How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Internist Your Own Question
Internist
Internist, Dr
Category: Urology
Satisfied Customers: 1066
Experience:  MBBS, FCPS (Resident),MD (USA), Ecfmg Certified
23050427
Type Your Urology Question Here...
Internist is online now
A new question is answered every 9 seconds

I went to the dr because if swelling in my ankles. So after

Customer Question

I went to the dr because if swelling in my ankles. So after all the test she says it is my sodium intake. And to cut back. But looking at my labs my creatine is .95 and my gfr is 78. It is not flagged for high or low it is in the normal range. But everything
I Google say ckd2. I'm 34. Should I be concerned? Or is that normal?
Submitted: 1 year ago.
Category: Urology
Expert:  Internist replied 1 year ago.

hi there,

I am online and will be happy to answer your questions.

Thank you for your patience.

normal GFR is above 90.

your gfr is in low range, ( creainine however is in normal range , but it takes bmi and other things into account to measuer gfr)

I recommend checking your blood pressure, Blood sugar level, ultrasound of kidneys, and urinalysis.

this may be a lab error, ( but if not, gfr of 78 IS low)

please let me know if you have any questions.

thanks

Expert:  Internist replied 1 year ago.

I am here to help you and I wish you best health,

if done for now, please leave positive rating above the chat box.

we only get credit for helping clients after positive feedback.

If you have any more questions, please feel free to ask anytime.

Please bookmark my profile for asking further questions!

This is the link to my profile:

http://www.justanswer.com/medical/expert-drhashmimd/?rpt=3800

Customer: replied 1 year ago.
She did everything including the cmp. No protienuria or anything like that. My bi is like 35. Do you think the swelling could have cause the 78 gfr. On the lab test it says normal is >59. So is every lab different? She said and I saw the gfr was not flagged in the test as high or low. It was normal.
Expert:  Internist replied 1 year ago.

bi you mean BMI ?

normal gfr range is 90-120 ml/min/body surface area

your gfr might be given in different units. ( can you attach a picture or tell me the units of your gfr values?

thank you

Customer: replied 1 year ago.
I meant bmi sorry. Yeah let me look it up. And I'm not anemic and my CBC and all that was normal too.78ml/min/m2
Expert:  Internist replied 1 year ago.

in ml/min/m2 normal is more than 90.

you can call lab and ask why did they mention it in normal range.

calculate your gfr with yyour creatinine value given from this link . ( your creatinine is within normal limits)

https://www.kidney.org/professionals/KDOQI/gfr_calculator

Expert:  Internist replied 1 year ago.

you can calculate without serum cystatin c values.

http://www.davita.com/gfr-calculator/

Expert:  Internist replied 1 year ago.

let me know about the values. or give me information needed and ill calculate for you.

Customer: replied 1 year ago.
I put in my creatine of .95 and it says 78. So how can my c level be normal but my gfr be 78? I just looked at the range on labcorp. At our office >60 is listed as normal per their labs. If their creatinine is in normal range.
Customer: replied 1 year ago.
Plus my weight wasn't added into my labcorp labs. I am 5'8 and weigh 278. So does that have something to do with it?
Customer: replied 1 year ago.
Also I read on davitas site that if a gfr is between 60-89 and there is no sign of kidney disease they are not considered ckd.
Expert:  Internist replied 1 year ago.

some labs only measure if gfr is more than 60 or not.

normal range varies with age and body surface area and race.

Normal creatinine values may vary among different laboratories, and some patients with serum creatinine levels within the “normal” range may have substantial reduction in kidney function

Likewise, the rate of increase or trend of serum creatinine levels can also indicate CKD.

it is not considered CKD if ultrasound of kidneys, urinalysis, cmp is all within normal range. but we do need to check them before declaring it normal

Expert:  Internist replied 1 year ago.

and there can be CKD even with GFR more than 90.

so yes it takes other things into account to fully understand if it is normal or not.

Expert:  Internist replied 1 year ago.

one reason for that with creatinine we get only an estimate of GFR and not an actual GFR

Customer: replied 1 year ago.
I had a mri of pelvis on September 1st bc I had surgery on 9/10 for a urethral diverticulum and I had a urinalysis on 9/1 along with the mri. The urologist said my urine actually looked good for someone that had a diverticulum. So what do you think? He didn't mention if anything was out of whack......and I'm sure being a urologist he would have.
Expert:  Internist replied 1 year ago.

did you get a urinalysis ? and it showed normal everything?

any comment on kidneys on ultrasound

Expert:  Internist replied 1 year ago.

yes , you can trust a urologist, if he said your kidneys are fine, he must have said by looking at all things.

I cannot comment at this stage without looking on ultrasound and urinalysis report. ( recent )

Customer: replied 1 year ago.
No he just said my urinalysis looked good for someone with a urethral diverticulum. He didn't mention anything about my mri but that everything looked ok. I go back for post op next tuesday. Should I take my labs and ask him--the actual urologist?
Expert:  Internist replied 1 year ago.

yes you should.

please mention swelling of your ankles and your gfr values.

since it was mri of pelvis, it may not have commented on kidneys.

Customer: replied 1 year ago.
One last question. Could I ask my md to run another cmp when I go back in 2 weeks and see if it goes up? I know I asked the lab and they don't put in height or weight in lab orders so it wasn't even considered. And you said it is just a rough estimate, so that gfr could be not really my actual gfr right?
Expert:  Internist replied 1 year ago.

yes it is not be actual gfr and is only an estimate.

cmp, and urinalysis, and ultrasound of kidneys to see the whole picture.

Customer: replied 1 year ago.
My swelling goes away when I put my feet up also. I sit all day long and I think my being overweight has a bit to do with it. I haven't swollen in 3 days. Plus sometime my bp is sometimes borderline. If I lose weight and start walking and exercising could I fix my gfr and get it to normal range?
Expert:  Internist replied 1 year ago.

first we do not know if kidneys are the cause of low gfr or if this is normal.

secondly, you should definitely do exercise and lose weight . 35 bmi means you are obese class 2. it will definitely help control your blood pressure and improve your overall health status including kidneys.

Customer: replied 1 year ago.
if it is truly 78 and ckd2 I could correct it by losing weight and getting bp under control since I am only 34? And move out of ckd2 of that is truly correct?
Expert:  Internist replied 1 year ago.

yes, you can improve and control deterioration further.

some causes of ckd are reversible and some are not.

but in all the cases these measures would help controlling and preventing further decline ( may also improve and get out of ckd )

Expert:  Internist replied 1 year ago.

http://www.uptodate.com/contents/chronic-kidney-disease-beyond-the-basics

you may find this link helpful.

I am here to help you and I wish you best health,

if done for now, please leave positive rating above the chat box.

we only get credit for helping clients after positive feedback.

If you have any more questions, please feel free to ask anytime.

Please bookmark my profile for asking further questions!

This is the link to my profile:

http://www.justanswer.com/medical/expert-drhashmimd/?rpt=3800

Customer: replied 1 year ago.
I checked some labs from 4/2014 my gfr was 74 and my creatine was 99.7ml/min. Also my BUN was 13. But also the BUN/creatinine ratio was 13 (with a red range of 15-24) it says it was low. But on my labs from Monday all that was normal. Does that mean somethings wrong with my liver?
Customer: replied 1 year ago.
Here are the labs from 4/2014
Customer: replied 1 year ago.
here are the labs from Monday 11/2015
Expert:  Internist replied 1 year ago.

all labs on april 2014 are within normal limits.

for nov. 2015 all labs are normal range except for estimated GFR and I would not worry about that ,

liver function test alt , ast are in normal limits.

however to clarify more, i would like to see urinalysis and ultrasound of kidneys.

Please click on accept/ positively rate my service to you so i can get credit of my work.

feel free to ask any follow-up questions you have,

thank you

Customer: replied 1 year ago.
The bin/creatinine is off because my creatine serum is so high on the 4/2014 labs. So that would be kidney not liver since my BUN was I'm normal limits correct?
Expert:  Internist replied 1 year ago.

your creatinine was not so high. (1.0) on april 2014.

your creatinine clearance was 99 which is perfectly normal. ( creatinine clearance is another way of saying GFR)

Expert:  Internist replied 1 year ago.

I am here to help you and I wish you best health,

if done for now, please leave positive rating above the chat box.

we only get credit for helping clients after positive feedback.

If you have any more questions, please feel free to ask anytime.

Please bookmark my profile for asking further questions!

This is the link to my profile:

http://www.justanswer.com/medical/expert-drhashmimd/?rpt=3800

Thanks for using justanswer.com

Customer: replied 1 year ago.
But what I am talking about is the bun/creatinine ratio was low. But my bun was normal. If my creatinine would have been a little lower then the ratio would not have been off. I saw where that ratio can be low because of liver failure, malnutrition, and some other things.
Expert:  Internist replied 1 year ago.

ratio can be low due to simply low protein intake, liver failure, etc.

but your liver function tests are normal and you do not need to worry about that

Expert:  Internist replied 1 year ago.

dear ja customer, you have not accepted my answer yet.

do you have any questions?

Expert:  Internist replied 1 year ago.

do you have any questions.?