Dehydration and elevated Urea/Creatinine

[unsubscribed]

Hi all, thank you for reading.

How much of an effect does dehydration have when it comes to the below elevated markers? I tend not to drink too much water daily. Around 1.5 litres maybe. Probably consume around 1.5 litres of skim milk daily along with some OJ. Fresh fruit, plenty of glycine. 200gms of meat either chicken breast or ground beef. My doc wants me to get an ultra sound on the old kidneys which I will do

Should I lower protein intake? Im a 42 yr old male (can I say that these days??).

Serum 10/01/22 06/03/23

Sodium 142 141 (135-145) mmol/L
Potassium 4.1 4.3 (3.5-5.5) mmol/L
Chloride 108 104 (95-110) mmol/L
Bicarbonate 28 28 (22-32) mmol/L
Anion Gap 10 13 (8-19) mmol/L
Urea 8.6 H 11.2 H (3.2-8.2) mmol/L
Creatinine 128 H 136 H (60-110) umol/L
eGFR 59 L 55 L (> 59)
Urate 0.40 0.34 (0.20-0.45) mmol/L
Total Protein 71 69 (60-80) g/L
Globulin 28 29 (23-39) g/L
Albumin 43 40 (34-50) g/L
Bilirubin 5 9 (< 21) umol/L
Alk. Phosphatase 73 70 (30-110) U/L
Gamma GT 10 9 (< 51) U/L
ALT 13 13 (< 40) U/L
AST 21 15 (< 35) U/L
LD 150 152 (120-250) U/L
Calcium 2.46 2.34 (2.10-2.60) mmol/L
Adj. Calcium 2.40 2.34 (2.10-2.60) mmol/L
Phosphate 1.25 1.03 (0.75-1.50) mmol/L

Status Random Random

Cholesterol 6.2 H 5.4 (< 5.6) mmol/L
Triglyceride 1.9 1.7 (< 2.1) mmol/L

 

[Lemminkäinen]

Yes, likely dehydration or overdoing protein supplements or creatine or digesting a big barbecue. Check your kidneys anyway. You're probably fine.

 

[yerrag]

Why do the values have two sets is numbers? What does H mean?

Water intake is overrated. You can drink anytime you thirst. No real need to follow the guideline of 2 liters per day. Let thirst be your guide. Unless you are at an age where you have incontinence and avoid drinking water subconsciously. Then you need to observe a minimum amount of water intake.

Kidney ultrasound is really a lagging indicator of kidney health. When the kidneys are at an advance stage of disease does the ultrasound detect it.

The other test of kidney health such as urine albumin/creatinine and eGFR falsely attribute to kidneys issues that are microbial in nature that don't necessarily involve anything to do with the kidneys.

Inho the main threat to kidney health is calcification, and having good acid base balance is the best proxy for kidney health.

You can use urine and saliva pH strip readings to determine how well your acid base balance is, together with breath rate as a proxy for serum pH.

Diabetic people tend to develop kidney problems because diabetes is a symptom of poor sugar metabolism and it is the association with poor acid base balance that is at the heart of why diabetics develop kidney issues.

Calcification occurs because of two concurrent issues that originate from poor sugar metabolism-

-the loss of the ability of potassium to regulate calcium entry into the cell properly due to an acidic ecf (extracellular fluid)

-the cell producing lactic acid in place of CO2 (from having aerobic glycolysis instead of oxidative respiration), which deprives the cell of the ability to spirit outside the cell the calcium that got in, this leads to calcium being retained inside the cell, and as the calcium accumulates over time leading to calcification of the organ

 

[unsubscribed]

Yes, likely dehydration or overdoing protein supplements or creatine or digesting a big barbecue. Check your kidneys anyway. You're probably fine.

Thanks Lemminkäinen. Have you heard of the Bock Saga?
Too much protein I think too.

 

[unsubscribed]

Why do the values have two sets is numbers? What does H mean?

Water intake is overrated. You can drink anytime you thirst. No real need to follow the guideline of 2 liters per day. Let thirst be your guide. Unless you are at an age where you have incontinence and avoid drinking water subconsciously. Then you need to observe a minimum amount of water intake.

Kidney ultrasound is really a lagging indicator of kidney health. When the kidneys are at an advance stage of disease does the ultrasound detect it.

The other test of kidney health such as urine albumin/creatinine and eGFR falsely attribute to kidneys issues that are microbial in nature that don't necessarily involve anything to do with the kidneys.

Inho the main threat to kidney health is calcification, and having good acid base balance is the best proxy for kidney health.

You can use urine and saliva pH strip readings to determine how well your acid base balance is, together with breath rate as a proxy for serum pH.

Diabetic people tend to develop kidney problems because diabetes is a symptom of poor sugar metabolism and it is the association with poor acid base balance that is at the heart of why diabetics develop kidney issues.

Calcification occurs because of two concurrent issues that originate from poor sugar metabolism-

-the loss of the ability of potassium to regulate calcium entry into the cell properly due to an acidic ecf (extracellular fluid)

-the cell producing lactic acid in place of CO2 (from having aerobic glycolysis instead of oxidative respiration), which deprives the cell of the ability to spirit outside the cell the calcium that got in, this leads to calcium being retained inside the cell, and as the calcium accumulates over time leading to calcification of the organ

Cheers @yerrag,

2 values are from 2 different date samples.
H means “high”.
From what I’ve read from many of your previous posts about this type of thing you have many valid points.
I’ll grab some PH strips for sure.
I’m suspecting poor sugar metabolism, I’ve had low serum potassium in the past.
I sometimes drink “K water” ( potassium bicarbonate & Taurine) but perhaps not enough.
I should probably focus on buffering lactic acid with Sodium Bicarbonate, Aspirin, Methylene Blue etc and do you think introducing Vitamin K would help with the calcification?
I’ll research more into improving sugar metabolism.

Much appreciated!

 

[Lemminkäinen]

Haha Ior Bock yes, pretty cool guy, not sure if he's really legit though, I don't like the fact that's he mixing together Swedish and Finnish lores, they are too different in my opinion.

Yes, I think you can safely listen to Yerrag he's explaining the dynamics very well, less lazy than me.

 

[Vinny]

Should I lower protein intake?

No.

Im a 42 yr old male (can I say that these days??).

 

[yerrag]

Hi all, thank you for reading.

How much of an effect does dehydration have when it comes to the below elevated markers? I tend not to drink too much water daily. Around 1.5 litres maybe. Probably consume around 1.5 litres of skim milk daily along with some OJ. Fresh fruit, plenty of glycine. 200gms of meat either chicken breast or ground beef. My doc wants me to get an ultra sound on the old kidneys which I will do

Should I lower protein intake? Im a 42 yr old male (can I say that these days??).

Serum 10/01/22 06/03/23

Sodium 142 141 (135-145) mmol/L
Potassium 4.1 4.3 (3.5-5.5) mmol/L
Chloride 108 104 (95-110) mmol/L
Bicarbonate 28 28 (22-32) mmol/L
Anion Gap 10 13 (8-19) mmol/L
Urea 8.6 H 11.2 H (3.2-8.2) mmol/L
Creatinine 128 H 136 H (60-110) umol/L
eGFR 59 L 55 L (> 59)
Urate 0.40 0.34 (0.20-0.45) mmol/L
Total Protein 71 69 (60-80) g/L
Globulin 28 29 (23-39) g/L
Albumin 43 40 (34-50) g/L
Bilirubin 5 9 (< 21) umol/L
Alk. Phosphatase 73 70 (30-110) U/L
Gamma GT 10 9 (< 51) U/L
ALT 13 13 (< 40) U/L
AST 21 15 (< 35) U/L
LD 150 152 (120-250) U/L
Calcium 2.46 2.34 (2.10-2.60) mmol/L
Adj. Calcium 2.40 2.34 (2.10-2.60) mmol/L
Phosphate 1.25 1.03 (0.75-1.50) mmol/L

Status Random Random

Cholesterol 6.2 H 5.4 (< 5.6) mmol/L
Triglyceride 1.9 1.7 (< 2.1) mmol/L

I guess you were concerned about the high readings in urea and creatinine and that's why you ask if you should lower protein intake.

Both markers are high because you have high protein intake. Am I right? If so, lowering your protein intake would lower those values, but it really isn't because lowering protein intake improves your kidney function, even if your calculated eGFR improves.

Because Dr. David Copperfield makes you think lowering protein intake improves your kidney function, but the reality is that your creatinine simply increases as a function of higher protein intake. Same with urea as more protein is metabolized wih higher protein intake and more ammonia is produced. Ammonia gets to become urea eventually as it combines with CO2.

As creatinine is lowered with lower protein intake, naturally eGFR improves as the formula used to estimate GFR (hence called eGFR) increases because your creatinine is the only parameter that changed (not your age, not your sex, and not your race - which are all the parameters used to determine your eGFR by Dr. Copperfield).

If you want to be free of the smokes and mirrors, go get yourself a 24 hr urine creatinine clearance test, where you get the amount of creatinine excreted in urine in a day, and using your serum creatinine, you can determine the filtration rate of your kidneys. Since the kidneys also produce its own creatinine, the result would be overestimated, and a rule of thumb is to conservatively reduce the obtained gfr by multiplying by a factor of 0.8. This way you can compare this other gfr by the eGFR and you can see how off the eGFR is. At 59, you may even think you have Chronic Kidney Disease Stage 1 and that you need some drug or even dialysis.

Nothing could be further from the truth.

 

[yerrag]

Haha Ior Bock yes, pretty cool guy, not sure if he's really legit though, I don't like the fact that's he mixing together Swedish and Finnish lores, they are too different in my opinion.

Yes, I think you can safely listen to Yerrag he's explaining the dynamics very well, less lazy than me.

I am more lazy than you think. I have ChatGPT analyzing unsubscribe;s markers.

 

[yerrag]

Cheers @yerrag,

2 values are from 2 different date samples.
H means “high”.
From what I’ve read from many of your previous posts about this type of thing you have many valid points.
I’ll grab some PH strips for sure.
I’m suspecting poor sugar metabolism, I’ve had low serum potassium in the past.
I sometimes drink “K water” ( potassium bicarbonate & Taurine) but perhaps not enough.
I should probably focus on buffering lactic acid with Sodium Bicarbonate, Aspirin, Methylene Blue etc and do you think introducing Vitamin K would help with the calcification?
I’ll research more into improving sugar metabolism.

Much appreciated!

If you have low K in the past, the normal K currently may simply be due to your serum being acidic, thus causing cellular K+ to exchange with serum H+ (H+ being more acidic, and H+ going into the cells). So your low serum K+ augmented by cellular K+ makes it appear that your serum K is normal.

Your body potassium stores can better be increased by higher potassium intake from fruits, vegetables, and even meat. But it also requires you to have adequate magnesium body stores in order to allow increased potassium intake to translate into an increased potassium store.

Increased CO2 production from optimal oxidative meta bolism is the best way o improve body pH buffering for optimal pH. While optimal oxidative metabolism is lacking, externally supplying CO2 thru drinking carbonated water and baking soda intake will help support your body's ability to maintain a good pH.

 

[unsubscribed]

Haha Ior Bock yes, pretty cool guy, not sure if he's really legit though, I don't like the fact that's he mixing together Swedish and Finnish lores, they are too different in my opinion.

Yes, I think you can safely listen to Yerrag he's explaining the dynamics very well, less lazy than me.

I actually read a book about this Bock bloke. Interesting story though it may be just a story.
Thanks for your input though @Lemminkäinen

 

[unsubscribed]

No.

@Vinny I couldn’t help myself haha

 

[unsubscribed]

I guess you were concerned about the high readings in urea and creatinine and that's why you ask if you should lower protein intake.

Both markers are high because you have high protein intake. Am I right? If so, lowering your protein intake would lower those values, but it really isn't because lowering protein intake improves your kidney function, even if your calculated eGFR improves.

Because Dr. David Copperfield makes you think lowering protein intake improves your kidney function, but the reality is that your creatinine simply increases as a function of higher protein intake. Same with urea as more protein is metabolized wih higher protein intake and more ammonia is produced. Ammonia gets to become urea eventually as it combines with CO2.

As creatinine is lowered with lower protein intake, naturally eGFR improves as the formula used to estimate GFR (hence called eGFR) increases because your creatinine is the only parameter that changed (not your age, not your sex, and not your race - which are all the parameters used to determine your eGFR by Dr. Copperfield).

If you want to be free of the smokes and mirrors, go get yourself a 24 hr urine creatinine clearance test, where you get the amount of creatinine excreted in urine in a day, and using your serum creatinine, you can determine the filtration rate of your kidneys. Since the kidneys also produce its own creatinine, the result would be overestimated, and a rule of thumb is to conservatively reduce the obtained gfr by multiplying by a factor of 0.8. This way you can compare this other gfr by the eGFR and you can see how off the eGFR is. At 59, you may even think you have Chronic Kidney Disease Stage 1 and that you need some drug or even dialysis.

Nothing could be further from the truth.

With my OP I was hoping @yerrag you were going to chime in. You’re all over it.
Yes I eat a high protein diet, I have an active job, I lift weights x 2 p/week.
Daily I would consume:
Greek yoghurt w/ fresh fruit @ maple syrup.
2L of milk.
250gm ground beef w/ Maple. (Dash of glycine)
Coffee w/ plenty of sugar & glycine.
Eggs.
OJ
Fruits.

What you say makes perfect sense.
The Dr Copperfield I use had the reaction you speak of. I wasn’t concerned too much as I’m quite familiar with your posts throughout this forum. Very very informative.
Just looking for confirmation and further clarification.
I will get that creatinine clearance test just to continue observations.
Again, thank you @yerrag for giving me your time. I really do appreciate it.

 

[unsubscribed]

If you have low K in the past, the normal K currently may simply be due to your serum being acidic, thus causing cellular K+ to exchange with serum H+ (H+ being more acidic, and H+ going into the cells). So your low serum K+ augmented by cellular K+ makes it appear that your serum K is normal.

Your body potassium stores can better be increased by higher potassium intake from fruits, vegetables, and even meat. But it also requires you to have adequate magnesium body stores in order to allow increased potassium intake to translate into an increased potassium store.

Increased CO2 production from optimal oxidative meta bolism is the best way o improve body pH buffering for optimal pH. While optimal oxidative metabolism is lacking, externally supplying CO2 thru drinking carbonated water and baking soda intake will help support your body's ability to maintain a good pH.

Admittedly, magnesium intake could be better monitored.
The ph strips I have ordered so I hope to have a better understanding on where I’m at internally

 

[yerrag]

With my OP I was hoping @yerrag you were going to chime in. You’re all over it.
Yes I eat a high protein diet, I have an active job, I lift weights x 2 p/week.
Daily I would consume:
Greek yoghurt w/ fresh fruit @ maple syrup.
2L of milk.
250gm ground beef w/ Maple. (Dash of glycine)
Coffee w/ plenty of sugar & glycine.
Eggs.
OJ
Fruits.

What you say makes perfect sense.
The Dr Copperfield I use had the reaction you speak of. I wasn’t concerned too much as I’m quite familiar with your posts throughout this forum. Very very informative.
Just looking for confirmation and further clarification.
I will get that creatinine clearance test just to continue observations.
Again, thank you @yerrag for giving me your time. I really do appreciate it.

You're welcome.

I'd like to add that I believe the downside to a high protein diet is that the byproducts of protein metabolism get to be acidic, and more protein intake requires more work out of the kidneys to remove the acidity. But as long as the body has a good buffering pH system, coupled with a healthy set of lungs and kidneys to excrete excess acidity, the body is capable of achieving acis base balance and won't be in a chronic state of having acidic imbalance.

As to your question on vitamin K, it helps in getting the CO2 from mitochondrial oxidation to carry away calcium away from the cell, keeping the cell from becoming calcified. This is why vitamin K ( and CoQ10) brings out the rubberlike suppleness and flexibility in blood vessels, so that it can constrict and dilate freely without becoming rigid from calcification.

Lastly, if you look at the different variations of how eGFR is calculated, if your creatinine stays the same 20 years later, you would still see your eGFR decrease to values that a doctor would say points to a deeper level of chronic kidney disease- just because you're 62 by then. Plug in 62 for the age parameter in the equation instead of 42, and you'll how much lower your eGFR would be.

One more thing: When you have water going in a container that is more il than water going out in a tank, there is no question the water level would keep on increasing over time.

If your kidneys are not filtering well, the argument foes that your production of waste in creatinine would be greater than the creatinine excreted by the kidneys. So, because the kidneys do not filter as effectively, your serum creatinine would increase due to the accumulation of this waste. And according to "science," your serum creatinine would be high.

What I see wrong with this logic though, is that my serum creatinine has held steady at around 1.1 for the past twenty years. Is my kidneys were not filtering creatinine well, shouldn't I be seeing a steady increase in serum creatinine levels over the years?

So clearly, my kidneys are doing a food job excreting creatinine, and for this reason, I don't believe eGFR calculations that give me the impression that my gfr is low, and that there is something wrong with my kidneys.


This is why I believe personally that eGFR is voodoo science and math because it is lacking in coherence and logic, and is used by the medical establishment to fleece a sheepish public.

 

[xeliex]

Ask your doctor to check

CYSTATIN C

Insurance would probably cover it and it's much more representative of kidney function.

From years working in hospitals, I can tell you almost all muscular people have higher creatinines and those consuming more protein, higher BUNs. Clearly dehydration skews things, but moreso in favor of BUN. Get cystatin c checked for peace of mind.

 

[yerrag]

Ask your doctor to check

CYSTATIN C

Insurance would probably cover it and it's much more representative of kidney function.

From years working in hospitals, I can tell you almost all muscular people have higher creatinines and those consuming more protein, higher BUNs. Clearly dehydration skews things, but moreso in favor of BUN. Get cystatin c checked for peace of mind.

I asked for Cystatin C, which is said to be a better indicator than creatinine.

But it is just as good as getting creatinine. I could find no good reason to take this test other than to see another marker mirror creatinine. It is just like asking for a 2nd opinion from a doctor of the same flock as the doctor you first consulted with.

If you have a better explanation as to why Cystatin C test is needed, I'm all ears.

 

[xeliex]

Cystatin C

www.kidney.org

When is cystatin C used to estimate GFR?​

A cystatin C blood test can be helpful if:

• A previous test for kidney function was inconclusive or needs to be confirmed. In this instance, your healthcare provider may give you cystatin C test to confirm whether or not you have kidney disease.
• You are overweight, elderly or have lots of muscle (such as a body builder). Cystatin C-based estimates for GFR are believed to be less influenced by muscle mass or diet than creatinine-based estimates.

 

[yerrag]

Cystatin C

www.kidney.org

When is cystatin C used to estimate GFR?​

A cystatin C blood test can be helpful if:

• A previous test for kidney function was inconclusive or needs to be confirmed. In this instance, your healthcare provider may give you cystatin C test to confirm whether or not you have kidney disease.
• You are overweight, elderly or have lots of muscle (such as a body builder). Cystatin C-based estimates for GFR are believed to be less influenced by muscle mass or diet than creatinine-based estimates.

Cystatin C

www.kidney.org

When is cystatin C used to estimate GFR?​

A cystatin C blood test can be helpful if:

• A previous test for kidney function was inconclusive or needs to be confirmed. In this instance, your healthcare provider may give you cystatin C test to confirm whether or not you have kidney disease.
• You are overweight, elderly or have lots of muscle (such as a body builder). Cystatin C-based estimates for GFR are believed to be less influenced by muscle mass or diet than creatinine-based estimates.

It sounds very much like the eGFR is computed in a similar fashion with Cyststin C as with Creatinine.

And the formula is based on age, sex, race and either cystatin or creatinine, whatever the case may be.

On the word of the experts.

So, if my cystatin stays the same, my eGFR would automatically by "science" deteriorate based on this formula, as I get older, and if the computed value is low enough at a much older age, I could be considered as having chronic kidney disease.

eGFR calculations based on such formulas, be it using cystatin or creatinine, are entirely useless as it does not reflect the actual GFR.

It is merely a composite representation of the GFR of a person of a particular age, sex, race having a certain cystatin value or creatinine value.

I mentioned the use of anorher test called the creatinine clearance test. It is based on actual creatinine excreted in urine over 24 hours of a particular individual. There is good reason to think it is more representative of actual GFR, compared to eGFR.

Why our medical system chooses to use something so nebulous has me thinking it has always been up to no good. And I refuse to be their next victim.