BigBallaGA

no prob, hope you recover 100%..... health is paramount to anything else

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jaim91

I'm slowly finding this out. I just wish it was something that possibly could have motivated me more to work out (hypothyroidism?), rather than something that scares me away from it.

bandaidwoman

Jaim,

A sodium level of 160 is incredibly rare and high.

Even sodium levels measured on long distance athletes who did not adequetly hydrate themselves were not as high. You either have a lousy thirst response or you still have some underlying kidney issues...The main one that comes to mind is diabetes insipidus (inadequete production of antidiuretic hormone or lack of its effect on the kidneys...not diabetes mellitus) These athletes, like you, can get profound hypernatremia very easily. Depending on the type, the cure may be a simple nasal spray (ADH nasal spray.) This way, you won't have to be afraid of working out!

There are different and subtle variations of DI that sometimes only a nephrologist can help discern. (There are more than the two to three types and causes that a simple google search will incorrectly state.)

By the way, high urea in the context of hypernatremia is always due to poor or inefficient elimination by the kidneys.

Official Race Member of the Crank Crushing Rednecks

Eat more mud, mountain bike until you die!

XX Feminine power

jaim91

I figured that because of the fact that they had to give me an IV to flush the kidneys. I didn't think it had anything to do with nephrogenic diabetes insipidus though. I researched it a little after you told me what it was, and while the symtoms do seem common to what I experienced, I got the sense that NDS was something you didn't just "get".

bandaidwoman

There are two main types, congenital (born with it ) or acquired (not born with it). However, even the congenital has many variations depending on genetic penetrance and some don't realize they have had it their whole lives until they do something that tips them over ie: athletics, gastroenteritis etc. We are still learning about this congenital variant. So even the congenital variant may be hard to spot.

As for the acquired, there are probably over 25 different causes (ie: simple drug induced by drugs like lithium or post obstructive uropathy, sarcoidosis, high aldosterone from either adrenal problems or too much licorice consumption...the list is endless!) The non medical internet searches does little justice to the many subtle presentations of DI ( They make is sound as if every DI pees or drinks alot, which isn't necessarily true.)

The highest sodium most docs see even with the most profound dehydration...ie: cholera like illness, marathon races, etc. almost never go above 150, even with frank kidney failure. anything above that always brings to mind the possibility of DI.

Official Race Member of the Crank Crushing Rednecks

Eat more mud, mountain bike until you die!

XX Feminine power

Vieope

FURtherness

jaim91

I know that urea is excess waste that your body is supposed to dispose of through the urine. My urea was high indicating a malfunction in the kidneys and therefore a lack of proper excretion of waste. That's what I got from my research. What made the kidneys malfunction in the first place, I don't know. The dr.'s hazard a guess that it has something to do with my protein intake/amino acid buildup/ bodybuilding....which brings us almost to the beginning of the thread.

bandaidwoman

Dehydration can prevent adequete renal excretion of urea. This is called pre renal failure. (you decrease the pressure perfusing the renal arteries and thus the kidneys themselves, thus, their "pumps" slow down tremendously) . Thus, the urea could have been tremendously high without necessarily the extra protein intake.

Intrinsic renal failure alone due to damage done to the kidneys can resulte in high urea and creatinine but usually does not raise the sodium...if anything, you get hyponatremia because the kidneys cannot concentrate the urine and has less free water exretion capabilities. The combination of such severe hypernatremia (such as yours )with high urea and creatinine has to suggest some component of prerenal failure (dehydration) although your protien intake may or may not have played a role. Once again, it depends on a thorough 24 urine creatine clearance, protein, urine osmolarity, analyzing the urine for casts etc. Sometimes this work-up may not have been done in the hospital completely if the doc does not have a strong renal background (an family practioner vs. an internist, the latter has extensive nephrology rotations and the former has almost none.)

Thus, excessive protein alone, which can cause intrinsic renal failure does not explain the hypernatremia along with the elevated urea and creatine.... that is what does not click right with me. That's why some form of DI or a combination of intrinisic renal disease with dehydration makes more sense than blaming it on the protien (which really wasn't that much).

You may want to just get a second opinion from a nephrologist just so you can sleep better at night and hopefully prevent this from happening again.

Official Race Member of the Crank Crushing Rednecks

Eat more mud, mountain bike until you die!

XX Feminine power

jaim91

Thank you very much bandaidwoman, your info was SOOOOOOO helpful!!! I will continue to be monitored, and if anything seems fishy, i'll let you know!