renal parenchymal disease – Peter Tan

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

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 Test Results For February 2012

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

Festive Guilt

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.