Renal and Liver Function Tests, Lipid Profile and KUB Ultrasound for December 2012

Blood test results
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.

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.