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.

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.

Eat Now, Regret Right After

The chronic kidney disease has curbed my enthusiasm for good food since I was diagnosed with it in 2004. Mr. Liong, the urologist at Lam Wah Ee Hospital in Penang, gave me an advice that I remembered till today, that I should take good care of my failing kidneys, which if not, would cause a lot of undue hardship to my family when they fail totally and I need to go for dialysis. I took that advice to heart and have been keeping to a strict renal-friendly low-protein, low-sodium and practically low-everything to keep the decline in check.

I pride myself for adhering to having just two matchbox sized portions of meat daily most of the time. I also scrutinise the mineral contents in the food that I eat. As hard as I try, there have been occasions that I allowed temptation to get the better of me with the notion that I should reward myself with some taboo food for depriving myself for so long. So, I would tuck in the food and savour every mouthful like it was my last meal. Food never tasted so good.

And as always, inevitably, the moment I put down the cutlery, I would ask myself if I over-indulged. Did I eat more meat than I should? Was that gravy a tad too salty? I would regret even more should I start to itch and had to take anti-histamine tablets. I did say I stuck to the low-protein diet most of the time. Those other time I did not, I would be trouble over a period of time wondering if I overloaded my kidneys and tipped them over the edge.

I am writing this post because I have a scheduled blood extraction together with an ultrasound of the kidneys, ureters and bladder on Friday, and I am troubled by the few times I ate more than I was allowed to or did not catheterise as often as I should have. This is the same emotional cycle that I go through every time I have to go for blood tests and ultrasound. It would persist until I get the test result when during the scheduled medical appointment two weeks later.