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What Does This Blood Report Indicate?
Question: I would like to know about blood test results. I have been experiencing sometimes severe pain in right flank area, but in front to and on side. I have had blood in urine twice 7 days ago result read "above 50". Also, even tho its in "normal" range My gfr continues to go down. Over last 6 months it was 105, then 82 (one month ago) now 70.99 1 week ago. other abnormal results are MPV 10.8, MCHC 30.9 and Bun/creat ratio 7.8. Everything else seems to be in "normal" range. Could you share your thoughts? Thanks for your time
Brief Answer:
please upload the reports...
Detailed Answer:
Hello,
in order to help me get a better understanding of your situation I would like the full reports and the reason you've done the tests. Was it the flank pain? Have you done an ultrasound scan too? What else? But most of all, please upload the reports...
I'll be waiting for your input.
please upload the reports...
Detailed Answer:
Hello,
in order to help me get a better understanding of your situation I would like the full reports and the reason you've done the tests. Was it the flank pain? Have you done an ultrasound scan too? What else? But most of all, please upload the reports...
I'll be waiting for your input.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi, Here are the reports you asked for. I have had this pain for months. It progressed to severe pain for 4 days. Frequent urination. I feel as if there is something sticking into my ribs (at bottom rib on right side) and I can feel it directly back into lower rib of back. Sometimes it is just an uncomfortable pain. sometimes it brings me to tears. Ultrasound of kidneys was done, it said "normal" but she didnt check bladder because it wasnt full. Let me know if you have any more questions. Thanks
Brief Answer:
most tests are normal
Detailed Answer:
Thanks for the report, it's much easier to talk about tests when I have all of them in front of my eyes. Most of the tests are indeed normal. The only worrisome finding is the presence of blood in a urinalysis ("about 50"). I'm not sure whether this "about 50" means 50 per high power field or is it just the result that the automated counter calculated. If it's 50 red blood cells per high power field then this is too much to ignore. It is called hematuria (microscopic since the color of the urine was recorded as yellow) and requires investigation.
A negative ultrasound scan of the kidneys does not exclude kidney pathology. Since it's an undiagnosed case with ongoing symptoms I would have asked a patient with these problems to do a CT scan which is a more detailed test and will detect accurately tumors and stones. We do need to exclude the presence of tumors and stones in a patient with pain and blood in the urine. If the CT scan is negative then a cystoscopy might provide additional help. This is direct visualization of the bladder which may detect various causes of bleeding inside it (papillomas for example).
Finally in patients with intermittent pain located under the ribs on the right and reflecting to the back, checking the gallbladder is important. An ultrasound scan of the gallbladder and liver should suffice to exclude such problems.
Regarding your GFR is seems there is no problem. I don't know the method they used to determine the GFR. The most commonly used method is by calculating it (estimated GFR or eGFR) by using the values of creatinine, body weight and age of the patient. In your case your body weight should be around 64kg for example. Although your GFR is not the best for your age, it's not definitely abnormal. Your creatinine levels which determine the GFR for its most part, are more or less normal (it depends on body musculature a lot, muscular individuals have higher creatinine readings which cause lower GFR estimations). I'm not that worried for the GFR particularly if your urine production is adequate (1-1.5 Litters per day).
Regarding the indices you've mentioned like MCHC, etc they are not significant in your case. In a normal blood count most doctors won't even look at them. In abnormal blood counts we do look at them but this is not your case.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
most tests are normal
Detailed Answer:
Thanks for the report, it's much easier to talk about tests when I have all of them in front of my eyes. Most of the tests are indeed normal. The only worrisome finding is the presence of blood in a urinalysis ("about 50"). I'm not sure whether this "about 50" means 50 per high power field or is it just the result that the automated counter calculated. If it's 50 red blood cells per high power field then this is too much to ignore. It is called hematuria (microscopic since the color of the urine was recorded as yellow) and requires investigation.
A negative ultrasound scan of the kidneys does not exclude kidney pathology. Since it's an undiagnosed case with ongoing symptoms I would have asked a patient with these problems to do a CT scan which is a more detailed test and will detect accurately tumors and stones. We do need to exclude the presence of tumors and stones in a patient with pain and blood in the urine. If the CT scan is negative then a cystoscopy might provide additional help. This is direct visualization of the bladder which may detect various causes of bleeding inside it (papillomas for example).
Finally in patients with intermittent pain located under the ribs on the right and reflecting to the back, checking the gallbladder is important. An ultrasound scan of the gallbladder and liver should suffice to exclude such problems.
Regarding your GFR is seems there is no problem. I don't know the method they used to determine the GFR. The most commonly used method is by calculating it (estimated GFR or eGFR) by using the values of creatinine, body weight and age of the patient. In your case your body weight should be around 64kg for example. Although your GFR is not the best for your age, it's not definitely abnormal. Your creatinine levels which determine the GFR for its most part, are more or less normal (it depends on body musculature a lot, muscular individuals have higher creatinine readings which cause lower GFR estimations). I'm not that worried for the GFR particularly if your urine production is adequate (1-1.5 Litters per day).
Regarding the indices you've mentioned like MCHC, etc they are not significant in your case. In a normal blood count most doctors won't even look at them. In abnormal blood counts we do look at them but this is not your case.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so very much! I appreciate you taking the time to share your thoughts on my concerns. I see my doctor Fri and I think I will ask to have the ct done. Hoping she will............. I will be sure to follow up with you to share results of ct. Thanks again.
Brief Answer:
You're welcome!
Detailed Answer:
You're welcome!
I'll be glad to comment on any further information you'd like to share.
Kind Regards!
You're welcome!
Detailed Answer:
You're welcome!
I'll be glad to comment on any further information you'd like to share.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi, sorry to bother you again! My pain is on pretty strong today. I am trying to pay attention to detail. What I have noticed is, this may sound stupid but I can almost feel my bladder filling. Meaning, when I have a slight urge to urinate, the longer I hold it (the more full it gets) the stronger that pain in my back and under my ribs in front gets.( THe same pain I was telling you about earlier) If i hold too long, the pain shoots down almost center of my abdomen. Now, the pain doesnt completely go away afterurination, but it does ease off quite a bit, until the process repeats. Am I crazy, or do you think its actually "something". Thank you XXXXXXX
Brief Answer:
sounds like renal colic
Detailed Answer:
Hi XXXXXXX
your question does not sound stupid at all... This kind of symptom resembles of renal colic type of pain, which starts from the flank and moves to the front and to the lower abdomen when the stone moves down the urinary tract. When it reaches the entrance of the bladder the patient usually feels an urge to urinate although the bladder is not that full. An ultrasound scan during the painful event would be diagnostic if it's indeed a colic. When the pain is of lower intensity or over, the ultrasound scan can be normal.
This is not the only possible diagnosis but it's one of the most common ones for patients with your symptoms. The tests would provide further information. For example a urinalysis may reveal blood in the urine, the ultrasound scan may show signs of colic. The CT may reveal a stone or other pathology.
I don't believe you're crazy. Your symptoms indicate irritation of the urinary tract, so investigation is recommended.
Kind regards!
sounds like renal colic
Detailed Answer:
Hi XXXXXXX
your question does not sound stupid at all... This kind of symptom resembles of renal colic type of pain, which starts from the flank and moves to the front and to the lower abdomen when the stone moves down the urinary tract. When it reaches the entrance of the bladder the patient usually feels an urge to urinate although the bladder is not that full. An ultrasound scan during the painful event would be diagnostic if it's indeed a colic. When the pain is of lower intensity or over, the ultrasound scan can be normal.
This is not the only possible diagnosis but it's one of the most common ones for patients with your symptoms. The tests would provide further information. For example a urinalysis may reveal blood in the urine, the ultrasound scan may show signs of colic. The CT may reveal a stone or other pathology.
I don't believe you're crazy. Your symptoms indicate irritation of the urinary tract, so investigation is recommended.
Kind regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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