General blood test - do I need to worry (not that it helps!)

[Bluey-1]

Urea & electrolytes

Serum sodium level 142 mmol/L (133.0-146.0)

Serum potassium level 4.5 mmol/ (3.5-5.3)

Serum urea level 6.7 mmol/L (3.5-7.2)

Serum creatinine level 86 urology/L (49.0-90.0)

EGFR. (F) 1.73M2

eGFR using creatinine (CKD-EPI) per 1.73 square metres 60 mL/min (60.9-200.0)

…results above noted as ‘abnormal’ and ‘need to speak to doctor’. I’ve an appointment booked for Monday. Just thought I’d ask your views as to what they might mean. I’m wading through the explanations linked to each result on the app but I’m unclear of any implications.

[DorsetLady PMRGCAuk volunteer]

My last ones came back as similar - with comment satisfactory - No Further Action. But as you are younger than me it might they might be slightly concerned that EGFR. (F) 1.73M2 falls into this comment -

"This result suggests Stage 3 CKD".

First time mine did I had just started on Pred and aged 63 - GP wanted to talk to me, just to advise, no action required. Now 13 years later it's still the same - so no panic...

[Bluey-1 in reply to DorsetLady]

Thanks DL. I can discuss on Mon with doc. Medical week next week - six monthly optometrist appoint Tues, bloods booked Thurs for rheumie appointment the following week. It’s all go with GCA…

[DorsetLady PMRGCAuk volunteer in reply to Bluey-1]

Certainly is! Still, stops you getting bored 🤣😂

[Bluey-1 in reply to DorsetLady]

How I long for GCA boredom! Went to docs for bloods yesterday (v efficient, results on app today) and was so pleased it had been several weeks since I’d been in to the practice. There have been times over the last year I’ve felt I’ve lived there.

[DorsetLady PMRGCAuk volunteer in reply to Bluey-1]

Know all about that -there was a time when either late hubby or I were there every week!

[piglette]

your results are a lot better than mine. My GP just says check again at some point.

[Bluey-1 in reply to piglette]

I suspect my GP will say the same. They’re very thorough. Do you know if these results are linked to long term steroid use?

[piglette in reply to Bluey-1]

I reckon they are, although the GP said they were not. Mine were fine when I first got PMR. I am now level 3b chronic kidney disease.

[Bluey-1 in reply to piglette]

Mine are raised v slightly since the March test, classed then as ‘borderline and repeat test in 3 months’, hence yesterday’s results. Not sure what we can do about it. I’m on a healthy diet, although addicted to plain Greek yoghurt which I eat daily.

[piglette in reply to Bluey-1]

I am not sure there is much you can do apart from eating healthily.

[DorsetLady PMRGCAuk volunteer in reply to piglette]

Lower stages are age related as much as anything I think -mine haven’t got any worse during my time with or without Pred.

Stage 3 is classed as mild to moderate-see link - just needs monitoring-like many other things!

kidneycareuk.org/about-kidn...

[Bluey-1 in reply to DorsetLady]

Thanks for the link. Very clear explanation

[DorsetLady PMRGCAuk volunteer in reply to Bluey-1]

Hopefully you’re not so worried now -just another thing to add to the joys of ageing.. but still better than the alternative 😊

[Bluey-1 in reply to DorsetLady]

I’m not thanks, just like to be up to speed before I see the doc on Monday. I cannot believe it’s almost a year since a fortunately, speedy diagnosis of GCA. It felt like a grim prognosis and brutal treatment but I am in a different place a year on as you all say. Recently had a relaxing week abroad, attended a brilliant gig in a large arena with friends and had a celebratory lunch for a friend’s birthday. I’m gentle with pacing to limit the fatigue days, am in no pain and basically trundle on, feeling more ‘me’ as time goes on. I take nothing for granted as there are still days where I trip up with a restless night and subsequent bone weary fatigue but things could be a lot worse.

[piglette in reply to DorsetLady]

I was not told my blood test result was not normal. I only discovered initially when they allowed us to see our results on-line. I came across the fact that I had had CKD for over two years. No one had said a word!

[DorsetLady PMRGCAuk volunteer in reply to piglette]

Sounds about right! 🤔

[Bluey-1 in reply to piglette]

That’s terrible. At least the online results are now available, although not for all across the country. It depends on the GP practice, such a postcode lottery across the country

[piglette in reply to Bluey-1]

The trouble is the on-line result info is a bit limited. My medical centre also expects us to contact them about the results.

[Bluey-1 in reply to piglette]

True, my GP added a message to contact surgery to discuss results.

[Temoral in reply to DorsetLady]

Same for me. I was a bit concerned initially, but readings have so far stayed tge same.

[Lonsdalelass in reply to DorsetLady]

Great link DSL, as always thanks very much!

[EdithWales in reply to DorsetLady]

Thank you so much, the GP wants to talk to me about my levels which has sent me into my normal hysterical hypochondria despite what himself, like you, says it’s mainly age related. I have felt dreadful for months and telling everyone I was severely depressed, not like me, also very cold, very tired and falling asleep. General diagnosis from my medical family is what do you expect from everything associated with selling the family home? Stop your moaning and you drink too much

Then the Pharmacist from the Practice rings me to say there is a problem with my thyroid levels and I need to increase my dose. Eureka! Of course there is, typical symptoms. That’s the problem with our disease, it’s blamed for everything and all the time it’s something very common and easily treatable.

The article is excellent

Thank you again x🥂🥂

[DorsetLady PMRGCAuk volunteer in reply to EdithWales]

Sorry to hear that -and yes we can become too preoccupied with one illness -and don’t look at the fuller picture .. Now why does that sounds ominously like we say about some our doctors 🤔..🤣😂

[Merryfield in reply to piglette]

oh no, piglette

[Grammy80]

I tapped to reply--- and saw that DL had the matter wrapped up....and it was as if she was speaking for me too. I can understand why they would want to explain your labs, but I've had a low EGFR (38-40..States readings), Stage 3 since 2019. Like DL, no discomfort or problems, no UTIs....I just make sure I drink as much water as iced coffee!!! My best💞

[PMRpro Ambassador]

What of that is abnormal? I can't see any there that is abnormal - even the eGFR at 60 is just in normal range and is perfectly acceptable for someone over 70. The computer that marks them as out of range doesn't take age into consideration - but for adults over 70, even eGFRs under 60 are OK.

I have told this story before: the eGFR was a research tool developed to see if it was possible to screen for kidney disease before the patient had symptoms and the intention was never to release it to GPs and patients without a lot of validation. But some group or other decided it should be released for public consumption. The result has been that the results are relative to someone young and healthy without considering it is perfectly normal for GFR to fall as you age and what is normal, not kidney disease, at 70 would be of serious concern in a 35 year old. Without that context, some GPs and more often nurses in a practice tell patients that they have kidney disease, scaring them to death, when in fact they are just a bit older.

What had you eaten the night before the blood test? And did you go for the blood test without having drunk much? A decent steak for dinner and nothing to drink before the blood was taken will give a high creatinine - and low eGFR.

[Bluey-1 in reply to PMRpro]

Interesting and informative, thank you. Funnily enough, while discussing this with a friend tonight I said that I suppose our kidney function isn’t generally as great as it would have been when we were young. On the morning of the test I had my usual yogurt, spinach, cucumber and avocado smoothie for breakfast, a cup of tea and a coffee. Can’t remember what we had for dinner the night before.

[DorsetLady PMRGCAuk volunteer in reply to Bluey-1]

Like most things -kidney function isn’t as good as it was… it’s called ageing! 😊

[PMRpro Ambassador in reply to DorsetLady]

In one!!!!

[Rebecca6 in reply to Bluey-1]

Does spinach not block absorption of nutrients from other foods? I ask because I really don't understand oxlates (?) but someone on here probably does.

[Bluey-1 in reply to Rebecca6]

I’ve no idea. I’ve been having a few leaves a day in a smoothie for breakfast. Can anyone enlighten me?

[DorsetLady PMRGCAuk volunteer in reply to Rebecca6]

It can affect the absorption of calcium which is why you should leave time between eating that and Vitamin C supplements

Found this online -

Did you know that raw spinach contains oxalic acid, an organic substance that can interfere with the absorption of essential nutrients like calcium and iron? Oxalic acid binds with calcium, making it unavailable for use by our bodies.but breaks down under high temperatures. So cooked -or blanched -is better.

See this post re timings of meds/supplements etc - does get a mention -

healthunlocked.com/pmrgcauk...

[Bluey-1 in reply to DorsetLady]

I take one CalciD plus a K2 tablet with my evening meal so that’s fine. Thank you

[Rebecca6 in reply to DorsetLady]

Thank you.

[PMRpro Ambassador in reply to Rebecca6]

"Oxalates in green leafy vegetables, tea, beans, nuts, beets—can bind to calcium and prevent it from being absorbed. Phytates (phytic acid) in whole grains, seeds, legumes, some nuts—can decrease the absorption of iron, zinc, magnesium, and calcium."

[Rebecca6 in reply to PMRpro]

Thank you.

[EdithWales in reply to PMRpro]

Thank you. Befuddled Brown Eyes Wales has been reading the posts out of sequence. Very reassuring and helpful as always 🥂🥂

[Koalajane]

when I was first diagnosed with diabetes 6months after my PMR diagnosis my urine sample showed protein in it, I know I was eating a lot of protein but not sure if related.

I was sent to see a kidney consultant who had loads of blood taken and said he wasn’t concerned. At my next appointment, after seeing all the blood results, he discharged me. In his letter to the GP he asked for me to have 6 monthly blood tests to check my kidney function. I normally have my blood tests in the morning but on one occasion I went late afternoon, having been out all day with not drinking much. I was called back for another blood test.

Since then they have all been at 9.30 after having drunk 2 mugs of tea and water through the night. I have had no problem since. My diabetic nurse said to me that it can fluctuate and it is best to have them taken at around the same time after drinking a fair bit, not alcohol!

[PMRpro Ambassador in reply to Koalajane]

Yes, if you are a bit dehydrated the blood level is artificially high and if you ate lots of protein the creatinine level is also raised - add the 2 together and it can look bad ...

[EdithWales]

Thanks Bluey. You are not alone, see my reply to DorsetLady 🥂

[Bluey-1 in reply to EdithWales]

I never thought I’d have to do so much medical admin/research since retirement. This forum and especially DL and PMRpro have been essential supporters as I’ve tried to get a handle on GCA. To be fair, when I was whittling about some twinge / fleeting headache my rheumi did say not everything is linked to GCA. It’s hard though not to get neurotic about every ache - although I think I’m getting slightly better. I’ve found since taking a low dose of Mirtazapine I’m less anxious and sleep has improved. I’ve been sent blood bags to have regular CRP/ESR tests which helps track things as well, plodding on basically…

[EdithWales in reply to Bluey-1]

That’s good about getting regular tests, since Covid getting routine work done is getting more difficult. I don’t have trouble sleeping, I think when my extra thyroid takes effect I will bounce back. Take care

🥂