Week Nine - More Labs.......

In the aftermath of the ER visit, they wanted us to go for more labs.  Despite the increase in fluids, her kidney failure did not improve.

Maybe it's time to talk about numbers.  There are basically 3 blood kidney function tests.

1) Creatinine (Cr).  Normal value in kids would be 1.0 or less.  It's a indirect reflexion of muscle mass and muscle turnover, and the kidneys eliminate waste from that balance.  It rises exponentially as kidney function worsens - for example, a rise from 1 to 2 represents a loss of nearly half of your kidney function.  From 2 to 4, another half (leaving 25%), and so on.  My daughter's first Cr was 4.7, It is now 6.2.

2) Blood Urea Nitrogen (BUN).  Normal varies based on circumstances, but if  Cr is normal, BUN should be around 10. It usually rises in proportion to the Cr, so a patient iin chronic kidney failure  will have a  BUN roughly 10 times the Cr.  A dehydrated patient will have a much higher BUN/Cr ratio. 

3) Glomerular Filtration Rate (GFR).  GFR is a reflection of the speed at which glomeruli (the kidney's tiny filters) can clear waste from the blood) . This is a calculated number based on height, weight, and age. Labs automatically calculate them for adults, but in kids you need a GFR calulator (or a formula).  My daughter's docs do not talk about her GFR.  At first I wondered why, but then I went to a GFR calcualation site. I plugged in her numbers and discovered that her GFR to start with was 13.  Now it's 6.  Normal is greater than 90.  So at this point the number is irrelevant.  Her kidney function is nearly as bad as it can get either way.

Renal failure is staged. with Stage 1 being a GFR just below 60. Stage 5 qualifies you for transplant/dialysis, with a GFR less than 15.  Usually they begin to prep for dialysis early in Stage 4, because it takes time to ready the body for that process.  She is deep into stage 5, and we do not have access for dialysis., AND we aren't on the transplant list yet.

We are running out of time.

DeeDee