Husbands last 2 labs

[alyce1949]

Could someone please make some sense out of these for me. My husband is 73 and in stage 4. Still only seeing his kidney doctor every 6 months. 7/3/2018 COMPLETE CBC WITH DIFF, COMPLETE CBC WITH DIFF, MAGNESIUM, RENAL FUNCTION PANEL, RENAL FUNCTION PANEL, RENAL FUNCTION PANEL

COMPLETE CBC WITH DIFF

Test Name Result Normal Abnormal Education

ABS. IMM GRAN 0.0 K/MM3 -

ABS. NRBC 0.0 K/MM3 -

AUTOMATED NRBC 0.0 #/100 WBC'S -

BASO 1.0 % (0-2) -

BASO # 0.1 K/MM3 (0.0-0.1) -

EO 7.7 % (0-6) HIGH

EO # 0.8 K/MM3 (0.0-0.4) HIGH

HCT 44.3 % (40.5-48.5) -

HGB 14.5 GM/DL (13.7-16.5) -

IMM GRAN 0.4 % (0.0-0.6) -

LYMPH 29.3 % (15-43) -

LYMPH # 3.0 K/MM3 (0.8-3.1) -

MCH 31.4 PG (27.0-34.0) -

MCHC 32.7 g/dL (33.0-37.0) LOW

MCV 95.9 FL (80.0-94.0) HIGH

MONO# 1.0 K/MM3 (0.4-1.3) -

MONOCYTE 9.3 % (4.5-10.5) -

MPV 12.9 FL (9.4-12.4) HIGH

NEUT 52.3 % (44-76) -

NEUT # 5.4 K/MM3 (1.3-7.0) -

PLT 292 K/MM3 (150-460) -

RBC 4.62 M/MM3 (4.70-6.10) LOW

RDW-SD 46.4 FL (<47.0) -

WBC 10.3 K/MM3 (4.0-11.0) -

MAGNESIUM

Test Name Result Normal Abnormal Education

MAGNESIUM 1.8 MEQ/L (1.3-1.9) -

RENAL FUNCTION PANEL

Test Name Result Normal Abnormal Education

ALBUMIN 4.0 GM/DL (3.4-4.8) -

ANION GAP 12 (4-17) -

BICARBONATE 29 MMOL/L (22-29) -

BUN 35 MG/DL (8-23) HIGH

CALCIUM 9.8 MG/DL (8.6-10.5) -

CHLORIDE 100 MMOL/L (98-107) -

CREATININE 3.0 MG/DL (0.5-1.0) HIGH

EST GFR AFRICAN AMERICAN 23 ML/MIN/1.73 M2 -

EST GFR NON AFRICAN AMERICAN 20 ML/MIN/1.73 M2 -

GLUCOSE 107 MG/DL (70-99) HIGH

PHOSPHORUS 3.4 MG/DL (2.5-4.5) -

POTASSIUM 4.4 MMOL/L (3.6-5.2) -

SODIUM 141 MMOL/L (133-145) -

5/22/2018 COMPLETE CBC WITH DIFF, COMPLETE CBC WITH DIFF, MAGNESIUM, RENAL FUNCTION PANEL, RENAL FUNCTION PANEL, RENAL FUNCTION PANEL

COMPLETE CBC WITH DIFF

Test Name Result Normal Abnormal Education

ABS. IMM GRAN 0.0 K/MM3 -

ABS. NRBC 0.0 K/MM3 -

AUTOMATED NRBC 0.0 #/100 WBC'S -

BASO 0.7 % (0-2) -

BASO # 0.1 K/MM3 (0.0-0.1) -

EO 5.3 % (0-6) -

EO # 0.5 K/MM3 (0.0-0.4) HIGH

HCT 42.3 % (40.5-48.5) -

HGB 14.2 GM/DL (13.7-16.5) -

IMM GRAN 0.4 % (0.0-0.6) -

LYMPH 27.3 % (15-43) -

LYMPH # 2.5 K/MM3 (0.8-3.1) -

MCH 31.6 PG (27.0-34.0) -

MCHC 33.6 g/dL (33.0-37.0) -

MCV 94.2 FL (80.0-94.0) HIGH

MONO# 0.9 K/MM3 (0.4-1.3) -

MONOCYTE 9.9 % (4.5-10.5) -

MPV 12.8 FL (9.4-12.4) HIGH

NEUT 56.4 % (44-76) -

NEUT # 5.2 K/MM3 (1.3-7.0) -

PLT 273 K/MM3 (150-460) -

RBC 4.49 M/MM3 (4.70-6.10) LOW

RDW-SD 46.8 FL (<47.0) -

WBC 9.2 K/MM3 (4.0-11.0) -

MAGNESIUM

Test Name Result Normal Abnormal Education

MAGNESIUM 1.9 MEQ/L (1.3-1.9) -

RENAL FUNCTION PANEL

Test Name Result Normal Abnormal Education

ALBUMIN 4.0 GM/DL (3.4-4.8) -

ANION GAP 13 (4-17) -

BICARBONATE 28 MMOL/L (22-29) -

BUN 36 MG/DL (8-23) HIGH

CALCIUM 9.3 MG/DL (8.6-10.5) -

CHLORIDE 100 MMOL/L (98-107) -

CREATININE 2.9 MG/DL (0.5-1.0) HIGH

EST GFR AFRICAN AMERICAN 24 ML/MIN/1.73 M2 -

EST GFR NON AFRICAN AMERICAN 21 ML/MIN/1.73 M2 -

GLUCOSE 119 MG/DL (70-99) HIGH

PHOSPHORUS 3.8 MG/DL (2.5-4.5) -

POTASSIUM 4.1 MMOL/L (3.6-5.2) -

SODIUM 141 MMOL/L (133-145) -

Any help would be greatly appreciated.

[Hidden]

My suggestion is to make an appointment with the physician who ordered the labs to have them explained to you until you and your husband understand them. If you have already spoken in person with the physician who ordered the labs contact another doctor, either his primary care physician or the nephrologist and ask for an explanation of the results.

If you'd like to check the tests and understand the results better on your own first use this website labtestsonline.org/tests-index

Without knowing more about your husbands' other health issues I couldn't give you the best information that will help you.

[MissMarvel]

Hi alyce. I’m new to CKD, and one of the most important and helpful things for me was doing my own personal research, and one main goal of that was to understand those numbers. I’ve definitely learned to not put my life and decisions about my life in the hands of anyone else. Including my doctors. I hope you get the answers you need and I wish you and your husband much peace and comfort.

[orangecity41 NKF Ambassador]

I am a male, age 77. I was diagnosed with Chronic Kidney Disease (CKD) level 3b, when I was 75 years old. I was put on a pre-dialysis diet and so far the progression of CKD has slowed down. Agree with Mr Kidney that best your Doctor gives an evaluation of your husband's levels. Many factors play into it I found for treatment, diet etc. I also have used the web site referred to for information. Also for some idea of questions to ask the Doctor about your concerns.

This is a good forum for support on CKD.

[Hidden]

It's been a while since I was on here earlier and I thought of something during the interval I was away. I'm not sure how much you and your husband may know about CKD and Stage 4 so I pulled this from my research and thought I would post it here for you and perhaps you can get an idea of what you are facing and some questions that need to be asked of your husband's nephrologist.

Stage 4 of Chronic Kidney Disease

A person with stage 4 chronic kidney disease (CKD) has advanced kidney damage with a severe decrease in the glomerular filtration rate (GFR) to 15-30 ml/min. It is likely someone with stage 4 CKD will need dialysis or a kidney transplant in the near future.

As kidney function declines, waste products build up in the blood causing a condition known as uremia. In stage 4, a person is likely to develop complications of kidney disease such as high blood pressure, anemia (a shortage of red blood cells), bone disease, heart disease and other cardiovascular diseases.

Symptoms of stage 4 kidney disease

Symptoms that are experienced in stage 4 include:

Fatigue

Fluid retention, swelling (edema) of extremities and shortness of breath

Urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal)

Kidney pain felt in their back

Sleep problems due to muscle cramps or restless legs

Nausea and/or vomiting

Taste changes, a metallic taste in the mouth

Bad breath due to urea buildup in the blood

Loss of appetite: People may not feel like eating, and some people report having a metallic taste in their mouth or bad breath.

Difficulty in concentrating: Having trouble doing everyday things such as balancing a checkbook or focusing on reading the newspaper can occur.

Nerve problems: Numbness or tingling in the toes or fingers is a symptom of CKD.

Seeing a doctor when you have stage 4 CKD

At stage 4, it’s necessary to see a nephrologist (a doctor who specializes in treating kidney disease). The nephrologist examines the patient and orders lab tests to gather information to recommend treatment.

People in stage 4 CKD will usually visit their doctor at least every three months. Blood tests for creatinine, hemoglobin, calcium and phosphorus levels will be done to see how well the kidneys are working. The doctor will also monitor other conditions such as high blood pressure and diabetes. In addition to helping the patient keep their kidneys working as long as possible, the nephrologist will also help prepare the patient for dialysis or a kidney transplant.

Looking at treatment options when you have stage 4 CKD

Those with stage 4 CKD who will need treatment are told about their choices, including:

1.Hemodialysis: This is a treatment that can be done in a center or in a patient’s home with assistance from a care partner. A dialysis machine removes a small amount of a patient’s blood through a man-made membrane called a dialyzer, or artificial kidney, to clean out toxins that the kidneys can no longer remove. The filtered blood is then returned to the body.

2.Peritoneal dialysis (PD): Unlike hemodialysis, PD is a needle-free treatment and a care partner is not required to help assist during treatment. PD can be performed at home or at work.

3.Kidney transplant: This is a preferred treatment and does not require as many diet restrictions as those who are on hemodialysis or PD.

Meeting with a dietitian when you have stage 4 CKD

A person in stage 4 may also be referred to a dietitian. Because diet is such an important part of treatment, the dietitian will review a person’s lab work results and recommend a meal plan individualized for their needs. Eating a proper diet can help preserve kidney function and overall health.

Diet and stage 4 CKD

For stage 4 CKD, a healthy diet is likely to consist of:

Reducing protein consumption to help decrease the buildup of protein waste

Consuming some grains, fruits, and vegetables (potassium and phosphorus are at normal levels)

Limiting phosphorus to help PTH levels remain normal, prevent bone disease and even preserve existing kidney function

Restricting potassium if blood levels are above normal

Lowering calcium consumption

Cutting back carbohydrates for those with diabetes

Decreasing saturated fats to help lower cholesterol

Lowering sodium for people with hypertension or fluid retention by cutting out processed and pre-packaged foods

Limiting calcium if blood levels are too high

Taking water-soluble vitamins such as vitamin C (100 mg per day) and vitamin B complex, or completely avoiding over-the-counter dietary supplements (unless approved by the nephrologist)

Medications and stage 4 CKD

It’s recommended that people in stage 4 keep their blood pressure at a healthy level and those with diabetes keep their glucose level under control. Taking all the medicines as prescribed by the doctor may help prolong kidney function.

Managing stage 4 CKD

In addition to eating right and taking prescribed medicines, exercising regularly and not smoking are helpful in maintaining health. Patients should talk to their doctors about an exercise plan. Doctors can also provide tips on how to stop smoking.

The National Kidney Foundation (NKF) guidelines recommend starting dialysis when kidney function drops to 15 percent or less. By doing everything possible to help prolong kidney function and overall health, the goal is to put off dialysis or transplant for as long as possible.

If you would like to see a doctor who specializes in the care of kidneys, called a nephrologist, you can use DaVita's Find a Kidney Doctor tool (davita.com) to locate a nephrologist in your area.

I hope you find some information here that will help you navigate the journey from here.

[Nannie-C in reply to Hidden]

Think you for that great reply explaining stage 4 and what’s probably ahead of me. I’m new to this as well and currently stage 3. Also have Polymyalgia rheumatica and AFib and hypertension for many years. Seeing renal consultant every 3months. Just had an iron infusion this week as due to Polymyalgia and kidneys reducing haemoglobin. So hoping this will help my fatigue as so worn out due to the various conditions, hardly able to walk or enjoy doing anything, but so fed up with it all, just been a case of what next.

[Hidden in reply to Nannie-C]

Glad we could help. Figure out which items you are dealing with and which are the most critical and what steps are available for you to take. Once you do that repeat the process for the next pressing item and repeat that process. When you come to a situation where there are competing plans for two different issues consult the appropriate medical professionals, get their advice and make the choice that you want as long as you understand the consequences of each decision. You're always welcome here to share and ask questions.

[Nannie-C in reply to Hidden]

Thanks for advice Mr_Kidney

[alyce1949]

Thank you all for your info. I guess I am just a might panicky at this point. He's got an appointment with his kidney Dr. in the next few weeks. I just wish he would have told us that this was progressing when it started. He has been going to a Nephrologist for years. He is a diabetic and on 25mg. of Metformin twice a day, high blood pressure 180 mg. diltiazem, 80 mg furosemide, fenofibrate 160mg, low dose aspirin, rescue inhaler, spariva respimat and albuteral inhillation when needed. So, diabetes is normal with meds, A1c is 6.4, blood pressure is 120/60 with meds, still urinating with help of furosemide (minimal foot swelling) , cholesterol is fine. I guess we have a lot to be thankful for. Thank all of you for helping us on this journey. Bless you all. Oh and he has none of the symptoms that Mr. Kidney wrote about.

[Bassetmommer NKF Ambassador]

HI Alyce, Everyone is correct about having the doctor explain all about the tests. One thing you could do to support your husband is finding out about renal diets. By changing what he eats, you can possibly slow the progression of CKD. There are many websites about kidney friendly food and what is good and bad but there is also a lot of conflicting information. The best thing is if you can visit with a renal dietician who will tailor a diet for your husband. It gets tricky with diabetes. davita.com/ is a good resource also. Best of luck.