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The blood urea nitrogen or BUN is a blood test that measures the amount of urea nitrogen in the bloodstream. When a person is dehydrated, false results might be obtained as BUN levels increase when blood is concentrated.
Elevated BUN levels indicate dehydration, excessive protein intake and impaired renal function.
Measuring urinary creatinine clearance during unilateral kidney impairment is insignificant as the healthy kidney can still excrete creatinine through the urine.
During dehydration, hematocrit tests may reveal false results as the blood is concentrated.
There are two kinds of lipoproteins – the low density lipoprotein or LDL and high density lipoprotein or HDL. On the other hand, an increase in serum potassium levels is called hyperkalemia which may elicit symptoms like increased irritability, diarrhea and ECG changes.
Serum potassium levels should be closely monitored for people with renal failure, diabetes, burns and electrolyte imbalance.
When there is an abnormally high ammonia levels in the blood, liver impairment should be suspected. When the pancreas is damaged, both lipase and amylase are also released into the bloodstream. However, amylase returns to normal levels within 3 days while lipase remains elevated within 7-10 days. Correct levels of sodium and chloride in the blood help in maintaining normal osmotic pressure, acid-base balance and nerve impulses.
Normal levels of potassium in the blood are essential in regulating electrical conduction within the muscles.
People taking diuretics and digitalis should also be monitored for changes in serum potassium levels. Troubles in starting and stopping urine flow, blood in urine and back pain when urinating are other symptoms indicative for a PSA test. In preparing for ammonia plasma test, the person being tested should refrain from smoking several hours prior to the test.

Views and opinions in this publication and the website are not necessarily endorsed by or reflective of those of the publisher. The opposite happens for urinary creatinine clearance; during renal impairment, urinary creatinine is extremely low.
High hematocrit levels may indicate dehydration, polycythemia vera and lung or heart diseases. A decrease in potassium levels is called hypokalemia which may elicit symptoms like dysrhythmias, weakness, decreased reflexes and ECG changes.
14-20) and the rest of this issue, which is invaluable for a mainly geriatric practice like my own. ALLHAT gave diuretics the edge, but I am not sure what these results mean to Canadian physicians. Other medications included the fossil reserpine and the rarely prescribed clonidine, hydralazine and doxazosin. Essentially, the choice of first drug prescribed for hypertension becomes irrelevant in moderate to severe cases.
These patients require a combination of two to five classes of drugs for success, a juggling game that leaves a lot of collateral damage in the form of very predictable adverse drug reactions. Beta-blockers, being mostly generic, are virtual orphans these days, yet they are invaluable with comorbid arrhythmias and coronary heart disease.
Calcium channel blockers and angiotensin II inhibitors have suffered a beating at the hands of the HOPE trial, which gave ACE inhibitors the edge.
However, the very common and intractable ACE cough guarantees a place for the other classes.
Among these tests were a serum creatinine and urinalysis to exclude underlying renal parenchyma disease or renal artery stenosis.
However, serum creatinine determination in the elderly is a poor reflection of creatinine clearance, as elderly patients frequently have low muscle mass.
Normal serum creatinine values are seen in elderly patients who may have significant renal impairment.
It is imperative that age, weight and sex of the patient be considered along with the actual serum creatinine measurements in order to adequately assess renal function.

The Cockcroft-Gault formula can predict the creatinine clearance when these parameters are known.
The slide ruler was developed by members of the Second Canadian Consensus Conference on the Use of NSAIDs. Campbell, co-author of the article "Screening for Secondary Causes of Hypertension in the Elderly", offered the following response to Dr. Tannenbaum that renal impairment is frequently overlooked in the elderly when assessed with serum creatinine and that asking family physicians to routinely request 24-hour urine collections is unlikely to be implemented.
Even if implemented, such advice may not be effective due to incomplete urine collection, and even if effective, it may not be cost-effective. The use of a validated formula such as the Cockcroft-Gault has had limited uptake by family physicians, likely due to the complexity of the formula, the lack of systematic computerised support and the breadth of knowledge required to practice family medicine. Educational programs to increase awareness of the decline in renal function with age and simple tools to detect renal impairment may be useful in avoiding adverse drug reactions associated with prescribing drugs that are cleared by the kidneys and have a low therapeutic threshold. The Canadian Hypertension Education Program (CHEP), a group of close to 40 Canadian hypertension specialists, systematically reviews and grades evidence in the area of hypertension every year.
CHEP has recommended a history and physical examination and assessment of serum creatinine and a urinalysis to assess for renal target organ damage and renal hypertension in uncomplicated hypertensive patients. Antihypertensive treatment based on CHEP recommendations will reduce complications, especially in the elderly and in those who have other risk factors, such as renal impairment. Further, if advice to start at lower doses and titrate to response is followed when treating the elderly, adverse events related to renal accumulation of antihypertensive therapy are unlikely in those whose serum creatinine is in the "normal range".
For those patients with resistant hypertension or additional features of renal hypertension, the CHEP program recommends additional renal investigations as outlined in our article.

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