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Anyone can explain abnormality of complete metabolic Test?

 
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Nick



Joined: 20 Jan 2014
Posts: 5
Location: AZ

PostPosted: Thu Feb 13, 2014 5:43 pm    Post subject: Anyone can explain abnormality of complete metabolic Test? Reply with quote

Hi everyone. Hope you all are doing well and enjoying your lives.
Recently I've had a CMP blood work drawn which shows my creatinine level has risen to 1.2 mg/dl (reference range 0.6-1.5) and BUN has been steady at 13. The problem is that calculation for GFR is only 74 ml/min, indicating mild kidney damage, falling into stage 2 chronic kidney disease catagory(range 68-89).
Is it normal to have a GFR lower than 90 ml/min while taking fluconazole? I know some medications will affect it, but I'm not sure if it's related to daily 800 mg fluconazole side effect.
I had my blood drawn two hours after meal. Does that contribute to change in test result?
Any input will be very appreciated!!

Hope everyone continue doing well.
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vfs_admin_Dave
Site Admin


Joined: 19 Dec 2004
Posts: 275

PostPosted: Fri Feb 14, 2014 12:03 pm    Post subject: Reply with quote

Hi Nick,

Some tests for GFR indicate specific eating requirements before the test; you would have to check with your doctor to see whether your eating could have affected the specific test you had taken.

As to how fluconazole affects the liver, it can be different for everyone. Some patients are helped by switching to other antifungal drugs, particularly posaconazole, which can sometimes be more effective with fewer side effects and even at a lower dose. Perhaps a change of fluconazole dose may even be in order.

One of the medical journal articles called "Dosing guidelines for fluconazole in patients with renal failure" obviously focused on more severe kidney issues rather than VF itself, but had interesting things to say. It discussed GFR/creatinine clearance showed that they found the 400mg/d dose acceptable in treating systemic fungal infections while having a 60ml/min creatinine clearance with a 800mg/d "loading dose" - so the treatment guidelines would indicate you could keep taking the fluconazole, but aren't specific on the continuous use of 800mg/d.

However, guidelines do not apply to every person's case. It would be very useful to discuss the idea of switching the drug, the dose, and your kidney concerns with your doctor ASAP. There may be a specific reason to keep you on fluconazole, so be certain that you understand the reasoning to be kept on the drug or why the doctor wants your treatment to be done a certain way. There may be trade-offs made between fighting the VF and keeping the liver functioning at its best.

Please keep us posted to your progress. I hope things can improve as quickly as possible.

All my best,
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