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Lab help - high bun creatinine ratio?

on 6/25/10 4:19 am - Akron, OH
RNY on 03/22/10 with
I just got labs back and while reviewing, saw that my bun creatinine ratio was high at 30.3 with a range of 6-22. This is the third time I had a high reading (last time it was 25.3), but the doctor always says everything looks good. What could cause the high reading? I also had a high calcium of 10.3 (range of 6-10.2). The only other thing that moved much was protein, and that went down to 6.8 from 7.1. This wasn't a full set of labs, just 6 month check up from PCP. Is that particular test something to watch after RNY or is it not related at all?

Kathy on a mission  

*Includes 24 pounds lost on pre surgical diet
Andrea U.
on 6/25/10 8:51 am - Wilson, NC
  • Kidney function
    • Blood urea nitrogen (BUN) – a measure of the amount of nitrogen in the blood in the form of urea (a waste substance secreted by the liver and removed from the blood by the kidneys) and a measurement of renal function; pronounced B-U-N; low BUN can indicate liver problems, malnutrition (including insufficient protein), excessive alcohol, or normal pregnancy changes; Range: 5-25 mg/dL
    • Creatinine - break-down product of creatine phosphate in muscle and usually produced at a fairly constant rate by the body; chiefly filtered out of the body by the kidneys; if filtering of kidneys is deficient, blood levels rise and thus usually a renal diagnostic tool; a BUN level and creatinine level together can point out other problems besides kidney issues –> a urea level raised out of proportion to the creatinine may indicate a pre-renal problem such as volume depletion; men tend to have higher levels, vegetarians tend to have lower; urine creatinine testing can be done to verify drug testing; Range: 0.5-1.5 mg/dL

How much fluids are you getting in?  How much protein are you getting in?

Your calcium is high -- did they do a PTH or D draw? 

on 6/26/10 12:37 am - Akron, OH
RNY on 03/22/10 with
Protein should not be an issue - I get in at least 90-100/day of whey isolate. Liquids could be a problem. I do struggle to get in enough liquids, probably getting around 50 oz/ day average. They did not do a PTH or D. I will be having a more comprehensive lab in a couple of weeks from my surgeon, so I will look at these again. As for the Calcium - that does concern me. I am taking 3/day of Celebrate calcium citrate, so I should be good there. I don't understand the high reading, and am frustrated that my PCP said all were good and then I go home with a copy of the labs and see 3 items in the High range with no explanation. I previously had left side pain which was attributed to an enlarged spleen, and though the pain has lessened, it is still there but is being ignored by both PCP and surgeon at this point. I am wondering if there is some kidney issue causing the enlargement.
Kathy on a mission  

*Includes 24 pounds lost on pre surgical diet
on 6/25/10 12:18 pm - Suffern, NY
How were your actual BUN and creatinine on there own?  If each one on there own were normal then you dont' have to worry.  Most labs nowadays, dont' even run the ratio if each individual one is normal.  Sometimes if one of them is on the top end and the other one is on the low end, you will end up with a high ratio but it doesn't really mean anything if they are both normal. If one or both of them are high, then you need to check it out.  A high BUN usually means you aren't drinking enough.  A high creatinine is related to your kidney function.  A low creatinine is usually just due to a high protein diet.

How much calcium are you taking and is it calcium citrate?  A calcium level that high usually means you are leaking calcium from your bones either from not enough calcium or the wrong type of calcium.  If you are taking calcium carbonate, then you need to switch to calcium citrate.  You also need to have a PTH to go with the high calcium level to see what is going on. In very rare instances, a high calcium and a high PTH can mean hyperparathyroidism and further testing needs to be done.  I would recommend seeing an Endocrinologist about your high calcium levels if it continues.

At 6 months out, you should be getting a full set of labs.  Here is a list of what you should be getting at all lab draws.  Wether it is your surgeon or your PCP.

CBC, Comprehesive Metabolic Panel, Iron, TIBC, Iron Sat %, Ferritin, B12, Folate, Vitamin D ( 25 Hydroxy), Phosporus, Calcium, PTH, Vitamin A, Vitamin E, Vitamin K, Lipid Panel, Zinc, Magnesium, Selenium, Copper, Vitamin B1 (Whole Blood), B6,  TSH and T3, HemA1C


on 2/6/12 8:57 pm
i am 8 months post op from RNY. I just had labs done and dont understand the results and the possibility of it being serious. my creatinine was 307.6 (scale 27.0-260 mg) which is high, but my protein/creatinine ratio was 0.04 (scale 0.00-0.20 mg) so that was normal, and my protein was 13 (scale 0-30mg).
So everything was normal except that creatinine, anyone know what could cause this and if it is serious? thanks
on 6/26/10 12:48 am - Akron, OH
RNY on 03/22/10 with
I am taking calcium citrate - Celebrate 3x's day. I am concerned about the high calcium reading. My creatinine by itself was .75 with range of .59-1.07. A separate BUN is not listed. These labs were just my own PCP's regular check-up labs. I will be getting a more comprehensive set in a couple of weeks by my surgeon. I gave my PCP a list of labs for my next check up in December (Vitalady's list) so I will be able to get all the info I need from her next time. SHe was willing to add them, although she questioned the Copper and one other one from the yearly list. I will check out the upcoming labs (and get a copy BEFORE my appointment) so I can ask questions or point out possible issues, and will probably be back with additional questions at that point (and armed with more information). Thanks for your help! 
Kathy on a mission  

*Includes 24 pounds lost on pre surgical diet