Urinary tract infection?

On the Lab report the normal range for BUN was 4-15 mg/dl. Seeing this my Mother got really upset and thought that she was suffering from Renal Failure because her BUN is 19 mg/dl. However in Books and at other places I found the normal range of BUN to be 7-20 mg/dl. Which one is correct?
I also feel that she is a bit dehydrated and her protein intake during the last 2 months was high. For example she takes 2 egg whites everyday in breakfast and also likes and eat meat. Can this be a reason for the Lab results?
 Dr. Tamer Fouad - Sat Dec 25, 2004 4:44 am

User avatar Hello Emerald,

1. Is her BUN and Creatinine levels within the normal range?
2. What is the normal range for the above?
The best estimate of the normal range is the one specified in her test results. There are variations in the normal range depending on the test-kits and the procedure used.

3. Do these results indicate Renal Impariement?
Many medical authorities do not like to use the term renal impairment. The kidney is either in failure or not. Renal failure may be temporary (acute renal failure) or permenant (chronic). The results above do not indicate renal failure. A better estimate of renal function would be a creatinine clearance test. I would recommend it.

4. Can passing albumin in urine be due to the Urinary tract infection?
Ok. This is what I think is wrong with your mother. It appears that her dehydration has caused her BUN to rise slightly indicating that she will need proper hydration. The albumin present in her urine is most probably attributable to her diabetes. To properly assess her albumin a 24 hour urinary albumin test is required. This is important to exclude nephrotic syndrome.

Best regards,

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