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juliejusu juliejusu
wrote...
Posts: 53
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12 years ago
Hi, My mom was admitted to the ICU yesterday. She had been getting progressively weaker since the end of November and finally collapsed on New Year's Day. My dad took her to the ER. She is 64 years old. So far she's been diagnosed with kidney failure, but that's all they know for sure yet. They are hopeful that the damage is reversible but nobody really knows yet. She had an ultrasound today but results won't be in until tomorrow. My mom has been smoking cigarettes for about 40 years. She also has had some periods in her life that she drank a little more alcohol than she probably should have. Worst of all, she has not been to the doctor since I was born 33 years ago. Her dad died when she was a teenager and she was traumatized and never went to the doctor (except for my birth). So we have no baseline information for her and no clue as to when all of this really started.

On to her labs... Here are some of the most critical results. She is under medical care but I just need some help understanding what some of these values mean and what could be causing some of her issues.

1. WBC 62,000 (high)
2. Clumped Platelets (why? what causes this?)
3. Sodium 117 (low)
4. Potassium 7.6 (high)
5. BUN 149 (high)
6. Creatinine Level 4.9 (high)
7. EGFR 9 (low)
8. Albumin 1.6 (low)
9. Globulin 6.1 (high)
10. AST (SGOT) 69 (high)
11. CK Total 533 (high)
12. CK-MB 43.3 (high)
13. Myoglobin >1000 (high)
14. Troponin I 0.09 (high)
15. CRP 40.8 (high)

Even if you can just comment on one or two of these I will appreciate it (just include the item number so I know which item you are commenting on)

THANK YOU FOR YOUR HELP!
To Sligh - thank you so much for your comments! Her hemoglobin was 10.6 but went down to 7 so they gave her a transfusion last night. Yes, they gave her the Kayexolate yesterday in the ED and she hated it (especially the after effects - lol).
To Sligh - Also, hematocrit was 31.7 (low)
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wrote...
12 years ago
I am an intensive care RN, not a doctor, but from what I can see in these labs your mom indeed looks very sick.  While I would love to know what her hemoglobin or hematocrit is, a couple of things i can tell is that:

1) Your mom is definitely in acute renal failure. The BUN and creatinine levels are extremely high, as well as the potassium level.  The high potassium can lead to cardiac arrhythmias, and potentially death, so I would expect your mom to be on something to make her have a couple bowel movements (kayexalate) to help get her potassium level down.

2) She most likely has an infection.  A WBC count of 62 is quite high, the problem, however is that while we can tell that she has an infection, it gives no clue as to where it is.

3) Your mom's cardiac enzymes are high, which can mean 1 of 2 things. 1) she has had a myocardial infarction (heart attack), or 2) that the kidneys are not filtering the protein out as well as they should and that the high enzymes are further confirming kidney failure.  I would be willing to bet it's #2.

I would expect your mom to be in intensive care for a while.  She will most likely get dialysis and/or a lot of fluid as she simply may be extremely dehydrated.  She also sounds a little malnourished (from the low albumin level), so she will probably need some enteral feeding support through tube feeding if possible.  Good luck to you both.
wrote...
12 years ago
Sorry to hear about your mom - I hope everything is able to be managed and that she's out of the ICE soon.

One thing that you need to know is that lab values are only a small piece of the diagnostic puzzle.  A single lab value is usually meaningless, and must be put together with the physical exam and history.

She is a metabolic mess.  I'll comment on a few values, but I'm not an internist or critical care specialist.

5, 6 & 7 are indications of kidney function, and those numbers suggest renal failure.  Whether this is chronic or acute, I don't know.  She may need dialysis to get her blood "cleaned" - to do what her kidneys should be doing but are not.

4.  Potassium being that high is very dangerous, as it can cause abnormal heart rhythms.  It's high because of the kidneys not doing their job.

8.  low albumin is a sign of malnutrition, possibly a result of chronic illness

11-15  show that she is having problems with her heart, possibly a heart attack.  There are other tests that will evaluate her heart function, determine if there is damage to the heart muscle, and if there are coronary artery blockages that can be treated.

There's a start, anyway.
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