My husband’s numbers

[PamelaSC]

Finally posting numbers. Mostly just the ones that don’t fall within the “normal range”.

eGFR = 26

Creatinine = 2.5

BUN = 30

Phosphorus = 4.8

And the following are different tests than what I usually see posted/mentioned but the nephrologist requested testing for. I looked them up and made notes:

Free Kappa Light Chains,Urine

(Normal 0.14-2.42 (mg/dL)

) = 6.6

Free Kappa/Lambda Ratio,Urine

(Normal 2.04-10.37 (ratio)

) = 28.7

These look for myeloma. But myeloma is indicated if the chains are monoclonal and Rick’s were polyclonal. But I’ve read that high polyclonal numbers can hide monoclonal. Need more info

ANA and complements C3 and C4 were negative. These are usually up if there’s something autoimmune is going on but ANA can be false negative Need more info.

We’re still waiting on echocardiogram results. Repeat blood and urine is being done Wednesday the 18th.

Do these numbers mean anything to anyone? I do need more info. Is creatinine the same as creatine? I’ve seen where it’s bad if creatine is double normal.

Help please.

[RickHow]

Obviously the first set of numbers you posted relating to kidney (gfr, etc.) are not great.

The second set of tests (regarding kappaxxxxxx) is a measurement of a type of protein that may be present in the urine (a simplistic definition, but is better than the technical one).

The ratio of kappa to lambda is important . When one level (kappa or lambda)is high and the other is low, this is an indication of active myeloma. If both kappa and lambda are increased, it can show a disease other than myeloma (like kidney disease). Again your husbands numbers are not great. You are obviously under a doctors care and have to follow his/her direction.

Creatine is a substance found in muscles. It also can be taken as a pill supplement. Creatinine is a waste product produced by the muscles. Think of it this way. The muscle contains Creatine. As that Creatine interacts with other "chemicals" in the muscle it creates waste that goes into the body. The kidney filters out this waste product. So when you have a blood test it measures how much Creatinine is in the blood to see if the kidney is filtering out the right amount.

Best of luck to you and your husband with his health. Keep us informed. Rick

[PamelaSC in reply to RickHow]

I’m waiting to see a couple things. First is his echocardiogram. He hasn’t had one in 10 years. He had a virus in 1998 that caused almost immediate CHF and cardiomyopathy. In ‘09 his echo was still low and the doctor said if it went lower they’d start talking about an implantable defibrillator. Rick didn’t want that so he never went back. (He hates doctors: his words). He hadn’t had any blood work done from ? - before we moved here in 2007 - until 2014. At that time his fasting glucose was around 350 but the doctor didn’t mention it. Same in 2015. Finally a new doctor noticed in 2016 and he was diagnosed with T2D. How long he’s had it we have no way of knowing.

He’s getting repeat blood/urine in 2 days then we see the nephrologist on Oct 7. I want to ask her about the light chain stuff especially since they were polyclonal.

So far the only diet changes have been to cut sodium to <2000mg/day. Also, i’ve Been reading that you shouldn’t be taking Metformin if your eGFR is under 30

So much info! So much to process!

[RickHow in reply to PamelaSC]

You may have read this publication about Metaformin if you have CKD. But I send you the link in case you have not. ncbi.nlm.nih.gov/pmc/articl...

Considering all your husbands health difficulties the small risk of taking metaformin with CKD seems well worth it considering the benefits. I think the article said something about 6 out of 100000 develop a problem. But your kidney doctor will explain it all and decide what to do. Regarding the polyclonal kappa light chains it is usual to have that if you have reduced renal function. Clearly from the numbers you posted your husband has CKD, and you say T2D, and you mention cardio related problems. It is good and natural that you seek all the information you can find so you are an educated "patient".

However sometimes it is too overwhelming. Wait for the kidney doctor and results of the upcoming blood/urine tests. You on your own, and stories we all post in response, are not going to find some magic solution to the problems. That is for the doctors. No matter how knowledgeable you become, again it all boils down to he has CKD and T2D and the doctors will develop a treatment plan.