Why is my BUN so big, I mean high!

[Guest guest]

I have been preparing to meet with my Nephrologists, and Department Chair if he

is available. Since I now know all there is to know about Conn's (haha) I

thought I'd figure out CKD. (You may recall we didn't have a very good appt.

the last time! He mentioned CKD Stage 3 in my " problems list " and I need to

find out exactly where he is coming from since this a problem my older brother

(by < 2yrs) lived and finally died with! (I draw a little experience from

supporting he over 30 year experience!

I've known about CREATININE and actually learned what eGFR was my last Nephr.

Meeting. I also picked up that BUN had something to do with it (I always

thought they were checking my Buns)! Enough, I'll try to stay on task!

Let me pause and report the last few labs to set the stage

Date (all 2011) CREAT BUN eGFR

Ref range low 0.5 7 60

Ref range high 1.5 25

6/24 0.98 20 77

6/7 0.9 18 >60

5/12 1.1 28 H >60

4/29 1.1 26 H >60

I have a few other numbers but had seen enough to decide maybe it was BUN that

triggered him and I better find out what that was all about so I Googled it!

The first article I looked at was Lab Tests Online: " To evaluate kidney

function or monitor the effectiveness of dialysis and other treatments related

to kidney disease or damage. " That took the wind out of my sails for about 32

seconds! That Nephr. I thought was a Quack might be onto something!

Wait a minute, a second opinion is always good and since MedlinePlus is next

let's look there. On the end of page 1 is: " Drugs that can increase BUN

measurements include: " BINGO, Furosemide is the 10th drug listed! Why that was

fun I thought, let's turn the page. Why imagine that, Spironolactone is listed

also!! Another AH-HA Moment! And he claimed to be the one that he " treated the

whole person and not just some internet Guru treating only one thing! "

Well that was a pretty good half hour! Being taught to be thorough I looked

back and BUN had been on the high side (22, 26H,20 and 23) back to 05/26/2010

when it was 15 and had never been over 18 for the previous 5 years with the most

14 - 15!

What happened in May 2010 you ask, why that is easy, that is when I met my

Savior, You remember, Dr. Yousefi, the one who Dxed me with Conn's and started

me on Furosemide and Spironolactone! Now you say, " okay smart a_ _, why did it

go back down in June 2011, explain that one! " That my friend is the easy one.

I convinced my PCP to eliminate Furosemide at my May 27th appt! Nepher.

Specifically did NOT want me to but I assured PCP that Dr. Grim and I think

said I no longer needed it, I remember the discussion surrounded a fact it

was a " loop diuretic " ! Wait till I tell PCP she wins again, God we make her

look good and trust me, she appreciates it! And I have just proved she trusts

us over the Nepherology Dept. when it comes to treat Conn's - told you she was

smart!

Okay, pay close attention here because this important (, jump in anytime)!

Lab Tests Online says this test, BUN, is used " When an acutely ill person comes

into the E.R. or is admitted to the hospital " Make sure your med list is up to

date and I'm going to list " May effect BUN " next to Spiro. on mine - you know,

the list I keep right in front of my Ins. Card, THEY'LL FIND IT!

And now to my question, Since I do not see Eplerenone on the list of drugs that

will affect the test is this any reason to choose Epler over Spiro?

A loooong post, hope you enjoyed reading it as much as I did writing it!

- 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank &

testicle pain. I have decided against an adrenalectomy at this time since

Meds. are working so well. Current BP: 130/77

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

Metformin 2000MG, Lisinopril 2.5MG and Spironolactone 75 MG.

[Guest guest]

The BUN is always part of a comprehensive metabolic panel - the CBC - (they used to call it a chem 14 and some fossils..uhm..Dr G .??..sometimes still do. it is sodium, K, Cl, glucose, calcium, albumin, protein, CO2, BUN and creatine, and 4 liver tests) and the basic metabolic panel - the BMP - also includes the BUN and creatinine, just minus the 4 liver function tests. So they likely always get it which is good. Just hope they look at the BUN/CREATININE ratio since that is not always marked or calculated for us, but is the important one. From all of our humble experiences with the system that BUN/Cr ratio is too often overlooked or not used as a tool to help. I don't think they teach physician assistant's well enough about lab values as a tool (they always say

don't rely on labs completely and of course we shouldn't rely on any one thing, but it may be "heard" different by some) and even many docs discount some things on labs that are great little pictures leading to the big picture.

And if they do say, "bumm" then bend over and touch your ankles and sing moon river since they would be checking your prostate - THAT'S always fun isn't it?..............not!

Subject: Why is my BUN so big, I mean high!To: hyperaldosteronism Date: Monday, July 11, 2011, 11:30 PM

I have been preparing to meet with my Nephrologists, and Department Chair if he is available. Since I now know all there is to know about Conn's (haha) I thought I'd figure out CKD. (You may recall we didn't have a very good appt. the last time! He mentioned CKD Stage 3 in my "problems list" and I need to find out exactly where he is coming from since this a problem my older brother (by < 2yrs) lived and finally died with! (I draw a little experience from supporting he over 30 year experience!I've known about CREATININE and actually learned what eGFR was my last Nephr. Meeting. I also picked up that BUN had something to do with it (I always thought they were checking my Buns)! Enough, I'll try to stay on task!Let me pause and report the last few labs to set the stageDate (all 2011) CREAT BUN eGFRRef range low 0.5 7 60Ref range high 1.5 25 6/24 0.98 20 776/7 0.9 18 >605/12 1.1 28 H >604/29 1.1

26 H >60 I have a few other numbers but had seen enough to decide maybe it was BUN that triggered him and I better find out what that was all about so I Googled it! The first article I looked at was Lab Tests Online: "To evaluate kidney function or monitor the effectiveness of dialysis and other treatments related to kidney disease or damage." That took the wind out of my sails for about 32 seconds! That Nephr. I thought was a Quack might be onto something!Wait a minute, a second opinion is always good and since MedlinePlus is next let's look there. On the end of page 1 is: "Drugs that can increase BUN measurements include:" BINGO, Furosemide is the 10th drug listed! Why that was fun I thought, let's turn the page. Why imagine that, Spironolactone is listed also!! Another AH-HA Moment! And he claimed to be the one that he "treated the whole person and not just some internet Guru treating only one thing!"Well that was a pretty

good half hour! Being taught to be thorough I looked back and BUN had been on the high side (22, 26H,20 and 23) back to 05/26/2010 when it was 15 and had never been over 18 for the previous 5 years with the most 14 - 15!What happened in May 2010 you ask, why that is easy, that is when I met my Savior, You remember, Dr. Yousefi, the one who Dxed me with Conn's and started me on Furosemide and Spironolactone! Now you say, "okay smart a_ _, why did it go back down in June 2011, explain that one!" That my friend is the easy one. I convinced my PCP to eliminate Furosemide at my May 27th appt! Nepher. Specifically did NOT want me to but I assured PCP that Dr. Grim and I think said I no longer needed it, I remember the discussion surrounded a fact it was a "loop diuretic"! Wait till I tell PCP she wins again, God we make her look good and trust me, she appreciates it! And I have just proved she trusts us over the Nepherology Dept. when it comes

to treat Conn's - told you she was smart!Okay, pay close attention here because this important (, jump in anytime)! Lab Tests Online says this test, BUN, is used "When an acutely ill person comes into the E.R. or is admitted to the hospital" Make sure your med list is up to date and I'm going to list "May effect BUN" next to Spiro. on mine - you know, the list I keep right in front of my Ins. Card, THEY'LL FIND IT! And now to my question, Since I do not see Eplerenone on the list of drugs that will affect the test is this any reason to choose Epler over Spiro?A loooong post, hope you enjoyed reading it as much as I did writing it! - 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP: 130/77Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2. and

PTSDMeds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG, Metformin 2000MG, Lisinopril 2.5MG and Spironolactone 75 MG.