confused by lab results

[rachelandtyke2]

I am seeing the OB tomorrow afternoon, so I imagine he will go over this then. But I am seeing the OB who I like the least, so not sure how it will go . . . but in the meantime, my curious brain is trying to figure out what all this means . . . (I've got too much thinking time on strict bedrest!) I am 34w4d, so not in too bad of shape at this point if need to deliver early.

My BP last week was 160/98 when I walked in with 2+ protein on the dip, so I had bloodwork and a 24 hr done. Bloodwork came back OK. I got the results from the 24 hr this morning. Next appt on Thursday my BP was a tad lower at 153/90. I normally run 110/70. I had started feeling "off" 2 days before, so wasn't surprised when my BP was high and I was spilling proteins (and had gained 7 lbs in 2 weeks). I was induced with DD due to PE, so figured this was coming.

I think the lab results show that I am definitely spilling protein (but not "too" bad), but that my kidneys are still functioning OK. I'm confused because the 24 hr creatinine level and clearance are high and the blood serum is right on the edge of low, which seems to be opposite of what I would expect from pre-e, right? My other question is if it is normal for the creatinine urine and total urine protein numbers to be in range when the 24 hr #s are out of range?

creatinine clearance 242 (range 88-128 mL/min)
creatinine, ur 24hr 1984.5 (range 800.0-1800.0 mg/24 hr)
creatinine, serum 0.57 (range 0.57-1.00 mg/dL)
egfr if nonafricn am 118 (range >59 mL/min/1.73)
egfr if africn am 136 range >59 mL/min/1.73)
creatinine, urine 73.5 (range 16.0-327.0 mg/dL)

prot,24hr calculated 210.6 (range 30.0-150.0 mg/24 hr)
protein,total,urine 7.8 (range 0.0-15.0 mg/dL)

[lemons]

Hi. I only have time for a very brief reply, but I am curious as to what your physician says tomorrow. Serum creatinine levels are normally lower in pregnancy so, while you are "borderline low" according to the lab results, that referance range is for non- pregnant people. You might be just right for a pregnant person. Similarly, creatinine clearance increases during pregnancy, which means that your result might not be elevated for pregnancy. I do not know how much of an increase is normal. In addition, since your overall urine creatinine concentration was normal, I'm guessing that you had a high volume of urine, which again would be a symptom of being pregnant. I'm not a physician so take all of this with a grain of salt! Good luck tomorrow!

[caryn]

How did it go?

[rachelandtyke2]

My BP was 166/93 today. Fortunately, I had labs drawn this morning, and they all came back OK (liver, kidney, platelets, etc). When the 2nd nurse retook my BP she used a cuff that was too big and my BP was (obviously) significantly lower. The OB even commented on it and questioned her, but she redid it with the same cuff. OB wasn't worried about the 24 hr, just commented that yes, I am spilling protein but that it's "not too bad yet". I completely forgot about the creatinine questions I had as I was more concerned about the baby not moving as much the last few days (and the fact that the baby did pass the BPP, but that it took poking and prodding to get movement when it's always been really active on u/s before - even last Thursday). I go back on Friday for an NST and appt with one of the OBs I saw last week (and I like her a lot). The one I saw today isn't one I prefer, although I don't think he handled things necessarily inappropriately today.

I hate this waiting game. I'm almost 35 weeks. I'd really like for baby to just go ahead and come on its own, although I've never gone into labor on my own so that seems doubtful. (DD was induced at 39w due to PE and DS was induced at 37w due to IUGR from HG and PIH)