any nephrologists or other physicians here?

S

SkinnyJoe

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I ran across this recently:

http://www.canada.com/montrealgazette/news/story.html?id=378f85de-27de-4046-815e-293b772666e5

..and this, which seems to contradict the first article?

http://www.military.com/military-fitness/health/water-plus-oxygen-equals-weight-loss

Background: for the last several years I have been consuming more water than the average person, in the mornings, roughly 4-5 large glasses. I don't have any symptoms.

For other reasons (health screening) I had some bloodwork done, with selected results below:

1) 06/30/11: BUN 9 (on a scale of 8-22 mg/dL) and Creatinine 0.74 on a scale 0.50-1.40 mg/dL, for a calculated GFR of 118, mean being 107 for my age group, if I understood some sources correctly.

2) 08/16/11: BUN 11 (same scale) and Creatinine 0.72 (same scale), for a GFR of 122.

Now, I interpret those values as being in the normal/desirable range. I see the BUN/Creatinine ratio normal as well (in the 10-20 range in either instance).

Question: are my kidneys in pretty good shape, or, based on the article 1 above, would I need a urine sample to test for proteinuria?

Thanks for reading.
 
I'm not a physician, just a nurse at a family practice, but those kidney numbers wouldn't alarm me or, I think, the doctors I work with. If you're concerned about proteinuria ask to get a urinalysis next time you're at the doctor. It only takes about two minutes and will show the presence of protein in the urine. My personal experience is that protein showing up in urine is generally more indicative of a kidney stone than anything else. I'll run the article in question past my docs and see what they say.
 
Thank you. I currently don't have anyone else to ask. :)

Addendum: I also noticed on the first test (Comprehensive Metabolic Panel) further down the line, the value for albumin of 3.9 (on a scale 3.2-4.9 g/dL). , total protein 6.8 (6.0-8.2 range).


Don't see these on the later test (Basic Metabolic Panel).
 
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I think that the article on the Montreal Gazzette is a bit on the simplistic side, at least, in the way they present the information. They say that the doctors conducting the study found 100 "otherwise healthy" persons with proteinuria. Well: this (proteinuria) is the sign of a problem but they don't say if they did any research or test to establish if there was a problem; you can have asymptomatic patients, which is not the same as saying healthy. The amount of water a person drinks depends on a lot of factors, including climate, physical activity, diet, etc. The kidney is a fine tuned system that eliminates excess water, or retains waters when is needed, provided it's healthy. This is going to change if you are for example, a diabetic person: a very common symptom is thirst, not easily alleviated by drinking water. If you are doing strenuous physical activity, on a hot day, you are not only to loose water but also sodium and other salts, that you need to replace.
Bottom line. One study, is not evidence enough. In fact, in the medical journals, this is the final conclusion: more studies are needed (by the way Mr SkinnyJoe, your blood chem. seems to be fine).
 
I seem to remember that at least for some disorders a test that uses blood as a sample is more reliable/definitive/specific/sensitive/whatever than a test using urine samples.

If true, and if applicable here, then perhaps doing that (?screening) test would be going backwards and perhaps unnecessary? I don't know. Blood chemistry and physiology are definitely not my areas.

I am easily scared by medical stuff, that's for sure.
 
One other thing to keep in mind is that the article may have drawn conclusions that the doctors never made. Media misrepresenting medical studies is a time-honored tradition and 'Drinking too much water is latest health risk' makes for much more compelling reading than 'possible corellation between excessive thirst and underlying kidney conditions'.
 
Insipid Moniker said:
One other thing to keep in mind is that the article may have drawn conclusions that the doctors never made. Media misrepresenting medical studies is a time-honored tradition and 'Drinking too much water is latest health risk' makes for much more compelling reading than 'possible corellation between excessive thirst and underlying kidney conditions'.
Click to expand...

Very good point.
 
I also seem to remember reading years ago that E.coli can shut down the kidneys. I assumed that was ruled out by the scientists (for this particular population they mentioned)? I am sure people were exposed to different amounts of E.coli, and their immune systems vary widely as well. Search for walkerton/william clark on webmd came back with this, no mention of water consumption?

http://www.webmd.com/digestive-disorders/news/20101119/e-coli-linked-to-heart-kidney-disease

More info on the study: http://www.cmaj.ca/content/178/2/173.full
 
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Insipid, Alvaro, Careboy, others interested in this:

Just received a response from the Doctor that did the original study (in article 1) above:

"Your kidneys appear to be in excellent shape. We now have the longterm outcomes (7 year follow-up) that will appear in CJASN shortly. Surprisingly it is those that are putting out >3 litre of urine per day that have the best kidney outcomes. We had discovered that the people with high urine volumes had increased protein in their urine but the standard method we employed for measuring protein we recently discovered produces an artificial elevation in urine protein when diluted by large urine volumes hence our retraction that most have not noted. So for the first time we can say now having just completed our 7 year follow-up that longterm kidney outcome(eGFR) is better in individuals that drink in the region of 8-10 glasses of fluid per day.
Suggest you read when it appears in CJASN shortly.
thanks"

Load off my mind, thanks to this nice gentleman and BFC folks.
 
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