February 13th, 2014


The Great Kidney Mystery

I received my lab results from my 2/7/14 blood draw, and ... drum roll, please ... they are back to the numbers we saw in August! WTF?

creatinine: 1.36
eGFR: 48
BUN: 13
BUN/creatinine ratio: 10
blood sodium: 142

I am utterly puzzled by these results. Apparently, Dr. Poor Communicator was on the right track, though I still don't understand how or why, or what I'm supposed to do now, except send the following email to my nephrologist:

Hi Dr. Poor Communicator -

I just received my lab results from 2/7/14, and I see that my creatinine and GFR levels are back to approximately where they were in August, but I'm not sure what this means. I spent *weeks* on a very high sodium diet, drinking lots of Gatorade in place of some of my water, before these labs, and then spent 3-4 days *immediately* prior to these labs consuming all the salt I could possibly manage to cram into myself, while drinking a bit less than I had been before the previous labs, because I wasn't purposely trying to drink more. I did replace more of my water with Gatorade, though, so that I was drinking about 64 ounces of Gatorade per day for those few days.

For the 3-4 days immediately prior to this blood draw, I basically ate nothing that didn't contain hefty amounts of sodium -- all canned soups, prepared frozen foods, soy sauce, ketchup, etc. -- which meant that I didn't eat much fresh food at all. No fresh vegetables, no fruit, etc. This diet obviously is not a good idea in the long term, so I'm not sure what I'm supposed to do now. I have some very specific questions:

1. Why did I have to massively load up on sodium to reach these lab numbers now, when I was able to just eat and drink normally back in August when we saw these numbers before? In fact, I was drinking *more* water back then, because I was thirstier when I first went off the lithium. So why does my body now need so much sodium? What has changed?

2. Was this dehydration, and the accompanying worsened creatinine and GFR numbers, a temporary thing which is now fixed by a few days of sodium loading? Or is this a continuing problem which will require me to load up on sodium all the time now?

3. If this is something that needs to continue, how in the world can I eat a healthy diet while getting this extreme amount of sodium every day? I didn't like cutting fresh fruit and veggies out of my diet, for example, just because I had to make sure that every single thing I ate contained significant amounts of sodium, but apparently that was what was necessary to get the lab numbers back on track. Getting my kidney numbers back on track by succumbing to malnutrition seems a poor course of action.

So what do I do now?

- Kimberly