Nephrologist Visit 20230428

I had my quarterly nephrologist visit today. It went well and I only had one prescription change to increase my Losartan dosage to 100 mL. I did my labs last week and the results were similar to previous tests. Here are some of the items that are still out-of-range:

• Creatinine: 1.50 mg/dL
• eGFR: 55
• Potassium: 5.4 mmol/L
• Urea nitrogen (BUN): 31 mg/dL
• Hematocrit: 51.0%
• Vitamin D: 27 ng/mL

All the other stuff were within Quest Diagnostic’s normal range.

The most important test result is probably for creatinine. This is a major indicator of kidney failure. Normal range is below 1.30 mg/dL for males. Post-transplant, my results have been from 1.40 to 1.60. Both the UCLA transplant team and my local nephrologist are good with this result. They are more worried if the number changes quickly for the worse. My blood pressure has been higher lately hence the increased Losartan dosage.

My nephrologist is also giving me a referral for a sleep study. I have been a snorer for as long as I can remember, and my sister said I sometimes stop breathing when I sleep. I have been very tired post-transplant so maybe my undiagnosed sleep apnea and anti-rejection medication is preventing me from sleeping well at night.

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I also got a reply from my endocrinologist. I have not seen her in about a year and all my prescriptions are running out. Previously, her office sent my continuous glucose monitor (CGM) to Edgepark because the reader and sensor were considered durable medical equipment (DME). I hate Edgepark. It has been a huge struggle to get anything priced and delivered. I managed to get a reader and fourteen sensor discs from them over the past twelve months. Since my prescription ran out, they were unwilling or unable to get a refill and instead cancelled my order. Sigh.

In my endocrinologist’s reply, she said she sent refills for my insulin and regular glucose test strip to my online pharmacy. She also sent a CGM sensor refill order to the pharmacy instead of Edgepark. I hope that gets processed.

I think the DME part of the prescription was the dedicated Libre 2 reader. Ironically, there was a warning sent out as the reader’s Lithium battery may overheat and catch on fire. Now I am using the Libre app on my iPhone to read the sensor, which means that I did not need the dedicated reader in the first place. Stupid.