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What Does My Lab Test Report Indicate?

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Posted on Wed, 13 Sep 2017
Question: I am a renal transplant patient. My reports are like given:-- creatinine: 1.2, urea: 38, TLC:11000, Hb:11 i take siromus tabs: 2mg/day and cyclosprine:50mg-BD as immunosuppresent and wysolone(5) OD along with other medicines for BP. My recent Siromus level test result is like this: "2.9 ng/ml where it is written that biological reference level for 2mg/day patients is 4.5-14 ng/ml". what is your suggestion on the dosage of siromus tablet i take---- should it be increased or decreased considering my TLC values. with regards, ------------Biplab XXXXXXX
doctor
Answered by Dr. Ravi Bansal (5 hours later)
Brief Answer:
sirolimus doses should not be changed

Detailed Answer:

Hi Biplab,

Dose of sirolimus and cyclosporine need not be changed if you are doing fine. If you have completed 6 month or more and your creatinine values are constant you should not change these transplant medicines until you have any toxicity symptoms or infections. Your treating doctor will see the risk and benefit of changing the dose and then only change them. the level of sirolimus targeted after transplant depends on whether you are using it with MMF and wysolone or you are using with cyclosporine, in which case you have to keep a lower level.

sirolimus level is not predicted by TLC test. and TLC level does not guide us about sirolimus dose.

your creatinine of 1.2 seems fine.

best wishes


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ravi Bansal (21 hours later)
Thank you for the answer.
But then why my TLC level is remaining so high?
If TLC level does remain so high for long time, will it not affect my kidney?
How can i treat for so high level of TLC?
Thanking you,
---------Biplab XXXXXXX
doctor
Answered by Dr. Ravi Bansal (56 minutes later)
Brief Answer:
High tlc may be from various causes

Detailed Answer:
hi,
High TLC can be from infections if you have signs of fever, cough or urine pus cells. but it can be high without infection also because of wysolone. As you are having this tlc level for long time then this may be new normal for you. in that case you need not worry it will not have any impact on the graft kidney. but if it is related to infections it may cause damage to the kidney.

you can show ti your doctor to rule out infection

best wishes.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ravi Bansal (1 hour later)
I do not have any infection, checked. I take Siromus 2mg/day, cyclosprin- 50mg twice and Wysolone-5mg/day.
As my TLC level is out of normal range, should wysolone be reduced?
doctor
Answered by Dr. Ravi Bansal (33 hours later)
Brief Answer:
No

Detailed Answer:
there is no need to change your wysolone dose. it is that some people just maintain higher tlc. but if the tlc levels are stable and not rising progressively then there is no problem.

best wishes
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Ravi Bansal

Nephrologist

Practicing since :1996

Answered : 359 Questions

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What Does My Lab Test Report Indicate?

Brief Answer: sirolimus doses should not be changed Detailed Answer: Hi Biplab, Dose of sirolimus and cyclosporine need not be changed if you are doing fine. If you have completed 6 month or more and your creatinine values are constant you should not change these transplant medicines until you have any toxicity symptoms or infections. Your treating doctor will see the risk and benefit of changing the dose and then only change them. the level of sirolimus targeted after transplant depends on whether you are using it with MMF and wysolone or you are using with cyclosporine, in which case you have to keep a lower level. sirolimus level is not predicted by TLC test. and TLC level does not guide us about sirolimus dose. your creatinine of 1.2 seems fine. best wishes