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My GFR in the Bmp test dropped from 57 to 50 in five weeks…

Customer Question
My GFR in the...

My GFR in the Bmp test dropped from 57 to 50 in five weeks and then to 44 in the next five days. Should I be concerned? Am I drinking too much water or not enough; right now I drink about 60 oz a day. I take 3 salt pills every day to keep that ok. It was 138 recently. BUN = 28 and the ratio was 23. Everything else was ok.

Doctor's Assistant: What medications do you take daily? Are you allergic to any medications?

Lisinapril 5mg, Lasix 20 mg and pravastatin 40 mg I am a little allergic to benydril though I can take Tynonal PM once in a while. Otherwise not allergic to anything.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

My chart says I have chronic kidney disease. I get heart burn if I am not careful. I am 83 have some artrithis but I walk 20 min a day and do exercises for balance and do a lot of gardening and painting, etc and keep house and drive a car a lot.

Submitted: 8 months ago.Category: Medical
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Answered in 11 minutes by:
9/28/2017
Doctor: Dr. D. Love, Doctor replied 8 months ago
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,651
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hello from JustAnswer. This is Dr. Love.

What was the reason that your labs were checked so frequently?

What is the medical reason for which you are taking the lisinipril and Lasix?

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Customer reply replied 8 months ago
I check my labs frequently because my salt dropped to 121 and was ordered to go to the emergency room and got 2 unit of salt there and then was put on salt bills. I was concerned about the drop to 50 and called the doc but he was out and another doc said to check in five days and then it was 44. I called to doc again but was put off until I have an appointment with him on Nov. 17.
I take Lisinipril because of high PB but it is ok now. Can go from 178 to 103 in a day. Thats just me - get stressed out easily.The lasix is because of so much salt but I never get swollen ankles.
Doctor: Dr. D. Love, Doctor replied 8 months ago

Thank you for the additional information.

The GFR on this lab is not a direct measure of kidney function; it is calculated based on the serum creatinine. A lowering eGFR is solely due to an increasing creatinine. An elevated creatinine can be due to worsening kidney disease, but when the creatinine increases quickly, it is also very common that it is due to being low in fluid. So, the usual response to a lowering creatinine is to increase the amount of fluid intake.

However, this can be complicated, because worsening congestive heart failure also can cause an increasing creatinine. Congestive heat failure usually needs less fluid intake or higher doses of Lasix. So, when there is congestive heart failure, increasing fluid intake may make it worse. You do not state a history of congestive heart failure (and I asked about lisinipril and Lasix because these can be used for congestive heart failure). You also do not describe any symptoms that would be worrisome for congestive heart failure. Therefore, there is no reason to be concerned that the increasing creatinine is related to worsening congestive heart failure.

Therefore, it would be appropriate to increase the amount of fluid intake by another 8 - 16 oz. per day. But with your history of rapidly changing sodium levels, it also would be appropriate to recheck labs after a week or so of higher fluid intake rather than waiting until the appointment in November.

If I can provide any additional information, please let me know.

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Doctor: Dr. D. Love, Doctor replied 8 months ago

Please let me know if I can provide any further assistance.

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