Blood Work BUN / Creatinine question

[drvinnybombat]

In short, is borderline high BUN and Creatinine something to worry about? Is the high protein diet damaging my kidneys?

Here's the long winded version:

I went for a regular physical and the doctor thought I had recently had a minor infection of some kind and ran my blood to find that she was probably correct and that the infection was subsiding which explained lack of symptoms. Overall, she thinks I'm healthy.

Anyway, my BUN was 33.0 mg/dl and the Creatinine was 1.3 mg/dl. She says the creatinine is slightly high, and the BUN is well high. I workout really hard lately and have recomposed from 20% to 13% BF remaining at 190 lbs. I also take Jack3d on and off (on now), and whey isolate. No creatine other than the Jack3d. High protein intake overall.

Bottom line, I told my doctor about the creatine and working out hard with high protein and she still did not like those numbers. Do I need to start protecting my kidneys?

[ssbackwards]

if your worried bout your kidney get a GFR,

but those numbers are expected from a high protein diet.

[amateurfreak]

BUN stands for blood urea nitrogen and as you can probably infer it detects urea nitrogen in your blood. Through a high protein diet the BUN will naturally be elevated because urea nitrogen is formed from the break down of proteins in your body. You mentioned an infection, was in treated with antibiotics? Certain antibiotics can give an elevated BUN as well as l-dopa metabolites. Certain drugs,infections, and even dehydration can give a higher serum creatinine test result. Although the reference range slightly changes based on a hospitals population common reference ranges are: BUN normal range 7-20 mg/dl and Serum creatinine normal range 0.8-1.2 mg/dl for a male. Whenever i test my blood at school or the hospital for clinical chemistry i run a high BUN around 24 but my creatinine is still always within range. If she was really worried or you still are then you can have a urinalysis, creatinine clearance, urine osmolality and a calculated glomerular filitration rate (gfr) done although i honestly wouldn't worry.

[Whacked]

"Working out hard" as you stated can impact the findings a little, but this will impact liver enzymes (AST+ALT) moreso than kidney values.

More importantly, did you consume creatine (USP Jacked) within 48 hours of the test? If so, it will alter/elevate the findings of creatinine. Also, foods high in creatine (red meats especially noted here) the day before the test will do the same (d/t creatine content).

Additionally, in the event creatinine levels are elevated, a concurrent urinalysis of creatinine (creatinine clearance) is warranted/indicated; because efficient urine output of creatinine will negate serum (blood) level concerns (to a degree).

Your numbers are not that high at all. Provided you are otherwise healthy and hydrating yourself well, your values are of no concern at least from what you have relayed.

PS: GFR as the other poster recommended will be skewed d/t elevated BUN and creatinine levels so this test is also not the be al end all with respect to kidney profiling.

Given your stats, (6'1 + 192 pounds), if your daily protein intake is less than 300 grams, I wouldn't worry about it as that is fine IMO. Again, this is assuming you do not have underlying health issues.

People need to look at the whole picture and all the pertient/relevant findings and not just one or two variables.

[R1balla]

no need to worry about creatinine. you can simply get off creatine if u are on it and the number will go down. and if u arent on it, just drink a lot of water throughout the day and the number will go down.

it makes me so mad when bodybuilders go in for blood work and the docs lecture them about how bad protein is for you and how bad creatine is for you. but when a 356 pound obese woman comes in, they dont say anything at all except give them blood pressure meds when they should be telling them to eat right (like we do) and workout (again, like we do). we are like the healthiest people in our society and our docs flip out when we tell them how much protein we take but they dont flip when somebody else tells them how much sodium then consume/day

just make sure u are drinking plenty of water throughout the day

[Whacked]

NAIL ON HEAD buddy!

[criticalbench]

You need to get a 24 hour creatinine clearance test, possibly a renal ultrasound if you are truly concerned.

BUN levels are greatly influenced by hydration status; although used as a lab marker for renal function, its significance is very small from what I see; most nephrologists I deal with care very little about the BUN.

Creatinine is a more specific marker of kidney function. Creatinine is a by-product from muscle breakdown; normal healthy glomeruli are able to filter this substance out and you excrete it in your urine. Anyone with a degree of kidney impairment will retain this in their blood and will be shown on blood work.

With that being said, the more muscle you have, the more creatinine you are going to have. If you want a more accurate example of what your true levels are, avoid working out, and eat a normal healthy protein diet for 48 hours prior to your next blood work.

Mike

[Whacked]

To add to that, if there is protein in the urine (proteinuria), then your doc MAY shose to move forward with more testing as that IS a potential indicator of kidney disfunction. HJowever, it can also be resultant of (bacterial) infections and other ailments (hypertention). But given the fact that a very basic/simple urinalysis will give you this info (protein present in the urine), it's a no brainer to have done and dirt cheap and typically, part of any routine exam.

Nice post CB

Creatinine is a more specific marker of kidney function. Creatinine is a by-product from muscle breakdown; normal healthy glomeruli are able to filter this substance out and you excrete it in your urine. Anyone with a degree of kidney impairment will retain this in their blood and will be shown on blood work.

[criticalbench]

no need to worry about creatinine. you can simply get off creatine if u are on it and the number will go down. and if u arent on it, just drink a lot of water throughout the day and the number will go down.

it makes me so mad when bodybuilders go in for blood work and the docs lecture them about how bad protein is for you and how bad creatine is for you. but when a 356 pound obese woman comes in, they dont say anything at all except give them blood pressure meds when they should be telling them to eat right (like we do) and workout (again, like we do). we are like the healthiest people in our society and our docs flip out when we tell them how much protein we take but they dont flip when somebody else tells them how much sodium then consume/day

just make sure u are drinking plenty of water throughout the day

Water is not going to help creatinine, that will alter your BUN levels via hemodilution, but if your nephrons are damaged, increased water intake will only do more harm than good if you loose the ability to properly excrete the appropriate amounts of fluid from your body, creating internal electrolyte imbalances, and risking placing your body into a state of fluid volume overload.

Don't be confused, creatinine and creatine are not directly related like most seem to think; our supplemental intake of creatine does not directly correlate with our bodies ability to produce and excrete creatinine from the body.

Creatinine is a by-product of muscle breakdown which in turn is excreted by the kidneys with very little to no re absorption occurring, so any deficit to the glomeruli/nephron will result in a decreased amount of creatinine leaving the body and an elevated level inside the body.

There is no excuse for having elevated creatinine levels; these levels are something to be taken serious. Normal renal function depending on what scale you are using goes from 0.7 - 1.3. A typical healthy adult lets say sits around 0.8, whereas a bodybuilder with increased muscle mass will sit around 1.3. Anything over 1.3, and I would be getting a creatinine clearance test done asap. Dialysis is not for me, to many of my pt's go for it daily, doesn't look to fun.

Vasotec, and ace inhibitor sucessfully brought my Cr down from 1.3, which I was not comfortably with it being, to 1.1 which I am happy with. Do what you want, but to many people take there renal function to lightly.


Mike

[TheKanezzi]

You need to get a 24 hour creatinine clearance test, possibly a renal ultrasound if you are truly concerned.

BUN levels are greatly influenced by hydration status; although used as a lab marker for renal function, its significance is very small from what I see; most nephrologists I deal with care very little about the BUN.

Creatinine is a more specific marker of kidney function. Creatinine is a by-product from muscle breakdown; normal healthy glomeruli are able to filter this substance out and you excrete it in your urine. Anyone with a degree of kidney impairment will retain this in their blood and will be shown on blood work.

With that being said, the more muscle you have, the more creatinine you are going to have. If you want a more accurate example of what your true levels are, avoid working out, and eat a normal healthy protein diet for 48 hours prior to your next blood work.

Mike

^this,

plus you had mentioned an infection, did you take any antibiotics or any other medications for that matter? Clinically, I see a big change in the CMP when we administer a variety of meds, especially some antibiotics. The beans are pretty sensitive.

The key is that the BUN really doesnt show you much, creat is a much better indicator of renal function, 24hour creat clearance is best.

I am about your size, and my BUN/Creat are not normally that high.

[criticalbench]

^this,

plus you had mentioned an infection, did you take any antibiotics or any other medications for that matter? Clinically, I see a big change in the CMP when we administer a variety of meds, especially some antibiotics. The beans are pretty sensitive.

The key is that the BUN really doesnt show you much, creat is a much better indicator of renal function, 24hour creat clearance is best.

I am about your size, and my BUN/Creat are not normally that high.

Time and again to many people get caught up with there bun number, when in reality it tells little like you said. Some people would be shocked with how drastically that number fluctuates day to day based on what was eaten, hydration status, etc.

The only treatment I am aware of for lowering creatinine besides restoring kidney function is mucomyst (Acetyl cysteine) when there is a known cause for renal impairment like that seen with dye's for cardiac caths and ct scans. 600mg twice a day is what is prescribed to my pts and works fairly well for them. Will typically drop a cr level in the 2's, down to the low 1's fairly quick.

Mike

[EasyEJL]

the other piece on creatinine which nobody mentioned so far as I can tell was that your creatinine is MUCH higher than normal if you worked out reasonably shortly before the blood draw. I do early morning workouts, and then would go for the blood draws right after and they'd be elevated like yours. If I skipped that morning workout (or worked out after the draw) levels were normal.

[criticalbench]

the other piece on creatinine which nobody mentioned so far as I can tell was that your creatinine is MUCH higher than normal if you worked out reasonably shortly before the blood draw. I do early morning workouts, and then would go for the blood draws right after and they'd be elevated like yours. If I skipped that morning workout (or worked out after the draw) levels were normal.

That is correct; they say skip exercise for 48-72 hours prior.

Mike

[eatingisfun]

That is correct; they say skip exercise for 48-72 hours prior.

Mike

So you would expect if someone works out really hard, their creatinine levels should be in the upper range?

[criticalbench]

So you would expect if someone works out really hard, their creatinine levels should be in the upper range?

Yes.

[EasyEJL]

Yes, if they didn't take a 2-3 day break from workouts pre-test. Schedule your test for a Monday, work out Friday and take the weekend off

[criticalbench]

Yes, if they didn't take a 2-3 day break from workouts pre-test. Schedule your test for a Monday, work out Friday and take the weekend off

def a very wise idea

[HATEFULone]

Unless you have a baseline value that really doesn't mean much. If you are really concerned get more blood work in 6 months or a year, just trend it. If you are still peeing you are ok, plenty of people have renal insufficiency and are fine, you may be one of them. People pretty much covered it all above, if you took anti-biotics that may increase the levels. I've seen people still peeing with a creatinine of over 3, you will be fine. Also taking oral creatine and exercising will really not have much effect on blood levels unless you have some atn, otherwise it will just raise your urine creatinine.

[criticalbench]

Unless you have a baseline value that really doesn't mean much. If you are really concerned get more blood work in 6 months or a year, just trend it. If you are still peeing you are ok, plenty of people have renal insufficiency and are fine, you may be one of them. People pretty much covered it all above, if you took anti-biotics that may increase the levels. I've seen people still peeing with a creatinine of over 3, you will be fine. Also taking oral creatine and exercising will really not have much effect on blood levels unless you have some atn, otherwise it will just raise your urine creatinine.

I have patients on a daily basis with creatinine of 7.5, BUN of 100, and GFR of 10 who are still peeing. I would not suggest basing renal function off of unine output. If you want to do anything with fluids, evaluate your lower extrems for edema.

Mike

[TheKanezzi]

ya, clinically i see ppl pee MORE when they first get a hit on their beans, then SOMETIMES their urine output will drop