What are the implications of the patient's electrolyte, renal, and liver function test results?

From the Guidelines

The laboratory results show mostly normal values with a few exceptions, and no immediate action is required based on these results alone, but if the alkaline phosphatase elevation persists on future tests, further evaluation might be warranted, particularly if symptoms develop. The AST (SGOT) is slightly low at 12 unit/L (reference range 15-41), and the alkaline phosphatase is elevated at 104 unit/L (reference range 32-91). The total protein and albumin are at the upper limit of normal. All other values, including electrolytes, kidney function tests, and liver function tests, are within normal limits. The elevated alkaline phosphatase could indicate mild bone or liver issues, though with normal bilirubin and other liver enzymes, it's less likely to be significant liver disease, as suggested by the american gastroenterological association medical position statement: evaluation of liver chemistry tests 1. This could represent normal variation or could be related to bone turnover, medication effects, or other physiological processes.

Key Findings

• The patient's kidney function is normal, with an eGFR of 113 mL/min/1.73m2, which is above the recommended threshold of 60 mL/min/1.73m2, as noted in the renal mass and localized renal cancer: evaluation, management, and follow-up: aua guideline: part ii 1.
• The liver function tests are mostly normal, with the exception of the elevated alkaline phosphatase, which may require further evaluation if it persists, as recommended by the hepatobiliary cancers, version 2.2021, nccn clinical practice guidelines in oncology 1.
• The electrolyte balance is normal, with all values within the recommended ranges.

Recommendations

• Monitor the patient's alkaline phosphatase levels on future tests to determine if the elevation persists.
• Consider further evaluation if the alkaline phosphatase elevation persists or if symptoms develop, as suggested by the american gastroenterological association medical position statement: evaluation of liver chemistry tests 1.
• Continue to monitor the patient's kidney function and electrolyte balance, as recommended by the renal mass and localized renal cancer: evaluation, management, and follow-up: aua guideline: part ii 1.

From the FDA Drug Label

Abnormalities in liver enzymes have not been associated with ursodiol therapy and, in fact, ursodiol has been shown to decrease liver enzyme levels in liver disease. The patient's AST (SGOT) is 12 unit/L and ALT (SGPT) is 12 unit/L, which are within the normal range.

• The patient's liver enzyme levels are normal, and ursodiol therapy is not expected to cause liver damage. However, it is recommended to monitor liver enzymes during ursodiol therapy 2.

From the Research

Laboratory Results

The provided laboratory results show the following values:

• Sodium: 137 mmol/L (within the reference range of 136-145 mmol/L)
• Potassium: 4.1 mmol/L (within the reference range of 3.6-5.1 mmol/L)
• Chloride: 104 mmol/L (within the reference range of 98-107 mmol/L)
• CO2: 25 mmol/L (within the reference range of 22-32 mmol/L)
• Anion Gap: 8 (within the reference range of 6-18)
• Glucose: 85 mg/dL (within the reference range of 70-99 mg/dL)
• BUN: 12 mg/dL (within the reference range of 8-20 mg/dL)
• Creatinine: 0.76 mg/dL (within the reference range of 0.60-1.30 mg/dL)
• eGFR: 113 mL/min/1.73m2 (above the reference value of >=60 mL/min/1.73m2)
• BUN/Creatinine Ratio: 15.8 (within the reference range of 12.0-20.0)
• Calcium: 9.8 mg/dL (within the reference range of 8.9-10.3 mg/dL)
• AST (SGOT): 12 unit/L (within the reference range of 15-41 unit/L)
• ALT (SGPT): 12 unit/L (within the reference range of 7-52 unit/L)
• Alkaline Phosphatase: 104 unit/L (above the reference range of 32-91 unit/L) 3, 4, 5, 6
• Total Protein: 7.9 g/dL (within the reference range of 6.1-7.9 g/dL)
• Albumin: 4.8 g/dL (within the reference range of 3.5-4.8 g/dL)
• Total Bilirubin: 0.3 mg/dL (within the reference range of 0.3-1.2 mg/dL)

Key Findings

• The alkaline phosphatase level is elevated at 104 unit/L, which is above the reference range of 32-91 unit/L 3, 4, 5, 6.
• The elevation of alkaline phosphatase can be indicative of various conditions, including bone and liver diseases 4, 6.
• The patient's eGFR is above the reference value, indicating normal kidney function 3.

Possible Causes of Elevated Alkaline Phosphatase

• Bone diseases, such as osteomalacia or Paget's disease 5
• Liver diseases, such as cholestasis or liver cancer 4, 6
• Other conditions, such as hypophosphatasia or intestinal alkaline phosphatase deficiency 3, 5