Confused about BUN - diuretic - drinking lots of water

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July 31 I had my left kidney removed.  I am 68 year old white male. Previously my Bun levels were high but in normal range.  My creatinine was similar.  After the removal the Bun ranges from 25, sometimes hits 30.  My creatinine was 1.9, now is about 1.6 to 1.7. All my other blood work (potassium, glucose, protein) are in normal range.  My GFR is 45 which they say is to be expected for one kidney.  I see a urologist and a kidney doctor.  My confusion is this.  My primary care tried a diuretic to lower BP.  This raised BUN to 38 so we stopped it.  So the forcing of "water" from my system increased the BUN.  But my urologist and kidney doctor want me to drink lots of water.  This makes me urinate more, therefore isn't this having the same effect as the diuretic, forcing more "water" through the kidney?  Thus my confusion.  The diuretic is bad because it forces water through the kidney, but drinking more water is good even though it forces more water through the kidney???

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  • Posted

    Hi,

    I too had a Kidney removed about a year ago.  My EGFR is quite a bit lower than yours at around 30, but other aspects are in normal range.  My Consultants too were concerned to get BP down to the range of approx 130/70-75.  I was given a range of BP meds including diuretics to achieve this (more or less!). Also had the advice to drink plenty water.

    I think though that the diuretic works to lower BP by decreasing total blood volume, whereas just drinking water and then passing it just keeps a normal blood volume, whilst keeping your remaining kidney functioning normally.  The thing to be avoided is high BP, as this can cause kidney damage directly, and you may need to find meds that work well for you - I insisted on changes as some of the meds gave me unwanted side effects - eg Candesartan increasesed my BP by 10-15 points!

    So  sensible water consumption and good BP control with regular function testing is the way to approach life!

    The best of luck!

    KenR

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    • Posted

      Thanks Ken.  Interesting all your other blood work is fine but have a low GFR.  I have read so many things on the internet which conflict each other it is good to hear from a real person in the same situation.  My blood work all normal too except that creatinine won't drop below 1.6 to 1.7 and the Bun is high, but I guess if the doctors are not in state of concern I should not be either.  I too went through many combinations of meds to lower bp.  It was great with 2 kidneys but went into the 150/70's range after one kidney.  I finally ended up with 20 mg of Lisinopril twice a day (which helps the kidney too), and 5mg of Amlodipine twice a day.  I too had side effects but after 3 or 4 weeks they passed.  Now I am consistently in the mid 120's over mid 60's.

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    • Posted

      Your BUN may lower some when you drink more water. My situation is completely different from yours in most respects but my BUN elevates when I don't drink enough water. Consequently my nephrologist wants me drinking more water--within reason, of course.

      Marj

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    • Posted

      I just had a blood test yesterday but have not seen the results.  But for the two days prior I drank a lot of water (actually the amount the is recommended of 64 oz per day, which I usually do not drink that much).  So I am anxious to see if this helped the BUN level.  
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    • Posted

      I struggle to drink 64 oz of water daily too. I don't drink anything but water so it's really important that I do my best to adhere to the water I'm supposed to drink daily. Here's hoping you'll see some improvement in you BUN data! And, keep drinking water🐶

      Marj

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    • Posted

      The most I can seem to get in me is 40oz per day.  And I too drink only water.  The doctors office called me with results of my blood and said everything is about the same, just continue what I am doing except my Phosphorus level is a little low.  To eat more nuts and beans.  Too many doctors I think.  This one says eat nuts and beans.  My primary care says to stay away from nuts and beans because if you look at their sodium levels they are very high.  Friday I go to the urologist who will probably tell me something else, lol.  I asked the person on the phone to send me a copy of the blood work so I can for myself exactly what "about the same" means.  

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    • Posted

      I know what you mean about too many doctors--it would be really helpful if the different docs would have an occasional conference call so they can develop one comprehensive treatment plan.

      And definitely a good idea to get copies of your actual lab results. I track my data pretty methodically. It's interesting how my doctor's differ in their clinical interpretations of my data too🐶

      I've just shifted to a new nephrologist specifically because he seems to have a better handle on my kidneys and what they need AND what he says in appointments actually makes sense. I was experiencing a fairly big difference of opinion across the two nephrologists (my regular nephrologist and a university nephrologist to whom I had been referred for a consult last summer). 

      Anyway, I made this change in nephrologists specifically due to the difference in treatment plans across the two--I'm going with the one who seems to have a better understanding of what is happening with my renal function. But it's tough to make this sort of decision as a layperson who does not have medical training.

      Marj

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    • Posted

      I agree totally.  And the internet does not help either.  I stay away from doing too many google searches.  My kidney functions were always normal.  Then the day the kidney was removed they then immediately say I am stage 3b CKD because naturally the GFR dropped.  My urologist says to be concerned about cancer recurrence, this is what he will watch for. It can take up to 13 years for it to show again. That if all remains as is my life should be near normal.  My kidney doctor indicates that the life expectancy for someone my age (68) with GFR 40, stage 3b is about 5.5 years.  My primary care doctor tells me I am only stage 3b because of a kidney removal due to a tumor, not really because I had declining kidney function and he anticipates my kidney function should only decline like any normal 68 year old.  So 3 doctors, 3 opinions, anticipating I will live for another 5 years OR 13 years OR Whatever I was going to even before the kidney removed.
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  • Posted

    I think the key word in your posting is "forces". The diuretic may force water through your system, but drinking more water doesn't force anything - your body will deal with it as it needs to.

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