Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

[Guest guest]

I have creatinine excretion 0.76 AndSodium 122Potassium 3.9Chloride 86Sorry, no salt excretion. Is there any other name for "salt excretion " ?Many thanks.Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. To: hyperaldosteronism Cc: Clarence Grim Sent: Mon, February 7, 2011 9:54:31 PMSubject: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

Good as you will note PRA can vary 50 fold depending on the salt excretion.Thus we still need the salt excretion in this urine. Must be in your reports somewhere.That's what I

found CREATININE, URINE QUANT. CREATININE URINE VOLUME 3045 ml CREATININE EXCRETION 0.76 [0.80 - 1.80] g/24hr PLASMA RENIN ACTIVITY 0.36

Unit: ng/mL/hr (NOTE) Adult Normal Salt Intake:

Upright 1.31 - 3.95 Supine 0.15- 2.33

Salt Excretion: (Na mEq/24 hr): Na= 0 - 30 8.82 -

23.86 Na= 30 - 75 4.09 - 7.73 Na= 75 - 150 1.44 -

2.80 Na= >150 0.39 -1.31 In the time I was on 160 Micardis and 20 lisinopril. Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 11:22:06 PMSubject: Re: Re: 39 yr old WM with HTN slightly low K and no adrenal mass what meds were you on when these were done and for the PRA and Aldo what was your sodium intake?One cannot interpret the renin and aldo without a urine Na and K and creatinine.CE Grim MDCORTISOL, 24 URINARY FREECORTISOL,F,UR 22CORTISOL,F, 24U 46PLASMA RENIN ACTIVITY 0.36ALDOSTERONE 1.9 To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:17:43 PMSubject: Re: Re: 39 yr old WM with HTN slightly low K and no adrenal mass They you have apparent cortisol excess.The you have Cushing's? Most studies don't show low renin in Cush.Give details on your cortisol. >Dr. Grim explained that using ACE or A2RB you try to block cortisol that PA patient already does not have and hence aldo/cortisol ratio goes up causing bp goes up. I didn't read that and it's a point! My aldo is low and my cortisol is high. So, we are different!> Remember that ACE+A2RB combo= heart attack! ??????? I was on Micardis and Lisinopril !!!!! Thank you, very interesting and informative as usually from you. Natalia Kamneva 66 Russian F with adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. To: hyperaldosteronism Sent: Sat, February 5, 2011 7:26:21 PMSubject: RE: Re: 39 yr old WM with HTN slightly low K and no adrenal mass I used to take 80 mg Micardis for several months but to no avail: My Systolic BP while on Micardis=80mg/d: My BP vs Spiro doses is posted earlier. Dr. Grim explained that using ACE or A2RB you try to block cortisol that PA patient already does not have and hence aldo/cortisol ratio goes up causing bp goes up. Lower Micardis=less cortisol blocking=lower aldo/cprtisol ratio= lover bp (my understanding). Remember that ACE+A2RB combo= heart attack! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqDid you try to play with spiro dosage? I am asking that because I have a strange effect. I was on Micardis 160 mg a day, when I started 50 mg a day of eplerenone and took it for three weeks. During my visit to my Doc my BP was 155/85 and he recommended to make eplerenone 100 mg (twice more) and Micardis 80 mg (50% off). I had it done and my BP became steadily higher. I got back to 160 Micardis and kept 100 of eplerenone. Still high BP. I got back

to original dosage 50 + 80. My BP is much better, but I still got almost all symptoms of PA that I didn't have on 100 eplerenone. Is it possible that lower dosage works better for BP than higher?Many, many thanks.

[Guest guest]

You

need to list the lab's normals for each value. 

Sodium = salt.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva

I

have

creatinine excretion 0.76

And

Sodium

122

Potassium

3.9

Chloride

86

Sorry, no salt excretion.

Is there any other name for " salt excretion " ?

Many thanks.

Natalia Kamneva 66

Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high

cortisol.

Good as you will note PRA can vary 50 fold depending on the

salt excretion.

Thus

we still need the salt excretion in this urine. Must be in your reports

somewhere.

On

Feb 7, 2011, at 5:28 PM, Natalia Kamneva wrote:

That's what I found

CREATININE, URINE QUANT.

CREATININE URINE VOLUME

3045 ml

CREATININE

EXCRETION

0.76

[0.80 - 1.80] g/24hr

PLASMA RENIN

ACTIVITY

0.36

Unit: ng/mL/hr

(NOTE)

Adult Normal Salt Intake:

Upright 1.31 - 3.95

Supine 0.15-

2.33

Salt Excretion:

(Na

mEq/24 hr):

Na= 0 - 30 8.82 - 23.86

Na= 30 - 75 4.09 - 7.73

Na= 75 - 150 1.44 - 2.80

Na= >150

0.39 -1.31

In the time I was on 160

Micardis and 20 lisinopril.

Natalia

Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron

and high cortisol.

what meds were you on when these were

done and for the PRA and Aldo what was your sodium intake?

One cannot interpret the renin and aldo without a urine Na and K

and creatinine.

CE Grim MD

CORTISOL, 24 URINARY

FREE

CORTISOL,F,UR 22

CORTISOL,F, 24U 46

PLASMA RENIN ACTIVITY 0.36

ALDOSTERONE

1.9

They

you have apparent cortisol excess.

The you have Cushing's? Most studies don't show low renin in

Cush.

Give details on your cortisol.

>Dr. Grim explained that using ACE or A2RB you try to block

cortisol that PA patient already does not have and hence aldo/cortisol ratio

goes up causing bp goes up.

I didn't read that and it's a point! My aldo is

low and my cortisol is high. So, we are different!

> Remember that ACE+A2RB combo= heart attack!

??????? I was on Micardis and Lisinopril !!!!!

Thank you, very interesting and informative as usually from you.

Natalia

Kamneva 66 Russian F with adrenal adenoma, HTN, low renin, low aldesteron and

high cortisol.

My BP vs Spiro doses is posted earlier.

Dr. Grim explained that using ACE or

A2RB you try to block cortisol that PA patient already does not have and hence

aldo/cortisol ratio goes up causing bp goes up. Lower Micardis=less cortisol

blocking=lower aldo/cprtisol ratio= lover bp (my understanding).

Remember that ACE+A2RB combo= heart

attack!

Max.

61M L adenoma NP59 Spiro=100, Amlo=10,

Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

Did you try to play with

spiro dosage? I am asking that because I have a strange effect. I was on

Micardis 160 mg a day, when I started 50 mg a day of eplerenone and took it for

three weeks. During my visit to my Doc my BP was 155/85 and he recommended to

make eplerenone 100 mg (twice more) and Micardis 80 mg (50% off). I had it done

and my BP became steadily higher. I got back to 160 Micardis and kept 100 of

eplerenone. Still high BP. I got back to original dosage 50 + 80. My BP is much

better, but I still got almost all symptoms of PA that I didn't have on 100

eplerenone.

Is it possible that lower dosage works better for BP than higher?

Many, many thanks.

[Guest guest]

Yes: Urinary sodium, potassium and creatinine excretion from a 24 hr urine.CE Grim MDI have creatinine excretion 0.76 AndSodium 122Potassium 3.9Chloride 86Sorry, no salt excretion. Is there any other name for "salt excretion " ?Many thanks.Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. To: hyperaldosteronism Cc: Clarence Grim Sent: Mon, February 7, 2011 9:54:31 PMSubject: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. Good as you will note PRA can vary 50 fold depending on the salt excretion.Thus we still need the salt excretion in this urine. Must be in your reports somewhere.That's what I found CREATININE, URINE QUANT. CREATININE URINE VOLUME 3045 ml CREATININE EXCRETION 0.76 [0.80 - 1.80] g/24hr PLASMA RENIN ACTIVITY 0.36 Unit: ng/mL/hr (NOTE) Adult Normal Salt Intake: Upright 1.31 - 3.95 Supine 0.15- 2.33 Salt Excretion: (Na mEq/24 hr): Na= 0 - 30 8.82 - 23.86 Na= 30 - 75 4.09 - 7.73 Na= 75 - 150 1.44 - 2.80 Na= >150 0.39 -1.31 In the time I was on 160 Micardis and 20 lisinopril. Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 11:22:06 PMSubject: Re: Re: 39 yr old WM with HTN slightly low K and no adrenal mass what meds were you on when these were done and for the PRA and Aldo what was your sodium intake?One cannot interpret the renin and aldo without a urine Na and K and creatinine.CE Grim MDCORTISOL, 24 URINARY FREECORTISOL,F,UR 22CORTISOL,F, 24U 46PLASMA RENIN ACTIVITY 0.36ALDOSTERONE 1.9 To: hyperaldosteronism Cc: Clarence Grim Sent: Sat, February 5, 2011 8:17:43 PMSubject: Re: Re: 39 yr old WM with HTN slightly low K and no adrenal mass They you have apparent cortisol excess.The you have Cushing's? Most studies don't show low renin in Cush.Give details on your cortisol. >Dr. Grim explained that using ACE or A2RB you try to block cortisol that PA patient already does not have and hence aldo/cortisol ratio goes up causing bp goes up. I didn't read that and it's a point! My aldo is low and my cortisol is high. So, we are different!> Remember that ACE+A2RB combo= heart attack! ??????? I was on Micardis and Lisinopril !!!!! Thank you, very interesting and informative as usually from you. Natalia Kamneva 66 Russian F with adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. To: hyperaldosteronism Sent: Sat, February 5, 2011 7:26:21 PMSubject: RE: Re: 39 yr old WM with HTN slightly low K and no adrenal mass I used to take 80 mg Micardis for several months but to no avail: My Systolic BP while on Micardis=80mg/d: My BP vs Spiro doses is posted earlier. Dr. Grim explained that using ACE or A2RB you try to block cortisol that PA patient already does not have and hence aldo/cortisol ratio goes up causing bp goes up. Lower Micardis=less cortisol blocking=lower aldo/cprtisol ratio= lover bp (my understanding). Remember that ACE+A2RB combo= heart attack! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEqDid you try to play with spiro dosage? I am asking that because I have a strange effect. I was on Micardis 160 mg a day, when I started 50 mg a day of eplerenone and took it for three weeks. During my visit to my Doc my BP was 155/85 and he recommended to make eplerenone 100 mg (twice more) and Micardis 80 mg (50% off). I had it done and my BP became steadily higher. I got back to 160 Micardis and kept 100 of eplerenone. Still high BP. I got back to original dosage 50 + 80. My BP is much better, but I still got almost all symptoms of PA that I didn't have on 100 eplerenone. Is it possible that lower dosage works better for BP than higher?Many, many thanks.

[Guest guest]

>Thus

we still need the salt excretion in this urine. Must be in your reports

somewhere.Here it's, Dr. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hrSodium

122 135-146 MMOL/L

Potassium

3.9 3.5 - 5.3 MMOL/L

Chloride

86 98-110 MMOL/LNatalia Kamneva 66

Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high

cortisol. To: hyperaldosteronism Sent: Fri, February 11, 2011 6:44:07 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

You

need to list the lab's normals for each value.

Sodium = salt.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva

I

have

creatinine excretion 0.76

And

Sodium

122

Potassium

3.9

Chloride

86

Sorry, no salt excretion.

Is there any other name for "salt excretion " ?

Many thanks.

Natalia Kamneva 66

Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high

cortisol.

Good as you will note PRA can vary 50 fold depending on the

salt excretion.

Thus

we still need the salt excretion in this urine. Must be in your reports

somewhere.

On

Feb 7, 2011, at 5:28 PM, Natalia Kamneva wrote:

That's what I found

CREATININE, URINE QUANT.

CREATININE URINE VOLUME

3045 ml

CREATININE

EXCRETION

0.76

[0.80 - 1.80] g/24hr

PLASMA RENIN

ACTIVITY

0.36

Unit: ng/mL/hr

(NOTE)

Adult Normal Salt Intake:

Upright 1.31 - 3.95

Supine 0.15-

2.33

Salt Excretion:

(Na

mEq/24 hr):

Na= 0 - 30 8.82 - 23.86

Na= 30 - 75 4.09 - 7.73

Na= 75 - 150 1.44 - 2.80

Na= >150

0.39 -1.31

In the time I was on 160

Micardis and 20 lisinopril.

Natalia

Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron

and high cortisol.

what meds were you on when these were

done and for the PRA and Aldo what was your sodium intake?

One cannot interpret the renin and aldo without a urine Na and K

and creatinine.

CE Grim MD

CORTISOL, 24 URINARY

FREE

CORTISOL,F,UR 22

CORTISOL,F, 24U 46

PLASMA RENIN ACTIVITY 0.36

ALDOSTERONE

1.9

They

you have apparent cortisol excess.

The you have Cushing's? Most studies don't show low renin in

Cush.

Give details on your cortisol.

>Dr. Grim explained that using ACE or A2RB you try to block

cortisol that PA patient already does not have and hence aldo/cortisol ratio

goes up causing bp goes up.

I didn't read that and it's a point! My aldo is

low and my cortisol is high. So, we are different!

> Remember that ACE+A2RB combo= heart attack!

??????? I was on Micardis and Lisinopril !!!!!

Thank you, very interesting and informative as usually from you. Natalia

Kamneva 66 Russian F with adrenal adenoma, HTN, low renin, low aldesteron and

high cortisol.

My BP vs Spiro doses is posted earlier.

Dr. Grim explained that using ACE or

A2RB you try to block cortisol that PA patient already does not have and hence

aldo/cortisol ratio goes up causing bp goes up. Lower Micardis=less cortisol

blocking=lower aldo/cprtisol ratio= lover bp (my understanding).

Remember that ACE+A2RB combo= heart

attack!

Max.

61M L adenoma NP59 Spiro=100, Amlo=10,

Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

Did you try to play with

spiro dosage? I am asking that because I have a strange effect. I was on

Micardis 160 mg a day, when I started 50 mg a day of eplerenone and took it for

three weeks. During my visit to my Doc my BP was 155/85 and he recommended to

make eplerenone 100 mg (twice more) and Micardis 80 mg (50% off). I had it done

and my BP became steadily higher. I got back to 160 Micardis and kept 100 of

eplerenone. Still high BP. I got back to original dosage 50 + 80. My BP is much

better, but I still got almost all symptoms of PA that I didn't have on 100

eplerenone.

Is it possible that lower dosage works better for BP than higher?

Many, many thanks.

[Guest guest]

How do I know about how much Na and K I am eating.Answer: measure in 24 hr urine the followingvolume how many liters.Concentration of Na in the urine in your case 122K in the urine 3.9 you say but I suspect this is really the blood test.Assuming it is the urine then you multiply the urine concentration of Na and K by the urine volume.I do not see a urine volume.The urine DASH index should be the UK over the U Na and there should be more UK than UNa.So you are eating 3.9K/122Na Way too much salt.You need to be eating enough K so that you have more K in your urine that Na.But I suspect what you gave us i the blood values not the urine.I have never seen a UK of 3.9>Thus we still need the salt excretion in this urine. Must be in your reports somewhere.Here it's, Dr. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hrSodium 122 135-146 MMOL/LPotassium 3.9 3.5 - 5.3 MMOL/LChloride 86 98-110 MMOL/LNatalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. To: hyperaldosteronism Sent: Fri, February 11, 2011 6:44:07 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. You need to list the lab's normals for each value. Sodium = salt. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva I have creatinine excretion 0.76 AndSodium 122Potassium 3.9Chloride 86Sorry, no salt excretion. Is there any other name for "salt excretion " ?Many thanks.Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.Good as you will note PRA can vary 50 fold depending on the salt excretion. Thus we still need the salt excretion in this urine. Must be in your reports somewhere. That's what I found CREATININE, URINE QUANT. CREATININE URINE VOLUME 3045 ml CREATININE EXCRETION 0.76 [0.80 - 1.80] g/24hr PLASMA RENIN ACTIVITY 0.36 Unit: ng/mL/hr (NOTE) Adult Normal Salt Intake: Upright 1.31 - 3.95 Supine 0.15- 2.33 Salt Excretion: (Na mEq/24 hr): Na= 0 - 30 8.82 - 23.86 Na= 30 - 75 4.09 - 7.73 Na= 75 - 150 1.44 - 2.80 Na= >150 0.39 -1.31 In the time I was on 160 Micardis and 20 lisinopril. Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. what meds were you on when these were done and for the PRA and Aldo what was your sodium intake? One cannot interpret the renin and aldo without a urine Na and K and creatinine. CE Grim MD CORTISOL, 24 URINARY FREECORTISOL,F,UR 22CORTISOL,F, 24U 46PLASMA RENIN ACTIVITY 0.36ALDOSTERONE 1.9 They you have apparent cortisol excess. The you have Cushing's? Most studies don't show low renin in Cush. Give details on your cortisol. >Dr. Grim explained that using ACE or A2RB you try to block cortisol that PA patient already does not have and hence aldo/cortisol ratio goes up causing bp goes up. I didn't read that and it's a point! My aldo is low and my cortisol is high. So, we are different!> Remember that ACE+A2RB combo= heart attack! ??????? I was on Micardis and Lisinopril !!!!! Thank you, very interesting and informative as usually from you. Natalia Kamneva 66 Russian F with adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. My BP vs Spiro doses is posted earlier. Dr. Grim explained that using ACE or A2RB you try to block cortisol that PA patient already does not have and hence aldo/cortisol ratio goes up causing bp goes up. Lower Micardis=less cortisol blocking=lower aldo/cprtisol ratio= lover bp (my understanding). Remember that ACE+A2RB combo= heart attack! Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq Did you try to play with spiro dosage? I am asking that because I have a strange effect. I was on Micardis 160 mg a day, when I started 50 mg a day of eplerenone and took it for three weeks. During my visit to my Doc my BP was 155/85 and he recommended to make eplerenone 100 mg (twice more) and Micardis 80 mg (50% off). I had it done and my BP became steadily higher. I got back to 160 Micardis and kept 100 of eplerenone. Still high BP. I got back to original dosage 50 + 80. My BP is much better, but I still got almost all symptoms of PA that I didn't have on 100 eplerenone. Is it possible that lower dosage works better for BP than higher?Many, many thanks.

[Guest guest]

Natalia's

last three numbers are blood, not urine.

Val

From: hyperaldosteronism

Here it's, D r. Grim:

creatinine excretion

0.76

[0.80 - 1.80] g/24hr

Sodium

122

135-146 MMOL/L

Potassium

3.9 & n

bsp; 3.5 - 5.3 MMOL/L

Chloride

86

98-110 MMOL/L

[Guest guest]

My lab:

Blood tests are reported in mmol/L

24-hr urine tests reported in mmol/V or mmol/24-hr (V= total volume of 24-hr urine).

Max.

But I suspect what you gave us i the blood values not the urine.

I have never seen a UK of 3.9

>Thus we still need the salt excretion in this urine. Must be in your reports somewhere.Here it's, Dr. Grim: urine creatinine excretion 0.76 [0.80 - 1.80] g/24hr

Serum Sodium 122 135-146 MMOL/L Serum Potassium 3.9 3.5 - 5.3 MMOL/L Serum Chloride 86 98-110 MMOL/LNatalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

[Guest guest]

may in urine will report both mM/L and then volume in LSo multiply mM/L x L/24 hr and you get mM/24 hr.CE Grim MDMy lab:Blood tests are reported in mmol/L24-hr urine tests reported in mmol/V or mmol/24-hr (V= total volume of 24-hr urine). Max.But I suspect what you gave us i the blood values not the urine.I have never seen a UK of 3.9>Thus we still need the salt excretion in this urine. Must be in your reports somewhere.Here it's, Dr. Grim: urine creatinine excretion 0.76 [0.80 - 1.80] g/24hr Serum Sodium 122 135-146 MMOL/L Serum Potassium 3.9 3.5 - 5.3 MMOL/L Serum Chloride 86 98-110 MMOL/LNatalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

[Guest guest]

Does it look right now:

Potassium Random Urine (mmol/L) 26.4

Sodium Random Urine (30-90 mmol/L) 58

Cortisol, F, UG/L,U 57

Cortisol,F, UG/24HR,U 34

Total Volume 600

Many thanks everybody.

Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4.

To: hyperaldosteronism Sent: Sat, February 12, 2011 10:04:24 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

Natalia's last three numbers are blood, not urine.

Val

From: hyperaldosteronism

Here it's, D r. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hr

Sodium 122 135-146 MMOL/LPotassium 3.9 & n bsp; 3.5 - 5.3 MMOL/LChloride

86 98-110 MMOL/L

[Guest guest]

Seems like a very small urine volume. Did you miss any of the ]24 hr sample? It was a 24 hr collection right? What arethe norms for ur lab. U are not DASHING or u would have more K in urine than NA. FIND OUT WHERE THE NA IS COMING FROM. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Does it look right now:

Potassium Random Urine (mmol/L) 26.4

Sodium Random Urine (30-90 mmol/L) 58

Cortisol, F, UG/L,U 57

Cortisol,F, UG/24HR,U 34

Total Volume 600

Many thanks everybody.

Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4.

To: hyperaldosteronism Sent: Sat, February 12, 2011 10:04:24 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

Natalia's last three numbers are blood, not urine.

Val

From: hyperaldosteronism

Here it's, D r. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hr

Sodium 122 135-146 MMOL/LPotassium 3.9 & n bsp; 3.5 - 5.3 MMOL/LChloride

86 98-110 MMOL/L

[Guest guest]

Is that a typo on 600 for the total volume? If not, are you sure this was a 24 hour sample and you didn't miss any voidings? 30 ml per hour is considered a bare minimum urinary output, so lower than 720 ml in 24 hours should throw up a red flag. It could indicate dehydration or problems with kidney function. Or more likely you missed a specimen, which would invalidate the results.

Subject: Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.To: hyperaldosteronism Date: Tuesday, February 15, 2011, 7:53 PM

Does it look right now:

Potassium Random Urine (mmol/L) 26.4

Sodium Random Urine (30-90 mmol/L) 58

Cortisol, F, UG/L,U 57

Cortisol,F, UG/24HR,U 34

Total Volume 600

Many thanks everybody.

Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4.

To: hyperaldosteronism Sent: Sat, February 12, 2011 10:04:24 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

Natalia's last three numbers are blood, not urine.

Val

From: hyperaldosteronism

Here it's, D r. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hr

Sodium 122 135-146 MMOL/LPotassium 3.9 & n bsp; 3.5 - 5.3 MMOL/LChloride

86 98-110 MMOL/L

[Guest guest]

She probably didn't miss collecting any urine. My husband just did one and his

24 hour volume, not a drop missed, was 700 mL. It used to be over 2000 mL

before getting onto right treatment for PA. I wasn't suprised at his low output

as he only drank about that much during the collection. It was a reminder to

him though that just because he's not thirsty all the time like he used to be,

he still needs to make a cencerted effort to keep well hydrated. His renal

function is perfect BTW.

>

>

>

> Subject: Re: Natalia Kamneva 66 Russian F with left

adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

> To: hyperaldosteronism

> Date: Tuesday, February 15, 2011, 7:53 PM

>

>

>

>

>

>

>

>

>

>

>

>

> Does it look right now:

>  

> Potassium Random Urine       (mmol/L)              26.4

>  

> Sodium Random Urine           (30-90 mmol/L)     58

>  

> Cortisol, F, UG/L,U                                            57

>  

> Cortisol,F, UG/24HR,U                                       34

>  

> Total Volume                                                      600

>  

> Many thanks everybody.

>  

>  

>

> Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low

renin , low aldosteron and high cortisol, K=3.4.  

>

>

>

>

>

>

> To: hyperaldosteronism

> Sent: Sat, February 12, 2011 10:04:24 PM

> Subject: RE: Natalia Kamneva 66 Russian F with left

adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

>

>  

>

>

>

> Natalia's last three numbers are blood, not urine.

>  

>

> Val

>  

>

>

>

>

>

>

>

>

>

> From: hyperaldosteronism

>

> Here it's, D r.  Grim:  

>

> creatinine excretion      0.76                              [0.80 - 1.80]  

g/24hr

>

>

>

>

>

> Sodium                      122                                135-146   

MMOL/L

> Potassium                  3.9                          & n bsp;        3.5 -

5.3   MMOL/L

> Chloride                     86                                  

98-110     MMOL/L

>

[Guest guest]

His body will tell him when to drink.What was his Ecreatinine. This is the best judge of a good collection. Volume is not.CE Grim MDShe probably didn't miss collecting any urine. My husband just did one and his 24 hour volume, not a drop missed, was 700 mL. It used to be over 2000 mL before getting onto right treatment for PA. I wasn't suprised at his low output as he only drank about that much during the collection. It was a reminder to him though that just because he's not thirsty all the time like he used to be, he still needs to make a cencerted effort to keep well hydrated. His renal function is perfect BTW. > > > > Subject: Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.> To: hyperaldosteronism > Date: Tuesday, February 15, 2011, 7:53 PM> > > > > > > > > > > > > Does it look right now:> > Potassium Random Urine (mmol/L) 26.4> > Sodium Random Urine (30-90 mmol/L) 58> > Cortisol, F, UG/L,U 57> > Cortisol,F, UG/24HR,U 34> > Total Volume 600> > Many thanks everybody.> > > > Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4. > > > > > > > To: hyperaldosteronism > Sent: Sat, February 12, 2011 10:04:24 PM> Subject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.> > > > > > Natalia's last three numbers are blood, not urine.> > > Val> > > > > > > > > > > From: hyperaldosteronism > > Here it's, D r. Grim: > > creatinine excretion 0.76 [0.80 - 1.80] g/24hr> > > > > > Sodium 122 135-146 MMOL/L> Potassium 3.9 & n bsp; 3.5 - 5.3 MMOL/L> Chloride 86 98-110 MMOL/L>

[Guest guest]

This test was done 3 months ago when I was in a hospital with a very high blood pressure and in a very bad condition. Now I eventually learned what test I need to ask my PCP to repeat to confirm that I am better.Thank you very much. To: "hyperaldosteronism "

<hyperaldosteronism >Cc: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, February 15, 2011 8:44:41 PMSubject: Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

Seems like a very small urine volume. Did you miss any of the ]24 hr sample? It was a 24 hr collection right? What arethe norms for ur lab. U are not DASHING or u would have more K in urine than NA. FIND OUT WHERE THE NA IS COMING FROM. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

Does it look right now:

Potassium Random Urine (mmol/L) 26.4

Sodium Random Urine (30-90 mmol/L) 58

Cortisol, F, UG/L,U 57

Cortisol,F, UG/24HR,U 34

Total Volume 600

Many thanks everybody.

Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4.

To: hyperaldosteronism Sent: Sat, February 12, 2011 10:04:24 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

Natalia's last three numbers are blood, not urine.

Val

From: hyperaldosteronism

Here it's, D r. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hr

Sodium 122 135-146 MMOL/LPotassium 3.9 & n bsp; 3.5 - 5.3 MMOL/LChloride

86 98-110 MMOL/L

[Guest guest]

Cannot say anything about volume, because this test was done in a hospital 3 months when I was in a very bad condition. I drank a lot in the time, but I had diarrhea. Maybe, they missed something. I should repeat 24 h urine test now.Many thanks for this information.NataliaTo: hyperaldosteronism Sent: Wed, February 16, 2011 4:30:27 AMSubject: Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

Is that a typo on 600 for the total volume? If not, are you sure this was a 24 hour sample and you didn't miss any voidings? 30 ml per hour is considered a bare minimum urinary output, so lower than 720 ml in 24 hours should throw up a red flag. It could indicate dehydration or problems with kidney function. Or more likely you missed a specimen, which would invalidate the results.

Subject: Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.To: hyperaldosteronism Date: Tuesday, February 15, 2011, 7:53 PM

Does it look right now:

Potassium Random Urine (mmol/L) 26.4

Sodium Random Urine (30-90 mmol/L) 58

Cortisol, F, UG/L,U 57

Cortisol,F, UG/24HR,U 34

Total Volume 600

Many thanks everybody.

Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4.

To: hyperaldosteronism Sent: Sat, February 12, 2011 10:04:24 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

Natalia's last three numbers are blood, not urine.

Val

From: hyperaldosteronism

Here it's, D r. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hr

Sodium 122 135-146 MMOL/LPotassium 3.9 & n bsp; 3.5 - 5.3 MMOL/LChloride

86 98-110 MMOL/L

[Guest guest]

My 1st 24-hr urine sample was about 3.2 L and sample was precisely obtained as directed within exact time period. Near the top od the container I was getting worried that it was not large enough! However, to my great surprise, the lab refused it as something must be wrong with too high a volume sample. So I had to take another sample to lab. I learned that I should not waste my precious time for collecting accurate samples! heh

Max.

Is that a typo on 600 for the total volume? If not, are you sure this was a 24 hour sample and you didn't miss any voidings? 30 ml per hour is considered a bare minimum urinary output, so lower than 720 ml in 24 hours should throw up a red flag. It could indicate dehydration or problems with kidney function. Or more likely you missed a specimen, which would invalidate the results.

Does it look right now:

Potassium Random Urine (mmol/L) 26.4

Sodium Random Urine (30-90 mmol/L) 58

Cortisol, F, UG/L,U 57

Cortisol,F, UG/24HR,U 34

Total Volume 600

Many thanks everybody.

Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4.

[Guest guest]

Suspect someone did not collect it all not your fault.CE Grim MDCannot say anything about volume, because this test was done in a hospital 3 months when I was in a very bad condition. I drank a lot in the time, but I had diarrhea. Maybe, they missed something. I should repeat 24 h urine test now.Many thanks for this information.NataliaTo: hyperaldosteronism Sent: Wed, February 16, 2011 4:30:27 AMSubject: Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. Is that a typo on 600 for the total volume? If not, are you sure this was a 24 hour sample and you didn't miss any voidings? 30 ml per hour is considered a bare minimum urinary output, so lower than 720 ml in 24 hours should throw up a red flag. It could indicate dehydration or problems with kidney function. Or more likely you missed a specimen, which would invalidate the results. Subject: Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.To: hyperaldosteronism Date: Tuesday, February 15, 2011, 7:53 PMDoes it look right now: Potassium Random Urine (mmol/L) 26.4 Sodium Random Urine (30-90 mmol/L) 58 Cortisol, F, UG/L,U 57 Cortisol,F, UG/24HR,U 34 Total Volume 600 Many thanks everybody. Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4. To: hyperaldosteronism Sent: Sat, February 12, 2011 10:04:24 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. Natalia's last three numbers are blood, not urine. Val From: hyperaldosteronism Here it's, D r. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hrSodium 122 135-146 MMOL/LPotassium 3.9 & n bsp; 3.5 - 5.3 MMOL/LChloride 86 98-110 MMOL/L

[Guest guest]

Still need the urine creatinine from that test.CE Grim MDThis test was done 3 months ago when I was in a hospital with a very high blood pressure and in a very bad condition. Now I eventually learned what test I need to ask my PCP to repeat to confirm that I am better.Thank you very much. To: "hyperaldosteronism " <hyperaldosteronism >Cc: "hyperaldosteronism " <hyperaldosteronism >Sent: Tue, February 15, 2011 8:44:41 PMSubject: Re: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. Seems like a very small urine volume. Did you miss any of the ]24 hr sample? It was a 24 hr collection right? What arethe norms for ur lab. U are not DASHING or u would have more K in urine than NA. FIND OUT WHERE THE NA IS COMING FROM. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension Does it look right now: Potassium Random Urine (mmol/L) 26.4 Sodium Random Urine (30-90 mmol/L) 58 Cortisol, F, UG/L,U 57 Cortisol,F, UG/24HR,U 34 Total Volume 600 Many thanks everybody. Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4. To: hyperaldosteronism Sent: Sat, February 12, 2011 10:04:24 PMSubject: RE: Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. Natalia's last three numbers are blood, not urine. Val From: hyperaldosteronism Here it's, D r. Grim: creatinine excretion 0.76 [0.80 - 1.80] g/24hrSodium 122 135-146 MMOL/LPotassium 3.9 & n bsp; 3.5 - 5.3 MMOL/LChloride 86 98-110 MMOL/L

[Guest guest]

Trust you have now taught that lab to think. But that may be too much to ask of them. That would really piss me off. Throwing away liquid gold.CE Grim MDMy 1st 24-hr urine sample was about 3.2 L and sample was precisely obtained as directed within exact time period. Near the top od the container I was getting worried that it was not large enough! However, to my great surprise, the lab refused it as something must be wrong with too high a volume sample. So I had to take another sample to lab. I learned that I should not waste my precious time for collecting accurate samples! heh Max.Is that a typo on 600 for the total volume? If not, are you sure this was a 24 hour sample and you didn't miss any voidings? 30 ml per hour is considered a bare minimum urinary output, so lower than 720 ml in 24 hours should throw up a red flag. It could indicate dehydration or problems with kidney function. Or more likely you missed a specimen, which would invalidate the results. Does it look right now: Potassium Random Urine (mmol/L) 26.4 Sodium Random Urine (30-90 mmol/L) 58 Cortisol, F, UG/L,U 57 Cortisol,F, UG/24HR,U 34 Total Volume 600 Many thanks everybody. Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4.

[Guest guest]

Natalia,

with low renin and low aldo, I'm not even sure you have PA, especially since

too much Inspra causes your BP to go higher. 

You need to get to a center where en expert can get to the bottoms of

what's going on with you.

Val

From: hyperaldosteronism

[mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva

This

test was done 3 months ago when I was in a hospital with a very high blood

pressure and in a very bad condition.

Now I eventually learned what test I need to ask my PCP to repeat to

confirm that I am better.

Thank you very much.

Seems

like a very small urine volume. Did you miss any of the ]24 hr sample? It

was a 24 hr collection right? What arethe norms for ur lab.

U

are not DASHING or u would have more K in urine than NA. FIND OUT WHERE THE NA

IS COMING FROM.

On Feb 15, 2011, at 5:53 PM, Natalia Kamneva

wrote:

Does

it look right now:

Potassium

Random

Urine (mmol/L)

26.4

Sodium

Random Urine (30-90

mmol/L) 58

Cortisol,

F, UG/L,U

57

Cortisol,F,

UG/24HR,U

34

Total

Volume

600

Many

thanks everybody.

..

[Guest guest]

She may have AME but should respond to spiro or inspra for BP unless she is out salting it.CE Grim MDNatalia, with low renin and low aldo, I'm not even sure you have PA, especially since too much Inspra causes your BP to go higher. You need to get to a center where en expert can get to the bottoms of what's going on with you. Val From: hyperaldosteronism [mailto:hyperaldosteronism ] On Behalf Of Natalia Kamneva This test was done 3 months ago when I was in a hospital with a very high blood pressure and in a very bad condition. Now I eventually learned what test I need to ask my PCP to repeat to confirm that I am better.Thank you very much. Seems like a very small urine volume. Did you miss any of the ]24 hr sample? It was a 24 hr collection right? What arethe norms for ur lab. U are not DASHING or u would have more K in urine than NA. FIND OUT WHERE THE NA IS COMING FROM. Does it look right now: Potassium Random Urine (mmol/L) 26.4 Sodium Random Urine (30-90 mmol/L) 58 Cortisol, F, UG/L,U 57 Cortisol,F, UG/24HR,U 34 Total Volume 600 Many thanks everybody. .

[Guest guest]

By Ecreatinine do you mean urine creatinine? If so, it was 13.0 mmol/D.

How does that sound?

> > >

> > >

> > > From: Natalia Kamneva <natalia_kamneva@>

> > > Subject: Re: Natalia Kamneva 66 Russian F

> > with left adrenal adenoma, HTN, low renin, low aldesteron and high

> > cortisol.

> > > To: hyperaldosteronism

> > > Date: Tuesday, February 15, 2011, 7:53 PM

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > Does it look right now:

> > >

> > > Potassium Random Urine (mmol/L) 26.4

> > >

> > > Sodium Random Urine (30-90 mmol/L) 58

> > >

> > > Cortisol, F, UG/L,U 57

> > >

> > > Cortisol,F, UG/24HR,U 34

> > >

> > > Total Volume

> > 600

> > >

> > > Many thanks everybody.

> > >

> > >

> > >

> > > Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN

> > and low renin , low aldosteron and high cortisol, K=3.4.

> > >

> > >

> > >

> > >

> > >

> > > From: Valarie <val@>

> > > To: hyperaldosteronism

> > > Sent: Sat, February 12, 2011 10:04:24 PM

> > > Subject: RE: Natalia Kamneva 66 Russian F

> > with left adrenal adenoma, HTN, low renin, low aldesteron and high

> > cortisol.

> > >

> > >

> > >

> > >

> > >

> > > Natalia's last three numbers are blood, not urine.

> > >

> > >

> > > Val

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > From: hyperaldosteronism

> > >

> > > Here it's, D r. Grim:

> > >

> > > creatinine excretion 0.76 [0.80

> > - 1.80] g/24hr

> > >

> > >

> > >

> > >

> > >

> > > Sodium 122

> > 135-146 MMOL/L

> > > Potassium 3.9 & n

> > bsp; 3.5 - 5.3 MMOL/L

> > > Chloride 86

> > 98-110 MMOL/L

> > >

> >

> >

> >

>

[Guest guest]

So 13 mM cr/dl x 600 ml x 1dl/ml x ? Mg cr/mMcr =mg Cr/daySome one needs to look up mgMwt of creat and solve. And u thought high school chem would never be used. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

By Ecreatinine do you mean urine creatinine? If so, it was 13.0 mmol/D.

How does that sound?

> > >

> > >

> > > From: Natalia Kamneva <natalia_kamneva@>

> > > Subject: Re: Natalia Kamneva 66 Russian F

> > with left adrenal adenoma, HTN, low renin, low aldesteron and high

> > cortisol.

> > > To: hyperaldosteronism

> > > Date: Tuesday, February 15, 2011, 7:53 PM

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > Does it look right now:

> > >

> > > Potassium Random Urine (mmol/L) 26.4

> > >

> > > Sodium Random Urine (30-90 mmol/L) 58

> > >

> > > Cortisol, F, UG/L,U 57

> > >

> > > Cortisol,F, UG/24HR,U 34

> > >

> > > Total Volume

> > 600

> > >

> > > Many thanks everybody.

> > >

> > >

> > >

> > > Natalia Kamneva 66 Russian F with left 1.5 sm adrenal adenoma, HTN

> > and low renin , low aldosteron and high cortisol, K=3.4.

> > >

> > >

> > >

> > >

> > >

> > > From: Valarie <val@>

> > > To: hyperaldosteronism

> > > Sent: Sat, February 12, 2011 10:04:24 PM

> > > Subject: RE: Natalia Kamneva 66 Russian F

> > with left adrenal adenoma, HTN, low renin, low aldesteron and high

> > cortisol.

> > >

> > >

> > >

> > >

> > >

> > > Natalia's last three numbers are blood, not urine.

> > >

> > >

> > > Val

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > From: hyperaldosteronism

> > >

> > > Here it's, D r. Grim:

> > >

> > > creatinine excretion 0.76 [0.80

> > - 1.80] g/24hr

> > >

> > >

> > >

> > >

> > >

> > > Sodium 122

> > 135-146 MMOL/L

> > > Potassium 3.9 & n

> > bsp; 3.5 - 5.3 MMOL/L

> > > Chloride 86

> > 98-110 MMOL/L

> > >

> >

> >

> >

>

[Guest guest]

I guess she had already specified it as:

creatinine excretion 0.76 [0.80 - 1.80] g/24hr

Max.

So 13 mM cr/dl x 600 ml x 1dl/ml x ? Mg cr/mMcr =mg Cr/day

[Guest guest]

guess I missed it. Sorry sounds like a good urine depending on how much she weighs.On can estimate the ECr from the Cockcroft-Gault equaton. which uses age, wt and gender. But don't have it handy now.IN wikipedia We need to set up a database for each person to complete from my intro on the perfect test.I guess she had already specified it as:creatinine excretion 0.76 [0.80 - 1.80] g/24hr Max.So 13 mM cr/dl x 600 ml x 1dl/ml x ? Mg cr/mMcr =mg Cr/day