Category Archives: Chronic Renal Failure

Festive Guilt

Braised pig trotter with fatt choy
Braised pig trotter with fatt choy, New She Lai Ton Restaurant, Ipoh.
Photo taken with the Samsung Galaxy S II.

With the festive celebrations over and done with, I can finally breathe a sigh of relief. It has been an especially difficult time for me. I had a hard time resisting all the good food that came with the ocassion. In fact, I worry that I may have over-indulged.

I need to seriously go back to the basics of my dietary requirements of low-everything; low-protein, low-sodium, low-purine, low-phosphorous, and now, low-cholesterol. Anything to preserve whatever renal function left in my kidneys.

Another blood test is due in two weeks. The doctors ordered it to check if Lipitor has any adverse effect on my liver and especially my kidneys. The most serious being rhabdomyolysis. This is the breakdown of muscle tissues that leads to the release of a huge amount of myoglobin into the blood stream and causes kidney failure.

The only side effect that I experienced so far was the first few days after I began taking the medicine. My philtrum and upper lips twitched incessantly. The twitchings stopped a week or so later. The blood tests shall reveal whether I suffered other subclinical effects.

On Lipitor 10mg

Until two days ago, my only medicine was Detrusitol SR 4mg for a neurogenic bladder. Yesterday, on the first day of 2012, I had to add one more to my daily medication for another health problem that has cropped up. My HDL and LDL cholesterol are not at their ideal levels. There is also the family history of heart disease. My father died of congestive heart failure.

The lipid profile done on November 18, 2011 was not too positive. My HDL cholesterol was 0.97 mmol/L and LDL cholesterol was 3.09 mmol/L. The ideal ranges should be above 1.10 mmol/L and below 2.59 mmol/L for the HDL and LDL respectively. In short, I have high cholesterol!

Lipitor 10 mg crystalline atorvastatin calcium
Lipitor 10mg (atorvastatin) daily to treat my high cholesterol.

Taking into consideration the family history, the undesirable levels of both HDL and LDL cholesterol and the fact that I lead a very sedentary lifestyle, I was advised by Dr. Kumaran of the UMMC Spinal Rehab Clinic to go on atorvastatin therapy. This is to keep my cholesterol levels in check and lower the risk of heart attack and stroke later on.

I took my first dose of 10mg Lipitor (crystalline atorvastatin calcium) last night just before bed. The serious side effects of taking Lipitor include muscle problems that could lead to kidney failure, and liver problems. A blood test to check on my liver and renal functions is scheduled in February. Hopefully, Lipitor will not exacerbate my existing kidney problem. I am keeping my fingers crossed.

Blood Tests, KUB Ultrasound and ECG for November 2011

I went for my schedule medical checkup at the University Malaya Medical Centre Spinal Rehabilitation Clinic on Wednesday. The good news is that the renal and liver profiles did not show significant changes. Serum creatinine has gone down to 272 umol/L from 291 umol/L in July 2011.

Renal profile for November 18, 2011

Sodium 139 mmol/L
Potassium 4.8 mmol/L
Chloride 105 mmol/L
Total CO2 26.0 mmol/L
Anion Gap 13 mmol/L
Urea 7.8 mmol/L
Creatinine 272 umol/L

Liver profile for November 18, 2011

Total Protein 76 g/L
Albumin 38 g/L
Globulin 37 g/L
Total Bilirubin 8 umol/L
Conjugated Bilirubin 2 umol/L
Alk Phosphatase 86 IU/L
ALT (GPT) 17 IU/L
AST (GOT) 15 IU/L
Gamma GT 12 IU/L

The cholesterol levels are not too encouraging though, especially when there is a history of heart problem in the family. My father passed away from congestive heart failure. I was advised to go on the lowest dosage of Lipitor (atorvastatin calcium) which is 10mg to keep the cholesterol levels in check.

Lipid profile for November 18, 2011

Triglyceride 1.4 mmol/L
Total cholesterol 4.7 mmol/L
HDL 0.97 mmol/L
LDL 3.09 mmol/L

The ultrasound of the kidneys, ureters and bladder report is somewhat similar although the length of the left kidney size was measured at 8.9cm this time as compared to 9.1cm in December 2010 and 6.89cm in February 2004. There is an inconsistence in the three reports, with the 2010 report being the odd one regarding size of both kidneys and the position of the cyst.

KUB Ultrasound Report for November 18, 2011

Findings

Comparisons made previous ultrasound dated 27.12.10
Both kidneys are normal in size but with increased echogenicity
The right kidney measures 9.5cm in BPL and 0.6cm in cortical thickness
The left kidney measures 8.9cm in BPL and 0.5cm in cortical thickness
There is a small cyst seen in the upper pole of the left kidney measuring 1.0cm
The bladder wall is trabeculated
Prostate is normal in size with smooth outline

Impressions
Renal parenchymal disease
Left renal cyst
Trabeculated bladder secondary to neurogenic bladder

Electrocardiograph (ECG) for November 30, 2011
Electrocardiograph (ECG) for November 30, 2011.
Photo by Wuan with Samsung Galaxy S II.

I also had an electrocardiogram (ECG) done on the same day as the checkup. According to the doctors, the results did not show any problem which is a relief.

ECG figures for November 20, 2011

Rate 88

PR 152
QRSD 94
QT 380
QTC 460

AXIS
P 62
QRS 90
T 67

Overall, I am happy with the blood test results except for my cholesterol levels. Renal and liver profile tests will be done two months after I have started on Lipitor to check whether these organs are effected by it. A urodynamics study is also scheduled in the first quarter of next year to determine the pressure in my bladder. It was last done in 2008 at Subang Jaya Medical Centre.