Elevated BUN numbers/Kidney Function/Protein Intake

  • fitginger

    Posts: 64

    Aug 14, 2011 1:15 AM GMT
    Hey guys,

    So I recently had a new medical done for work and then went on vacation for 2 weeks and when I got back was asked to see the doctor about something.

    He told my my BUN number was elevated meaning my kidney function is higher than normal. I have since had another blood test and the same results came out. I've also had an ultrasound to see if there is anything physically wrong with them, for which I haven't had the results for just yet.

    After having googled BUN numbers and elevated kidney function I came across some interesting research:

    "The blood urea nitrogen (BUN, pronounced "B-U-N") test is a measure of the amount of nitrogen in the blood in the form of urea, and a measurement of renal function. Urea is a by- product from metabolism of proteins by the liver and is removed from the blood by the kidneys."

    What I can gather from this is that my body isn't absorbing protein very well and is expelling it through my kidney's making this "BUN" number higher.


    Has anyone else had this problem before? Should I be worried that the amount of protein I'm taking is effecting my kidneys?

    Any advice?



    Thanks!
    Fitginger icon_smile.gif
  • Posted by a hidden member.
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    Aug 14, 2011 1:35 AM GMT
    Depends on how high it is. An elevated BUN actually indicates decreased kidney function, but only in certain circumstances.

    Simplistic way of thinking about this: What goes in, either stays in or comes out.

    It's not so much you're not absorbing protein, but that the catabolic products of protein (e.g. urea) are not excreted in the usual manner by the kidneys or they are being generated quicker than the kidneys can excrete them.
    I hope you told your doctor you eat a lot of protein and exercise a lot. (If that is the case, then it probably isn't so much your kidney function is down)

    BUN can change quite a bit between adequately hydrated (low) and dehydrated states (high) as well.

    Now, if you have protein in your urine, that different. You should probably not be eating too much protein because it may worsen your kidney function over time.
  • nanidesukedo

    Posts: 1036

    Aug 14, 2011 2:13 AM GMT
    You are young and, frankly, I wouldn't worry about it. If your creatinine level were to come back elevated as well, other things would have to be examined (IE your BUN:creatinine ratio which shouldn't be above 15-20 and may indicate inadequate hydration if it is). Also, if your doctor is worried, as the poster above me stated, he can check for protein in the urine with a simple dipstick test. Typically, protein, sugar, and blood (or blood imitators like myoglobin which can be seen in the urine of long distance runners or those who are severely dehydrated) don't "spill over" into your urine unless your kidneys have suffered some sort of damage (either reversible or otherwise). Also, with kidney disease, as it progresses, you begin to develop some pretty nasty edema, typically beginning in the extremities (most often in the legs). So, all things considered, I'd reckon the poster above me is correct: The test was A. Either done when you were dehydrated or B. You are consuming massive amounts of protein and your body is getting slightly backed up in metabolites (which is benign...just give your kidneys a little break ;) ).
  • Posted by a hidden member.
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    Aug 14, 2011 3:10 AM GMT
    nanidesukedo saidTypically, protein, sugar, and blood (or blood imitators like myoglobin which can be seen in the urine of long distance runners or those who are severely dehydrated) don't "spill over" into your urine unless your kidneys have suffered some sort of damage (either reversible or otherwise). Also, with kidney disease, as it progresses, you begin to develop some pretty nasty edema, typically beginning in the extremities (most often in the legs).

    Some caveats:
    Glucose is freely filtered in the glomerulus, and the proximal tubule has a limited ability to resorb glucose. Normal kidneys "spill" glucose when the serum level is >160-180 mg/dl. Some kidney diseases lower this threshold (e.g. if you damage the proximal tubular cells) and you get glycosuria below 160.

    Some people with kidney disease have no edema at all, even when advanced.
  • Posted by a hidden member.
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    Aug 14, 2011 3:21 AM GMT
    are you hydrating enough? BUN can elevate when your body's not getting enough water, and given your protein intake, it's important that you have enough water, your kidneys will thank you :-)
  • nanidesukedo

    Posts: 1036

    Aug 14, 2011 3:22 AM GMT
    What you said about glucosuria is true, but again...we're gonna assume he's not a diabetic and that, being as fit as he is, that his insulin resistance is rather low and that he isn't reaching those levels that would cause overflow spilling and glucosuria. Also, glucose in urine is not really considered normal unless you are a diabetic (again, not exactly normal...but this is America, the land of obesity, and that's becoming more the norm than not, I guess.). If a young person came in with glucose in their urine and they didn't just consume like 20 pixie sticks, I'm gonna work it up.

    As for renal disease not causing edema - I guess that would be the case if you have more of a nephritic picture, but in renal diseases that either cause A. loss of regular filtration leading to loss of protein or B. Progressively decreasing renal function to the point that urine output begins to be lower than fluid intake, edema will develop - it has to go somewhere. While in the case of renal failure, it takes considerable loss of function to become oliguric to the point that edema may start developing, it will indeed occur after the intake/output balance is thrown all out of whack.
  • Posted by a hidden member.
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    Aug 14, 2011 3:26 AM GMT
    Doesn't have to be nephritic syndrome. I got a guy who's got 10 g/day of proteinuria from membranous nephropathy and he has absolutely no edema. (Just started on dialysis)

    Urine output can be preserved right till the end. You don't necessarily have to have decreased urine output even when your GFR is <10 ml/min. (Some dialysis patients don't gain any weight between dialysis because they still urinate). What IS impaired even early on is concentrating and diluting ability, which explains why one of the first signs of kidney disease is nocturia.

    If you haven't guessed it already, I'm a nephrologist.icon_lol.gif
  • nanidesukedo

    Posts: 1036

    Aug 14, 2011 3:30 AM GMT
    If he's losing 10g protein a day and not developing edema/anasarca, he must be doing something right lol...or diuresing very very well. I have had a few poor cirrhotics and ESRD patients come in looking like the love child of the michelin man and the stay-puft marshmallow man (I guess it was a gay marriage?).
  • Posted by a hidden member.
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    Aug 14, 2011 3:34 AM GMT
    nanidesukedo saidIf he's losing 10g protein a day and not developing edema/anasarca, he must be doing something right lol...or diuresing very very well. I have had a few poor cirrhotics and ESRD patients come in looking like the love child of the michelin man and the stay-puft marshmallow man (I guess it was a gay marriage?).


    Not necessarily. HIV nephropathy, for example, does not typically present with edema, even when nephrotic. I don't think we fully understand why some people have edema and others don't.

    This article suggests it's because their globulin levels are high but then presents a case that knocks that hypothesis (and the hypovolemia hypothesis) down:
    http://ndt.oxfordjournals.org/content/14/10/2522.full.pdf
  • waccamatt

    Posts: 1918

    Aug 14, 2011 3:36 AM GMT
    Basically if your diet is excessively protein-based it CAN cause this problem and you should drink a great deal of water on a regular basis. It is a good reason why a balanced diet is the best even if it isn't the most helpful for weight training.
  • Posted by a hidden member.
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    Aug 14, 2011 3:38 AM GMT
    OK NANI and Q1! Quit showing off!icon_eek.gif
  • nanidesukedo

    Posts: 1036

    Aug 14, 2011 3:38 AM GMT
    q1w2e3 said
    nanidesukedo saidIf he's losing 10g protein a day and not developing edema/anasarca, he must be doing something right lol...or diuresing very very well. I have had a few poor cirrhotics and ESRD patients come in looking like the love child of the michelin man and the stay-puft marshmallow man (I guess it was a gay marriage?).


    Not necessarily. HIV nephropathy, for example, does not typically present with edema, even when nephrotic. I don't think we fully understand why some people have edema and others don't.



    High plasma globulin providing oncotic pressure or hypovolemia reducing hydrostatic pressure?
  • Posted by a hidden member.
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    Aug 14, 2011 3:40 AM GMT
    nanidesukedo said
    q1w2e3 said
    nanidesukedo saidIf he's losing 10g protein a day and not developing edema/anasarca, he must be doing something right lol...or diuresing very very well. I have had a few poor cirrhotics and ESRD patients come in looking like the love child of the michelin man and the stay-puft marshmallow man (I guess it was a gay marriage?).


    Not necessarily. HIV nephropathy, for example, does not typically present with edema, even when nephrotic. I don't think we fully understand why some people have edema and others don't.



    High plasma globulin providing oncotic pressure or hypovolemia reducing hydrostatic pressure?


    Lol I just quoted that article. But that isn't universally the case. E.g. diabetics who are nephrotic often have no edema as well.

    And yes, we should quit showing off here. icon_lol.gif
  • nanidesukedo

    Posts: 1036

    Aug 14, 2011 3:42 AM GMT
    q1w2e3 said
    nanidesukedo said
    q1w2e3 said
    nanidesukedo saidIf he's losing 10g protein a day and not developing edema/anasarca, he must be doing something right lol...or diuresing very very well. I have had a few poor cirrhotics and ESRD patients come in looking like the love child of the michelin man and the stay-puft marshmallow man (I guess it was a gay marriage?).


    Not necessarily. HIV nephropathy, for example, does not typically present with edema, even when nephrotic. I don't think we fully understand why some people have edema and others don't.



    High plasma globulin providing oncotic pressure or hypovolemia reducing hydrostatic pressure?


    Lol I just quoted that article. But that isn't universally the case. E.g. diabetics who are nephrotic often have no edema as well.

    And yes, we should quit showing off here. icon_lol.gif


    Oh, fine...I didn't think it was showing off, though. Oh bother icon_lol.gif
  • Posted by a hidden member.
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    Aug 14, 2011 3:49 AM GMT
    nanidesukedo said
    q1w2e3 said
    nanidesukedo said
    q1w2e3 said
    nanidesukedo saidIf he's losing 10g protein a day and not developing edema/anasarca, he must be doing something right lol...or diuresing very very well. I have had a few poor cirrhotics and ESRD patients come in looking like the love child of the michelin man and the stay-puft marshmallow man (I guess it was a gay marriage?).


    Not necessarily. HIV nephropathy, for example, does not typically present with edema, even when nephrotic. I don't think we fully understand why some people have edema and others don't.



    High plasma globulin providing oncotic pressure or hypovolemia reducing hydrostatic pressure?


    Lol I just quoted that article. But that isn't universally the case. E.g. diabetics who are nephrotic often have no edema as well.

    And yes, we should quit showing off here. icon_lol.gif


    Oh, fine...I didn't think it was showing off, though. Oh bother icon_lol.gif



    actually, i've been taking notes (im a RN, so i love this stuff icon_smile.gif)
  • Posted by a hidden member.
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    Aug 14, 2011 3:52 AM GMT
    nanidesukedo said
    q1w2e3 said
    nanidesukedo said
    q1w2e3 said
    nanidesukedo saidIf he's losing 10g protein a day and not developing edema/anasarca, he must be doing something right lol...or diuresing very very well. I have had a few poor cirrhotics and ESRD patients come in looking like the love child of the michelin man and the stay-puft marshmallow man (I guess it was a gay marriage?).


    Not necessarily. HIV nephropathy, for example, does not typically present with edema, even when nephrotic. I don't think we fully understand why some people have edema and others don't.



    High plasma globulin providing oncotic pressure or hypovolemia reducing hydrostatic pressure?


    Lol I just quoted that article. But that isn't universally the case. E.g. diabetics who are nephrotic often have no edema as well.

    And yes, we should quit showing off here. icon_lol.gif


    Oh, fine...I didn't think it was showing off, though. Oh bother icon_lol.gif


    Conversations like these make me happy....icon_biggrin.gif
  • LJay

    Posts: 11612

    Aug 14, 2011 4:00 AM GMT
    Some very interesting posts here.

    Sit down with your doctor and explain your diet, including any supplements you use. If you don't need to be taking extra protein, why are you? A lot of people here seem to get their nutritional advice from the grapevine and the labels of supplements whose makers are trying to sell same. Is that wise?
  • musclmed

    Posts: 3274

    Aug 18, 2011 7:46 AM GMT
    q1w2e3 saidDoesn't have to be nephritic syndrome. I got a guy who's got 10 g/day of proteinuria from membranous nephropathy and he has absolutely no edema. (Just started on dialysis)

    Urine output can be preserved right till the end. You don't necessarily have to have decreased urine output even when your GFR is <10 ml/min. (Some dialysis patients don't gain any weight between dialysis because they still urinate). What IS impaired even early on is concentrating and diluting ability, which explains why one of the first signs of kidney disease is nocturia.

    If you haven't guessed it already, I'm a nephrologist.icon_lol.gif


    Well I thought I would chime in here since a odd number of gentlemen come in with unusually higher BUN's from time to time.

    The zip code I practice in has a abnormal proportion of the health-nut bodybuilder types ( 90069) that will take and do anything to look a certain way.

    As a practical matterer Fitginger mentioned a higher BUN but what is the actual NUMBER?

    I have internists send me patients with Bun's of 27 , you have them drink a glass of water and its guess what its 20


    I bet Fitginer if you really go over what you are eating you may realize you are eating alot of protein. Maybe to gain weight?

    There is so much you can assimilate in a day. Genetics and hormones play a part. So if you are , you are making expensive urine.

    The next question is, and do not take offense at this btw....

    I generally know that Anabolic steroids are VERY available in the U.K. , almost in an over the counter fashion, compared to the U.S.

    Again in West Hollywood , we have a fair number of British citizens, 2 of whom I take care of with pristine bodies and Creatinine's of 8.0 near dialysis from cycles of steroids.

    Is this a feature of your program any PROHORMONES?/HORMONES?


    My advice would be a 2 week wash out period eat and drink normally. No supplements, keep protein at or less than 100g a day and recheck the BUN.


    Last , rarely overproduction of natural cortisol can raise the BUN independently , and drugs like Medrol or prednisone.

    Acutane for acne as well I have seen raise the BUN, even Zantac and Pepcid can elevate the BUN

    q1w2e3 is spot on about edema, frankly its absence doesn't help me much at this point.

    Last within the HIV population I see more medical renal disease from uncontrolled hypertension than any other process. One confounding factor is the liberal dosing of testosterone for wasting syndrome. Testosterone levels of 1500 will cause edema btw. And shrink your testicles.

    But again we need more info
  • CuriousJockAZ

    Posts: 19119

    Aug 19, 2011 10:18 PM GMT
    This thread title got me all confused. You see I was in Southern Cali this past weekend with RJ members CuriousJo (Toronto) and RightTurn (Phoenix) and I was checking some BUN numbers too icon_lol.gif

    ToddJoeTyler.jpg

    JoesButt1.jpg

    JoeButt.jpg



    Yep, DEFINITELY elevated! icon_eek.gif There appear to be several members here with similar elevated BUN levels, like...

    http://www.realjock.com/fullphoto/840782e0e0a9492bdc2adf38a676f962
  • Posted by a hidden member.
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    Aug 19, 2011 10:34 PM GMT
    I had a class on this stuff once called medical nutrition therapy, but I'm not a full blown dietitian yet.

    My opinion is since you're a healthy guy, you probably are just buying into the media hype, set forth by marketing people and not bonified nutrition professionals or physiologists, that you need way too much protein.

    If you're fit, go for about 1.2g of protein per kg body weight.

    So at 176 lbs, that's 80 kg, or 96 grams of protein per day. You could even go less than this at 68g (0.8g/kg, the RDA for the general population of sedentary adults) and probably not risk losing muscle unless you're seriously starting a new exercise program.

    My guess is you are eating WAY too much protein, ie 300g+ or something to get numbers that high, and has already been mentioned, your liver is faster at turning the protein into urea and fat/glucose than your kidneys are able to excrete the urea, hence the "stress on the kidneys." However, I've never read any research that this is an issue in healthy people, but there is also not long-term research of people eating low carb, super high protein intakes for years and years on end religiously, as many fitness people like to do these days.
  • CuriousJockAZ

    Posts: 19119

    Aug 19, 2011 10:47 PM GMT
    Depending on how much protein you are taking in, you intake of water and other liquids is really key. Some people's systems can only handle so much protein.
  • fitginger

    Posts: 64

    Aug 20, 2011 7:02 PM GMT
    Thanks for you're replies guys. Its still all very confusing! I don't understand all the medical jargon!

    My BUN numbers were 32 on the 13th July and then 44 on about the 1st of August.

    I'm not taking anything other than protein and amino acid tablets.

    Another thought had crossed my mind today... could it perhaps be the brand of protein powder I am using? I think this is probably unlikely.

    I hadn't mentioned my high protein diet when I saw the specialist because it wasn't until after then that I had googled it for myself that I found out about it. I'm very concerned that when I next go to see the specialist that he will tell me to stop taking protein supplements and I will start losing weight. Being a dancer I'm finding it typically hard to retain the weight as working out and doing shows every night of the week is burning off a lot of calories.

    Could there perhaps be some alternative to whey protein that I could take to help me gain size?!

    So much conflicting stuff is out there about protein intake. I'm currently aiming to have about 1g for 1lb (so 176g a day) Is that too much?

    I feel so lost!!
  • nanidesukedo

    Posts: 1036

    Aug 20, 2011 7:15 PM GMT
    fitginger saidThanks for you're replies guys. Its still all very confusing! I don't understand all the medical jargon!

    My BUN numbers were 32 on the 13th July and then 44 on about the 1st of August.

    I'm not taking anything other than protein and amino acid tablets.

    Another thought had crossed my mind today... could it perhaps be the brand of protein powder I am using? I think this is probably unlikely.

    I hadn't mentioned my high protein diet when I saw the specialist because it wasn't until after then that I had googled it for myself that I found out about it. I'm very concerned that when I next go to see the specialist that he will tell me to stop taking protein supplements and I will start losing weight. Being a dancer I'm finding it typically hard to retain the weight as working out and doing shows every night of the week is burning off a lot of calories.

    Could there perhaps be some alternative to whey protein that I could take to help me gain size?!

    So much conflicting stuff is out there about protein intake. I'm currently aiming to have about 1g for 1lb (so 176g a day) Is that too much?

    I feel so lost!!


    I think the problem here is your diet. If you are using protein as your caloric intake to maintain weight while dancing, you are using protein incorrectly. I think you could be more than fine on only 100g of protein a day. Instead of using protein as your source of calories, I'd recommend complex carbohydrates. They act as far better sources of energy than protein does - especially with aerobic type exercises.
  • fitginger

    Posts: 64

    Aug 20, 2011 7:32 PM GMT
    Thats not the specific reason I'm using protein at all. You miss understand.

    I'm using protein to help me build and repair my muscles. The caloric intake is just an added bonus that is helping me keep my weight consistent.
  • Posted by a hidden member.
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    Aug 27, 2011 1:02 AM GMT
    You might want to include Cranberry Juice into your diet. It contains an enzyme which is known to boost the function of your kidneys.