tinkll1 (tinkll1) wrote,
tinkll1
tinkll1

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To Dialyze or Not to Dialyze

This is a hell of a lot more personal than it should be. The only system that is dragging is renal. So I just got a call from the ICU and the nephrologist who's been teetering on the edge of dialyzing Lin. He points to the BUN of maybe 178, says she's well hydrated (I agree) and he's nervous. So am I. But the creatinine stays at 4.7-4.8. She's not acidotic or hyperkalemic. She's not oliguric, so? No nausea or vomiting. No pericardial friction rub. No itching. No ICU psychosis. No GI bleed. Corticosteroids will raise the BUN.

Now, urea is not intrinsically toxic. It's an indicator, but it's not as good an indicator as the creatinine change is, as the creatinine is only affected by muscle mass and diet. So, when the creatinine isn't changing, kidney function isn't getting worse, whatever the BUN does.

Now, you're all nephrologists. And, no, no sign of GI bleeding despite the steroids and stress.

That's it for now! I'm going to see her and watch The News Hour with her, and tell her that her Badgers.... she was a cheerleader at the University of Wisconsin.... just lost to MSU, kind of raising the status of the other 3 loss teams, like... the Bruins!
Tags: lin
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