A1c down! BUN up :( How are your kidneys?

[Jan2306]

The good news: I was dx six months ago with an A1c of 16.3. Now six months later I got myself down to 7.0 with MDI. Yippie.

Coupled with feeling great about that is my anxiety about the health of my kidneys. My biggeset fear with having diabetes is kidney problems since 30% of us end up with some kind of problem including dialysis and transplants.

The lab results for my BUN (which measures how well your kidney is getting rid of urea waste, and basically how healthy it functions) went from 17 at dx to 19 and now 23. Average standard is 7-18. I'm seeing my endo end of next week and will talk about it but in the meantime I'm so anxious.

Does anyone have experience with BUN numbers, what the prognosis is, and most imporant, can you bring the number down?

[Cinnabon]

How is your creatinine level?

How much water do you drink daily?

[4519]

I have slightly elevated BUN numbers also. The doctor just said it was due to my high protein intake. It does matter what your other numbers are. Like Cinnabon ask, what are your creatinine numbers? That is important - if both are out of range then there might be more chance of a problem.

[am1977]

I know hearing about abnormal test results, we get a little anxious and worried- that's a very normal reaction. However, try your best not to stress out or imagine the worst case scenario. It's very likely that things will be okay & why worry unneccessarily?

Personally, I don't know that much about BUN or creatinine, but I do know that we do want to protect our kidney as well as possible. You may, like 4519, may be asked to reduce your protein intake, and also start on some type of medication as well...

I hope you will keep us posted with how everything goes-

Hang in there.

[Jan2306]

Thanks for responding. I didn't get my creatinine number so waiting to find out but I do know that it was within the normal range. So hopefully it's a ratio. As far as water, I try for 6-8 glasses a day but many days I'm only good for 3-4.

[Cinnabon]

Def. get your creatinine level. I know about the water... lol
I get real lazy with that, too. We have to drink water!!!! LOL

[kgm0612]

Congratulations on getting your A1c to drop down so much. Good luck with your endo appointment.

Karen

[trailrunner]

An elevated BUN is not always a sign of trouble. Your BUN can fluctuate from day to day depending on how hydrated you are. When I had my labs:) drawn in march my bun was elevated also, I had just gone for a run before. what truly matters for kidney function is your creatinine level. When you look at both BUN and creatinine that gives you a much better indicator of renal function.

[BriOnH]

When getting kidney checkups these are the things you want to keep track of:
- Blood Test -
Creatinine level - normal is .8-1.5 mg/dl. Creatinine is a biproduct of muscles. Body builders often have a creatinine level of 1.5-1.9 mg/dl. The kidneys filter creatinine out of your system, thus Creatinine levels is usually the golden standard for kidney function.

BUN - Normal is 10-20 Blood Urea Nitrogen - This is other waste that builds up in the blood and is excreted by the kidney's

- Urine -
Protien level - you do not want your kidneys to spill protein. With diabetics, when they constantly spill sugar out in their urine it starts to destroy (due to the pressure and acidity) the tips of the kidney cells (nephrons - these are quite fascinating cells.) Over time this causes those tips(Glumerous Capsules) to become bigger and bigger allowing essential elements to get past them and into the urine. Protein leaking out is a measurement of your kidney cells being worn and torn. A normal individual will show a trace amount of protein approx once every 24 hours for one bathroom trip(in that 24 hours). You can test this at home with chetostix

if protien is negative - Microalbumin determines if the start of kideny disease has happened. If this level is high you can intervene with medication and keep the kidneys running well and long.

Protein to Creatinine - this test is used in conjunction with your blood work to determine kideny function. There is a detailed formula for this level to your blood levels that I wont bore you with.

While a continual rise in your BUN is troubling, I would hardly think that it is anything to worry about. Instead its something you should be aware of. A BUN <35 is fine. a creatinine level of <1.7 mg/dl is also fine. When you cross the 40 BUN / 2.0 Creatinine levels and continue to spill protein is where you really need to start becoming very concerned for the well being of your kidneys. By the time you reach that point though the percentage of keeping your kidneys functional drops exponentially. My advice would be to just keep those sugars under control, exercise (if you can), and get rechecked in 1-3 months.

[Jan2306]

Thanks for all the great feedback. And wow Brian, you sure know know your stuff. Very informative and I definitely feel less anxious. Will report on my endo visit later this week.

[GOM]

Doc says we'll recheck in December. If it is still above 20 then, I might have to take meds to protect kidneys. Is there any way to lower my 22 before Dec? (Im hoping that increasing water intake instead of Diet coke and Diet Mtn Dew etc. could help.)

[Cinnabon]

Gom,
dont worry too much. I take BP med to protect the kids' (kidneys). It makes me feel a bit more secure to feel as If I am protecting them.

[June91]

I've got slightly elevated microalbumin levels and hopefully serious complications are not lurking around. Thank you BrionH for explaining in a few paragraphs what I've been trying to understand from reading a couple of books.

Gom,
dont worry too much. I take BP med to protect the kids' (kidneys). It makes me feel a bit more secure to feel as If I am protecting them.

Can anyone tell me if blood pressure meds protect kidneys in any other manner except by actually lowering blood pressure thus protecting blood vessels, arteries, etc. My endo seems intent on my taking them, but my blood pressure is always very low (90/50) and I get serious dizzy spells from the meds. I will take them if they will do something for my kidneys though.

[BriOnH]

Can anyone tell me if blood pressure meds protect kidneys in any other manner except by actually lowering blood pressure thus protecting blood vessels, arteries, etc. My endo seems intent on my taking them, but my blood pressure is always very low (90/50) and I get serious dizzy spells from the meds. I will take them if they will do something for my kidneys though.

It's the way that ACE Inhibitors lower blood pressure that makes it so effective in helping the kidneys. Ace inhibitors block an enzyme (The ACE II enzyme it blocks is just one of many cascading enzymes in this event) that tell the kidneys to filter out waste, now. By blocking this enzyme from catalyzing it reduces stress on the kidneys. Blood work needs to be taken to make sure the dose you are on is appropiate. Many dr's will send you off and not follow up with blood work; be safe and ask for labs. You don't want this drug to halt the kidneys too much, just reduce their filtration a little bit, so it can alleviate the strain on them, especially being diabetic when it's easy for us to spill sugar. If you have high blood pressure AND sugar coming out, this is super bad on the kidneys. If you put anything under high pressure and an excessive sugar solution, it will eventually destroy it.

Every diabetic that has diabetes for 20+ years will start to show some [increase in] microalbumin(uA) and some retinopathy. In little amounts, and with the great medications we have it honestly isnt to much to concern yourself with. And in regards to uA, this test is relatively new in the world of blood labs, it is simply a measurement that >indicates< (not confirms) that some kidney damage has occured. When you start spilling BIG protiens, on a consistant basis that is when you need to get worried, and take a serious lifestyle change.

[seacomp]

It's the way that ACE Inhibitors lower blood pressure that makes it so effective in helping the kidneys.
Brion's explanation is correct as far as I understand the issue. I just wish to point out that it is not all types of blood pressure medication that directly help the kidneys, but only the type identified as ACE Inhibitors.
Some people may not realize that there are multiple types of BP medication that have different modes of action. Diuretics, for example, are taken to help control BP, but don't have the kidney protecting quality.

[JasonSmithMT]

I just wish to point out that it is not all types of blood pressure medication that directly help the kidneys, but only the type identified as ACE Inhibitors.

The Angiotensin Receptor Blockers (ARBs), those drugs that end in "sartan", have the same end result in the renin–angiotensin system as ACE inhibitors and thus have the same renal protective mechanism. Whereas ACE inhibitors inhibit the formation of angiotensin II (AII), ARBs block the AII receptor on blood vessels. In fact one recent study I read suggested the most effective renal protective mechanism is to used them combined.

I am coming to this thread kind of late and don't have much to add that hasn't already been said. I wouldn't sweat the slightly elevated BUN level since you have a normal serum creatinine level. Dehydration and high protein diet are the two must common non-renal causes for a BUN result like that. I would file it as just one of those things to monitor periodically. If the numbers continue to be elevated a creatinine clearance test would probably be warranted.

Jason

[June91]

Thanks BrionH and JasonSmith for the detailed explanations I will use to further shame my endo so she prepares even harder for my visits. :-