CHF and High levels of Urea Nitrogen

[Bobbi6693]

My dad had CHF and has been in the hospital for about a week now and they have been doing a lot of blood work and I have some of the result but haven't been able to pin the DR. down for a few minutes, I never seem to get there at the right time, hopefully someone here can help me.

He has had CHF for about 10 years and the last 4 have been really bad , getting worse with time.  He was admitted as 4+ edemiatic, CHF and Kidney issues.  So he hasn't come down in the swellign much, his urea nitrogen level is 90 normal range is 5-25 his creatinine level is 2.7 which is high but I can't recall the normal limits.  His heart has suffered more damage and is operating at 10%, down from 30 the last time he was admited.  So my questions are , at what level is dialysis started?  He is always either throwing up or has the dry heaves, is this from one of the problems or is this somehting that wouldn't be related?  Having such a high urea nitrogen level with his heart function, does this put him at a greater risk for death?  

His normal routine for hopsitalizations is as follows.  Enters hospital for swelling, they get it down adn release him, he goes home and continues to take in way to many fluids and the same thing starts al over again, he thinks prednisone is the only way you can get rid of the swelling which I keep telling him isn't going to help that by itself.  

Oh, his BMI (?) level is 5000, the nurse said she has never seen a level this high.  BMI if I have it right, is the test that tells how in control the congestive haert failure is, the normal range is 100 and below.

So there you have all my questions and I do appreciate any help you can give me with these.  I am totally prepared for anything you may say, I know he is dying so please don't try to spare my feelings, I just need the truth.

Thank You so much God Bless you all.....


Bobbi  in Washingotn State

[gmachris518]

Normal creatinine level is around 1.1, but the number you are needing is his GFR.  Dialysis is usually started when the GFR falls to 15 or below.

My creatinine ran around 4.7 for several years, it is now up to 5.9, and my GFR is 8.  I will be starting dialysis as soon as my dialysis fistula is healed enough to be able to insert needles into it.

There are 5 stages of kidney failure.  Stage one is a GFR of 130-90, stage two is 90-60, stage three is 60-30, stage four is 30-15 and stage five(end stage renal failure) is 15-0.

I can't answer your questions about the heart, as I just don't know enough.  Even though I suffer from CHF also.  I do wonder about prednisone, though.  Everyone I have ever known who had to take it, had terrible problems with swelling.  Prednisone is usually used to keep the body from rejecting a tranplanted organ.

Is your dad on any kind of diurectic, such as lasix?  It seems to work real well for me, along with diet and all of the exercise I can do safely.  I've managed to stay out of the hospital for swelling for 6 months, and at that time I came close to drowning in my own body fluid, so I think lasix is a great medication,.

I notice you're in Washington State, does your dad see a cardiologist and kidney specialist?  Washington State has some of the best in the world, and chances of survival for kidney and heart patients goes up about 18% just because they live in the Pacific Northwest.  So, if you can't find the doctor at the hospital, then find him at his office.  Make an appointment if you have to, and then go prepared with all of your questions written down, and don't let him go until you have the answers you seek.

I hope all the best for you and your dad...keep us informed.

[pedroviva]

I just saw your question.  I wonder how things have gone for your dad.  My dad died from CHF, and now my brother has it following a heart attack.  The high urea is probably causing the dry heaves and nausea, and the other numbers don't look good.  I think you mean BNP (not BMI).  I never knew that the BNP could be 5000.  The BNP is an indicator of how much stress the heart is suffering from the CHF.  For example, the BNP will go up when the patient is "wet" or loaded with fluid (edema) because the heart and kidneys are in distress trying to manage the overload.  CHF is very difficult to manage especially toward the end stage.  I hope you and your dad have an easy time of it.  Best of luck.