From the Research
The patient's lab results indicate a need for increased fluid intake to address possible dehydration, as suggested by the elevated BUN/Creatinine ratio of 31.7, despite overall adequate kidney function with an eGFR of 106 mL/min/1.73m² 1. The lab results show mostly normal values with a few exceptions. The BUN/Creatinine ratio is elevated at 31.7 (normal range 10.0-20.0), which may suggest dehydration or possibly early kidney dysfunction. However, kidney function appears adequate overall as the eGFR is excellent at 106 mL/min/1.73m², well above the normal threshold of 60. Electrolytes including sodium, potassium, chloride, and bicarbonate are all within normal ranges, as are glucose and calcium levels. The anion gap is normal at 15 mmol/L. Some key points to consider in the management of this patient's condition include:
- Increasing fluid intake to address possible dehydration, as there is no evidence that lower-than-average fluid intake can cause chronic kidney disease, nor accelerate progression of established kidney disease 1.
- Monitoring for symptoms like fatigue, decreased urination, or dark urine, which could indicate dehydration or other underlying issues.
- Considering the patient's size and activity level when determining the appropriate daily water consumption, aiming for at least 2-3 liters per day.
- If the elevated BUN/Creatinine ratio persists despite adequate hydration or if symptoms worsen, further evaluation would be recommended to rule out other causes of this laboratory finding. It is also important to note that certain medications, such as diuretics, nonsteroidal anti-inflammatory drugs, and renin-angiotensin system blockers, can increase the risk of kidney injury during fluid depletion 1.