I had blood extracted for a series of tests on 4th March 2013 before seeing the nephrologist the following week. They were Renal Function Test, Liver Function Test, Complete Blood Count, Lipid Profile, Nutritional Anaemia and calcium-phosphate test. It was to be my first time consulting a nephrologist at the University Malaya Medical Centre.

I went to see the nephrologist on 11th march 2013. Serum creatine broke the 300 umol/L threshold to hit 301 umol/L. It was unsettling to see the creatinine slowly creeping up the scale. Dr Wong, the nephrologist, explained that at some point in time in the future, I will need dialysis. I am at a pre-dialysis stage and need to be prepared for it. He explained the two options available to me – peritoneal dialysis or hemodialysis.

For hemodialysis, I need to go to a hemodialysis centre where I will be hooked up to a machine to have the waste product in my blood filtered. Each session lasts about four hours and has to be done thrice weekly. For this method, I have to have to undergo a surgery to create a fistula for blood to be extracted dialysis and then returned.

In peritoneal dialysis, a catheter is used to fill the abdominal cavity with dialysis solution. The solution draws waste from the body using the membrane in the abdomen called peritoneum as a filter. The waste is then drained away through the same catheter. This procedure has to be repeated every six-hourly and can be done anywhere.

A Complete Blood Count was also done to check on my anemia. The figures looked horrible with most of the blood elements tested coming in below the average ranges. Serum calcium-phosphate test show that I am hypocalceamia or low blood calcium concentration. There is no treatment recommended at the moment and I had to go back to see him in another three months which coincides with my appointment at the Rehabilitation Medicine Clinic.

However, Dr Wong suggested that I start on Ketosteril again and gave me two boxes to start off. That supply will last me forty days at two tablets twice daily. I had stopped taking it after I developed itching. I have been taking it for one month now and have not experienced any allergic reaction so far.

My LDL level went up because I stopped taking Lipitor for three months to see if it was causing the urea level to go up. Apparently, it did not as urea level was still high. I have since gone back to 10mg daily. I hope the next blood test will show better results.

Renal and Liver Function tests and Lipid profile done on 4th March 2013.

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

Findings
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.

Impressions
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.

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