Can someone help me understand blood test results?
My 75-year-old father had an ischemic stroke in January 2023 and after discharge from the hospital, I took him to see the family doctor who performed a blood test and urine test. I can see the results online and there are a lot of abnormal results. I've attempted to call the doctor back several times but his receptionist is known not to answer the phone.
If someone can tell me what these results mean and give me an idea of what might be happening because my father is dealing with severe confusion at the moment and it seems to be getting worse every single day.
Erythrocyte Distribution Width – 15% CV – High
Creatinine – 139 umol/L – High
Urate – 560 umol/L – High
Potassium – 5.5 mmol/L – High
Ferritin – 521 ug/L – High
Vitamin D, 25-Hydroxy – 31 nmol/L – Low
Blood (in urinalysis chemical) Value: +1, Flag: High, Range: NEG-NEG
Any explanations or advice on these would really help me out in figuring out why my dad's delirium/confusion is getting so intense!
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Hello @greatwhitenorthgal. Welcome to Connect. How frustrating not to get answers from your dad’s doctor for the blood work. Is this a small clinic? I can’t imagine a receptionist not answering the phone! In our office she’d have been out looking for a new job!
Members on connect aren’t able able to interpret blood tests, diagnose or offer treatments but I thought I could help you with what the terms mean and also give you the corresponding websites so that you can read the information on each item you listed.
Erythrocyte Distribution Width ~ Erythrocytes are red blood cells.
Unlike some other blood tests, the RDW does not measure red blood cell counts. Instead, it measures red blood cell variation and looks at their shape and size. In your dad’s blood it’s showing varying sizes of red blood cells.
Creatine ~ A creatinine test is a measure of how well the kidneys are performing their job of filtering waste from blood.
So in your dad’s case, it indicates his kidneys aren’t filtering efficiently. That can happen with age, dehydration, side effect from some medicaions, UTI’s or kidney disease… that will be something for the doctor to research further.
Urate or Uric acid in the urine ~ A high uric acid level can be the result of the body making too much uric acid, not getting rid of enough of it or both. It’s not being filtered out of your dad’s kidneys.
Potassium ~ A normal potassium level for adults is between 3.5 and 5.5 millimoles per liter (mmol/L). Your dad’s level is right at high normal and could just be the result of ruptured blood cells while taking the sample. That happens frequently to me when having potassium measured. This is not an alarming reading.
Ferritin ~ Ferritin is a blood protein that contains iron. A ferritin test helps the doctor understand how much iron the body stores. For men, 24 to 336 micrograms per liter is normal. That means your dad’s ferritin level is quite a bit higher than normal. This can happen if he’s had a blood transfusion. His doctor will want to determine the reason for the high iron level in his blood. I’ve posted 2 links for Ferritin and the treatment of high iron levels.
Vitamin D deficiency is just what it says. Your dad’s Vit D level is low, which isn’t uncommon in people in their golden years. Or for anyone living in a northern climate. His doctor may order supplements.
The urinalysis is showing blood cells in your father’s urine from some cause. It could be a UTI or a kidney issue, etc.
***A UTI or kidney/bladder infection could be causing your dad’s confusion. That’s quite common in older people. He really should be evaluated soon. What about his water intake. Does he drink a fair amount of water daily? Dehydration can also lead to confusion.
I hope you’re able to get in contact with your dad’s doctor quickly. Having blood in the urine and some of the elevated kidney numbers are conditions that should be examined. How long ago were these blood tests done?
Hi! I cannot tell you enough how thankful I am for your thoughtful and detailed reply, that really helped me a lot! Thank you a bunch!
I believe these tests were done on March 17th. There have been ups and downs in regard to his confusion since then. Some days were surprisingly bad, so much that I couldn't help but cry a little bit and some days (rare ones) were almost like his usual self. But there are definitely more confused days than not.
I've noticed that he also is not sleeping nearly as much as he used to. I'm guessing the confusion gets worse when he's not getting enough sleep. He is taking melatonin and trazodone at night to help with sleep but for some reason, he maybe sleeps only 4-5 hours a night with a one hour nap a day.
He had an issue where he would need to use the washroom maybe 5 or 6 times within the hour! That was happening around the time we did those tests but the doctor said he was taking a lot of water pills which would explain the frequent urination. It seems to be back to normal now.
I'm just confused and frustrated. Doctors are not helping in this case and I feel scared and trapped.
It’s just so sad to hear that your dad is basically falling through the cracks of his medical care. He’s obviously got a few issues that need followups with his doctor and they’re not answering the phone. Yikes. My heart goes out to you as I remember many years ago when my mom was getting the runaround with her doctor. He totally missed the diagnosis and I could see it! So thankfully, I made an appt for mom with my doctor who quickly assessed and addressed the stage 4 uterine cancer…she went on to live many more healthy years.
So the key here, if possible might be to get a second opinion for your dad. Is there an opportunity for that to happen? A larger clinic or teaching hospital? If not, you’ll need to be your dad’s advocate and be assertive in getting some answers. It’s ok to get a little pushy!
A couple pieces of the puzzle regarding your dad’s confusion came to mind when you mentioned he’s taking both Trazodone and Melatonin at the same time.
Melatonin is a great sleep aid, but if your dad is already taking Trazodone to help with sleep, that may be too much for his system to handle.
Trazodone is an antidepressant but can be used (off label) as a sleep aid. As people age, some medications can take more time to process through the system. Antidepressants have the possibility to cause confusion in older patients.
I found an article that might be helpful for you regarding the mixing of those two drugs at the same time:
Two more links to information on Trazodone: https://www.drugs.com/trazodone.html
You might talk this over with your dad and suggest backing off the melatonin to see if that makes a difference for him. Sadly, as we age, that luxurious 8 hours of sleep seldom happens anymore so what he’s going through might be normal with 4-5 hours at night and naps. (My husband at 72 is the same way)
While he might stop the melatonin, your dad can’t stop taking the Trazodone cold turkey…that’s a med which needs tapering and also consistency once started.
Stopping the melatonin might be worth a try, what do you think?
I am not qualified to comment on the results – however, I would offer that following a stroke, your father's GP/PCP might not be the best kind of doctor with whom to consult.
Does he have a cardiologist? Neurologist?
Hi! He has his first post-stroke follow-up with a neurologist coming up in mid-June. It feels like it's quite a ways away considering what is happening at the moment.
I would call the neurologist and let them know whats happening and that you're not getting the answers you need. Relate to them that you feel waiting for 2 MORE months to be seen is unacceptable and you may need to take him to the ER if hes not seen sooner, as then they would be forced to see him. If that doesn't work call your primary and tell them to call the neurologist and get him a sooner appointment.
I'm an RN, and I will not diagnose without seeing your father, but suffice it to say that his labs are concerning, especially mixed with the symptoms your relating, and need to be addressed before 2 MORE months have passed. If your PCP doesn't answer the phone, GO TO their office, cause a little scene if necessary. Believe it or not, I've had to do the very same to advocate for my patients before. It's even more effective when it's the family.
It's possible the confusion is simply from a urinary tract infection, but it's possible it's due to something more concerning. Regardless, it needs to be addressed.
Can someone recommend a doctor who will care and work with you, a friend or relation……Find out quickly and move on it!
I finally got a hold of the doctor via e-mail since the receptionist still does not answer my calls.
The doctor confirmed my father has chronic kidney disease but has not given me further details, waiting on him to respond to my last e-mail asking for more information.
My gosh, that is crazy that the doctor’s receptionist doesn’t answer your calls! Did you put that in your letter to the doctor? Shaking my head…wow.
I do hope you get some clear answers because I know very worried about your father. Is this a large clinic or just a single practioner?
I mentioned in the e-mail that I've tried calling numerous times and my calls go unanswered, which is why I sent him an e-mail instead. This is a single practitioner's office.
I don't know what to expect at this point. From his test results and the research I've been doing, it seems my father is in stage 3B of kidney disease, but of course, I will not diagnose him myself, it is just what seems to be making sense from what I understand.
His eGFR result while still in the hospital 2 months ago was 52 and as of March, it dropped to 42.