Creatinine 1.6 Bun 22 one yr after left kidney and mass removal

lovingwife_scared

Can't believe it has been a year since my husband found out he had a 7.5cm mass, and subsequently a few weeks later had the mass and his left kidney removed, which they determined was cancerous, but thankfully, no spreading to other organs.  We just went for his 1 year CT Scan w/contrast.  After drinking the wonderful fluid, the radiologist told him he would not be able to have the scan w/contrast as his ratios were not in line (from the blood work done a couple days prior).  We have follow up appt with Urologist in 1 week, but also searching to understand more.  His creatinine is 1.6, and his BUN is 22, 51 year old white male, one kidney.  What have others experienced.  I know when he left the hospital the creatinine was 1.8--I wrote it down since I really do not have any medical experience (again thankfully).  I looked up his pre-surgery info, he had .98 and BUN 12 one week before his kidney/mass removal in April 2012.

Just wondering whether others are experiencing same changes, and if this is a sign of anything more serious; and what questions to be asking.  They still did a CT w/o contrast, but how common is it to not be able to have a CT w/contrast; and are they able to determine if cancer is back without the contrast.

Thanks for all your help!

Texas_wedge

Questions

Good case for MedScanMan, if Jeff sees this and has time.  Meanwhile, an amateur's take - even without contrast, CT gives a good deal of valuable info.  Your Husband's situation isn't uncommon. You shouldn't worry unduly - the results will probably be fine.  He may have been a bit dehydrated and that may have made his figures look less favourable.  Try to stay calm and await the outcome of the scan.

lovingwife_scared

Texas_wedge said:

Questions

Good case for MedScanMan, if Jeff sees this and has time.  Meanwhile, an amateur's take - even without contrast, CT gives a good deal of valuable info.  Your Husband's situation isn't uncommon. You shouldn't worry unduly - the results will probably be fine.  He may have been a bit dehydrated and that may have made his figures look less favourable.  Try to stay calm and await the outcome of the scan.

thanks Texas

He still had the CT w/o contrast, to be honest, was very worried when he first left the scan--what does it mean, is his only remaining kidney not functioning.  The more I read, I am hopeful he has a ways to go to be serious issue, but still cause for concern.  Don't think he was dehydrated as he drinks LOTS of water, but still could be the issue.  I realize everyone goes through the same nervousness upon annual anniversaries for surgery, and the uncertainty of finding out if it the cancer is back from testing.

Also, I created my user name last year at this time, when I was seriously scared to death over what we had just learned, went to ER on 3/14/12 late night for bleeding severe pain, learned he had the mass, most likely cancerous, must be removed along with his kidney, had surgery, da vinci, 4/5/12, subsequently found out was indeed cancerous, but all removed in surgery.  Recover, live life as normal, schedule CT, get nervous, learn of ratios out of line, get more nervous, wait for appt......not nearly as scared as last year at this time, but found the forum helpful then so thought I would jump back on and ask the actual life experienced comrads about the creatinine and BUN levels. 

Thanks for your support:). 

lovingwife_scared

Texas_wedge said:

Questions

Good case for MedScanMan, if Jeff sees this and has time.  Meanwhile, an amateur's take - even without contrast, CT gives a good deal of valuable info.  Your Husband's situation isn't uncommon. You shouldn't worry unduly - the results will probably be fine.  He may have been a bit dehydrated and that may have made his figures look less favourable.  Try to stay calm and await the outcome of the scan.

thanks Texas

He still had the CT w/o contrast, to be honest, was very worried when he first left the scan--what does it mean, is his only remaining kidney not functioning.  The more I read, I am hopeful he has a ways to go to be serious issue, but still cause for concern.  Don't think he was dehydrated as he drinks LOTS of water, but still could be the issue.  I realize everyone goes through the same nervousness upon annual anniversaries for surgery, and the uncertainty of finding out if it the cancer is back from testing.

Also, I created my user name last year at this time, when I was seriously scared to death over what we had just learned, went to ER on 3/14/12 late night for bleeding severe pain, learned he had the mass, most likely cancerous, must be removed along with his kidney, had surgery, da vinci, 4/5/12, subsequently found out was indeed cancerous, but all removed in surgery.  Recover, live life as normal, schedule CT, get nervous, learn of ratios out of line, get more nervous, wait for appt......not nearly as scared as last year at this time, but found the forum helpful then so thought I would jump back on and ask the actual life experienced comrads about the creatinine and BUN levels. 

Thanks for your support:). 

todd121

Creatinin and Contrast

Before my surgery, my creatinine was something like 1.1 or 1.2. I had a 6.8 cm tumor at that time in my right kidney. My right kidney was slightly larger than my left, so they were a bit concerned about removing it. However, the flow study they did showed that my left was doing a good enough job. They expected it to improve a little when I was depending on it more.

After my surgery in the hospital the creatinin was 1.9. My doctor said at that time as long as it was stable and not going up, he was ok with me going home with no real dietary restrictions.

Now, nearly 4 months after my surgery, the creatinin is 1.53.

My doctor (a medical oncologist) said he wouldn't want me to have contrast on my CT scan unless it drops below 1.5.

I talked to my nephrologist about creatinine and what it is. I'll do my best to tell you what he said, but I suggest you look into it further if you want really accurate information. He said that creatinine was found to be a fairly accurate estimate of kidney function. However, it doesn't take into account differences in body types (muscle mass), gender, and race. Turns out that a large number on a heavily muscled male weigh lifter means something much different than the same number on a female with a much smaller frame and less body mass. The test is a trade off between accuracy and ease of giving the test and cost. Creatinine is easy to administer and cheap, but not a great estimate, but an ok estimate. I believe it's calibrated such that a healthy person with 2 kidneys functioning well should have a creatinine level of 1.0.

A better estimate is another test called GFR (but they usually estimate this). I'm not going to go into that test, but to say that it's more accurate and takes into account body mass, race, and gender. There's another test that is very accurate, but the test is very expensive and time consuing to administer and they don't usually do it.

1.6 is an abnormal reading for someone with 2 functioning kidneys, and technically people like us are technically considered to have kidney disease (I believe it's Stage 3, but don't take my word for it). The function is good enough to somewhat ignore. However, contrast can be hard on the kidneys and can cause kidey failure. They don't want to risk our one remaining kidney, so they skip the contrast. But for us it's a pretty normal reading...Look at the results of eGFR, if they did it, for a better indication of kidney function if you're really concerned about it. If your husband has very low muscle mass, it might be worse. If he's a big man with a lot of muscle mass, it might be better.

My nephrologist recommended that I take good care of the remaining kidney. What he recommended was sound nutrition, exercise and doing everything I can to keep my blood pressure down and my blood sugar down, because high blood pressure and diabetes can harm your kidneys. Avoiding too much salt was advised. Avoiding too much protein was advised. Excess protein is processed by the kidney and excreted in the urine. Excess protein can be hard on the kidneys.

Hope this helps.

Todd

Texas_wedge

todd121 said:

Creatinin and Contrast

Before my surgery, my creatinine was something like 1.1 or 1.2. I had a 6.8 cm tumor at that time in my right kidney. My right kidney was slightly larger than my left, so they were a bit concerned about removing it. However, the flow study they did showed that my left was doing a good enough job. They expected it to improve a little when I was depending on it more.

After my surgery in the hospital the creatinin was 1.9. My doctor said at that time as long as it was stable and not going up, he was ok with me going home with no real dietary restrictions.

Now, nearly 4 months after my surgery, the creatinin is 1.53.

My doctor (a medical oncologist) said he wouldn't want me to have contrast on my CT scan unless it drops below 1.5.

I talked to my nephrologist about creatinine and what it is. I'll do my best to tell you what he said, but I suggest you look into it further if you want really accurate information. He said that creatinine was found to be a fairly accurate estimate of kidney function. However, it doesn't take into account differences in body types (muscle mass), gender, and race. Turns out that a large number on a heavily muscled male weigh lifter means something much different than the same number on a female with a much smaller frame and less body mass. The test is a trade off between accuracy and ease of giving the test and cost. Creatinine is easy to administer and cheap, but not a great estimate, but an ok estimate. I believe it's calibrated such that a healthy person with 2 kidneys functioning well should have a creatinine level of 1.0.

A better estimate is another test called GFR (but they usually estimate this). I'm not going to go into that test, but to say that it's more accurate and takes into account body mass, race, and gender. There's another test that is very accurate, but the test is very expensive and time consuing to administer and they don't usually do it.

1.6 is an abnormal reading for someone with 2 functioning kidneys, and technically people like us are technically considered to have kidney disease (I believe it's Stage 3, but don't take my word for it). The function is good enough to somewhat ignore. However, contrast can be hard on the kidneys and can cause kidey failure. They don't want to risk our one remaining kidney, so they skip the contrast. But for us it's a pretty normal reading...Look at the results of eGFR, if they did it, for a better indication of kidney function if you're really concerned about it. If your husband has very low muscle mass, it might be worse. If he's a big man with a lot of muscle mass, it might be better.

My nephrologist recommended that I take good care of the remaining kidney. What he recommended was sound nutrition, exercise and doing everything I can to keep my blood pressure down and my blood sugar down, because high blood pressure and diabetes can harm your kidneys. Avoiding too much salt was advised. Avoiding too much protein was advised. Excess protein is processed by the kidney and excreted in the urine. Excess protein can be hard on the kidneys.

Hope this helps.

Todd

Assessing kidney function

If you need to delve into the technicalities, this gives a fairly useful, brief and up-to-date overview

http://www.patient.co.uk/doctor/Assessing-Renal-Function.htm

 

icemantoo

Kidney function and contrast

For the first 5 years after surgery my doctor ordered a CT w/contrast. Each test required a creatine Bun ratio test beforehand to make sure the contrast was not harmful to the Kidney. Only once did the Radiologist question the bloodwork and called my doctor for permission to proceed, He could not reach the doctor and the CT proceeded without contrast. My doctor commented to me that the blood work was ok for the contrast and the Radiologist was chicken. I don't remember the exact numbers, but all of us in the club have somewhat abnormal resullts for this bloodwork and it is a matter of degree and opinion whether you can proceed with a CT w/ contrast. Having abnormal bloodwork after the surgery is to be expected. At some point the degree of abnormality may lean in favor of a CT w/o contrast.

 

Icemantoo

AprilandChuck

icemantoo said:

Kidney function and contrast

For the first 5 years after surgery my doctor ordered a CT w/contrast. Each test required a creatine Bun ratio test beforehand to make sure the contrast was not harmful to the Kidney. Only once did the Radiologist question the bloodwork and called my doctor for permission to proceed, He could not reach the doctor and the CT proceeded without contrast. My doctor commented to me that the blood work was ok for the contrast and the Radiologist was chicken. I don't remember the exact numbers, but all of us in the club have somewhat abnormal resullts for this bloodwork and it is a matter of degree and opinion whether you can proceed with a CT w/ contrast. Having abnormal bloodwork after the surgery is to be expected. At some point the degree of abnormality may lean in favor of a CT w/o contrast.

 

Icemantoo

Kidney Function

I watch Chucks..Creatine level like a hawk because its one of the few things I actually understand... his has been between 1.26 and 1.77 the 1.77 happened during HD IL2 so I think of that as an anomily...but since HD IL2 he has not really dropped below 1.40.. During this last scan his level was 1.50 and they called his doctor.. he told them Chuck has 1 Kidney and his levels will flucuate...according to hydration, nutrition and so on.. do the test with contrast...I can not stress Hydration enough for those with one Kidney...I make Chuck drink between 6 and 8 20oz bottles of water a day.. because he is a coffee drinker and coffee dehydrates...he has cut all other forms of caffine from his diet..They did warn us that there may come a time when he will have to get his CT without contrast...So I think it happens to everyone at some point...