Comparative renal function test, liver function test and lipid profile results for December 2012.
I had my blood extracted and a KUB (kidneys, ureters and bladder) ultrasound on 17 December at University of Malaya Medical Centre (UMMC) and went back to the Rehabilitation Medicine Clinic on 26 December for the review. Serum creatinine increased slightly but is not significant. However, urea is markedly elevated from 7.5 mmol/L in February 2012 to 9.3 mmol/L in June 2012 and to 10.7 mmol/L in December 2012. I suspect it could either be caused by Lipitor or the fish oil that I have been taking.
KUB Ultrasound Report for December 17, 2012
Both kidneys are increased in echogenicity.
Right kidney measures 9.6cm in bipolar length.
Left kidney is small in size measuring 7.7cm.
No calculi or hydronephrosis.
The bladder wall is trabeculated.
1. Renal parenchymal disease.
2. Trabeculated bladder secondary to neurogenic bladder.
As for the KUB ultrasound. the findings showed no significant changes from the previous one done in November 2011. I am scheduled to see a nephrologist in March 2013 for a review of my kidneys with a renal function test and liver function test done prior to that. In view of this, I have unilaterally decided to stop taking Lipitor until then to see if it affects my serum urea level. Other than that, I am quite happy with the results of the blood tests and ultrasound of the kidneys and bladder.
Tags: atorvastatin calcium, blood test, Crystalline Atovarstatin Calcium, echogenic kidney, high serum creatinine, kidney failure, lipid profile, Lipitor, liver function test, neurogenic bladder, PPUM, Pusat Perubatan University Malaya, renal function test, renal parenchymal disease, ultrasound, UMMC, University Malaya Medical Centre
In 2004, I was diagnosed with Stage 3 Chronic Kidney Disease with a serum creatinine of 188 umol/L. At this stage, the kidneys are moderately impaired with decreased function to filter out waste products from the bloodstream. The urologist put me on 1mg Detrusitol twice daily and advised me to continue perform clean intermittent catheterisation (CIC) every four hourly which I have been doing since 1991. That is to reduce the occurence of urine reflux back to the kidneys and damaging them further.
By the following year, my serum creatinine climbed to 262 umol/L and bumped the diagnosis to Stage 4 Chronic Kidney Disease (CKD). I have been living with Stage 4 CKD for the past seven years. At Stage 4, there is advanced kidney damage. It is likely that I will need dialysis or kidney transplant in the future. There are five stages of chronic kidney disease altogether. Stage 5 CKD is known as end stage renal disease (ESRD). This is the final stage of kidney disease where the kidneys have lost almost all their function and dialysis or kidney transplant is needed to live.
I have not thought much about how serious my kidney failure was until recently when I read up more on this disease. At Stage 4, my kidneys are teetering on the brink. Dr. Liong, the urologist at Lam Wah Ee Hospital in Penang, had warned me that life will be difficult not only for me but the family as well should I need to undergo dialysis. It will be a drain on finance and time. Each dialysis treatment costs about RM200.00, requires four hours and has to be performed three times per week. That was the reason he kept reminding to mantain my remaining kidney function as much as possible by catheterising religiously, cut down on protein intake and avoid red meat.
My low-potein diet is basically two matchbox-sized portions of meat per day. I am also to cut down on the intake sodium, phosphorous and purine. High phosphorous level in the bloodstream causes itching. I cut down on the consumption of carbonated drinks, dairy products, peas, beans, nut and chocolates. Purine is metabolised into uric acid. My kidneys are unable to keep the uric acid level optimal. This could lead to gout. To prevent this condition, I avoid spinach, cabbage, cauliflower, organ meats, sardines and mackerels.
Stage 4 CKD is associated with a host of symptoms that I have been experiencing for the last few years. I get exhausted easily because of anemia which is common in people with kidney disease. This condition is exacerbated by the fact that I also have alpha thalassemia trait that causes anemia and small red blood cells. The other apparent symptom is short attention span. This could be the reason why I have been unable to finish the books I have been reading and the lack of updates in this blog lately. I just could not keep my mind focused on one single task long enough to see it to completion.
Chronic kidney disease increases the risk of cardiovascular disease. This is already manifested by my undesirable cholesterol levels that necessitated the long term use of Lipitor to bring my cholesterol under control. The good news is that the electrocardiogram done in November last year did not show any problem with the heart. The other good news is that after a two-month therapy of Lipitor, my cholesterol levels showed marked improvements. At the same time, I did not suffer the potentially kidney-damaging side effects associated with the medicine.
Considering that the sword of Damocles is hanging over my head where my kidneys are concerned, I am quite laid-back about it now as compared to when it was first diagnosed, not that there is much I can do to reverse the condition. I can only slow down the progression of the disease by going for regular check-ups and following the advice of doctors and dieticians.
Of course there were the occasional anxieties, especially just before getting the blood test results or after indulging on more meat that I should. Otherwise, my daily routine is least disrupted. I am determined not to let it affect Wuan’s and my quality of life. It has not so far. My greatest hope is that the kidneys’ current condition will to hold for a long time to come. From the looks of the latest medical reports, there is a good reason for me to be cautiously optimistic. That aside, there is a nagging sense that I will be blindsided by a health condition I least expected, as if a Stage 4 CKD is not bad enough. Hopefully, that is just an overactive imagination working overtime.
Tags: Detrusitol 2mg tablet, Detrusitol SR 4mg, dialysis, end stage renal failure, kidney failure, kidney transplant, Lam Wah Ee Hospital, Lipitor, low-protein diet, renal diet, Tolterodine 2mg, Tolterodine SR 4mg, Tolterodine Tartrate
The results for the blood tests done on February 20 showed marked improvement in my cholesterol levels. At the same time, I do not seem to be suffering any side effect of Lipitor as evident from the renal and liver profiles. This is good news indeed. I am to continue with the 10mg daily dosage. The doctors scheduled another blood test in June just to be sure.
Since I started on the cholesterol-reducing medicine, I have cut down dramatically on pork in my diet and replaced that with fish, either salmon or threadfin. Additionally, it is supplemented with folic acid, Vitamin B complex, cordyceps, Omega-3 fish oil and CoenzymeQ10.
It may appear like I am taking too many pills and turning into a supplement junkie. Anything to keep my frail kidneys at it current functional levels. Besides, these supplements do not seem to be doing any damage to my health apart from making a big dent in my bank account.
Renal profile for February 20, 2012
Sodium 140 (139) mmol/L
Potassium 4.8 (4.8) mmol/L
Chloride 106 (105) mmol/L
Total CO2 25.6 (26.0) mmol/L
Anion Gap 13 (13) mmol/L
Urea 7.5 (7.8) mmol/L
Creatinine 273 (272) umol/L
Liver profile for February 20, 2012
Total Protein 78 (76) g/L
Albumin 39 (38) g/L
Globulin 39 (37) g/L
Total Bilirubin 7 (8) umol/L
Conjugated Bilirubin 2 (2) umol/L
Alk Phosphatase 78 (86) IU/L
ALT (GPT) 18 (17) IU/L
AST (GOT) 10 (15) IU/L
Gamma GT 13 (12) IU/L
Lipid profile for February 20, 2012
Triglyceride 1.0 (1.4) mmol/L
Total cholesterol 3.1 (4.7) mmol/L
HDL 1.01 (0.97) mmol/L
LDL 1.64 (3.09) mmol/L
Tags: atorvastatin calcium, CoQ10, cordyceps, Crystalline Atovarstatin Calcium, folic acid, high cholesterol, kidney failure, lipid profile, Lipitor, liver profile, Omega-3 fish oil, renal parenchymal disease, renal profile, ubidecarenone, ubiquinone, Vitamin B complex