Kidney failure u/e charts, 2006
Graphs and charts for blood pressure, potassium and creatinine, 2006
These charts are mostly of interest to doctors and medical students
Morning blood pressure chart, 2006:
Blood pressure was very high until the Royale put me on amlodopine and got to treating the underlying cause of the kidney failure.
Evening blood pressure chart, 2006:
As can be seen, the evening blood pressure was dangerously high early on and indeed, with other problems, caused such a literally blinding headache that I was vomiting to the point I was coughing up blood from torn muscles in my throat.
Indeed – and I lay this wholly on Whiston Hospital’s doorstep – at its monitored peak my blood pressure was a massive 185/145 and I apparently exhibited all the symptoms on an aneurysm! It may even have been higher but I was curled up a ball screaming and puking by then. My entry for the day after – 5th September 2006 – read that it
progressed to the sort of headache that feels like people are stabbing needles into your eyes.
Daily creatinine levels, 2006:
Creatinine is more a marker in the blood than anything else.
‘Popping a catheter in’ in early September relieved some of the back pressure alleviating some of the symptoms, but not the underlying causes.
Bilateral insertion of stents to the ureters did the trick though, as can be seen by the rapid drop.
Months on things still aren’t right (and may be deteriorating again) as the damage had already been done, but at least I’m off the danger list.
Note to doctors:
I’ll just pop a catheter in. There is no ‘just‘, and it’s not so much ‘pop‘ as insert it into a delicate area and wait for the screams. Trust me on this, it HURTS – the lubricant and numbing gel just lures the victim patient into a false sense of security! Strangely enough, I was more terrified of having it removed than put in. Go figure!
Creatinine is a waste by product of muscle activity, and is affected by your age, race, gender, and body size. Urology consultants seem to consider creatinine a better guide to kidney functions, but others (e.g., kidney.org, pharmacologists) consider the eGFR a better guide.
Personally, for myself, I go by this: urea, then creatinine, then eGFR, then potassium etc., the reasoning being I know when my kidneys are failing because I can taste it! Creatinine and eGFR are different guides to how bad they are. As for electrolytes, which in many ways they matter the most, the fact is that if you are having regular blood tests, high potassium is a huge red flag.
As a rough guide, AKI, acute kidney injury, goes to level 3. For eGFR, anything under 60 is a red flag. 45-59 is stage 3a, 30-44 stage 3b, 15-29 stage 4. Anything under stage 15 is stage 5, basically end-stage renal failure, where the kidneys have lost almost all functionality and you have about a week, maybe a month to live without dialysis.
Not actually that clear cut, obviously and, as mentioned above, consultants seem to put more store in creatinine (a marker) than eGFR. As long as you are producing enough bicarbonate to keep your electrolytes in check your body can generally tolerate it – hence panic when they see potassium at high levels, ‘cos that will kill you. Well, that and blood pressure, which is also a problem with kidney patients.
Daily potassium levels, 2006:
People have individual tolerances, obviously so it’s a rule of thumb, rather than an absolute, but being casually told by a nurse that
Oh, that’s high translates as
any higher and you are dead does not inspire a great deal of confidence in a hospital trust. Way to go Whiston – NOT!
While I was in the Royale one old git (and he was!) came in with a Potassium of 8.5 and left long before me. However, another came in with a potassium of 6.2 and died a few hours later of a major heart attack. Really!
Mostly mine remained stable but no-one at Whiston ever mentioned the importance of diet. I was allowed unlimited fruit juice, vegetable with meals, pints of milk and bananas served with meals.
As an aside, more recently, (October 2017, January 2018), following more kidney problems, my potassium was up to 6.4 or higher and while I felt OK-ish it was high enough, and rising fast enough, that as soon as they realised they pumped me full of bicarbonates, ordered urgent 2-hourly blood tests, and were considering moving me to intensive care!
Addenda 2018, revision:
The updated healthy range for potassium is 3.5 to 5.3, rather than 3.5 to 5.0 on the (old) graph.
Daily urea levels, 2006:
Again, something people have different levels of tolerance with. My friend Peter (another kidney patient) was perfectly fine at levels around 25, but anything over 15 and I was heaving. I needed to keep eating sandwiches etc to settle my stomach. It was not a fun time for me, especially given I’d never really had an upset stomach in my life before all this.
Fast forward to 2018 and urea levels in the blood up around 29. The nausea is awful and the taste in your mouth, constantly.
As an aside, stress levels!
Just before I went into hospital I did a stress test online with the NHS’s ‘Oh What a Relief’ site. While overall it was moderate, touching high on the check itself, I scored 161 on the stress indicator, where 25 is considered moderate and 49 is considered very high. Clearly there are issue to sort!