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Nephrology/Abnormal Labs with Flank Pain, Hx Kidney Stones


I have a history of kidney stones & went to ER with flank pain. The CT showed no stones however my CMP lab abnormalities were:
         Results     NL Range
Creatinine   1.1 High   [0.5-1.0]
Neutrophil% 76.3 High   [40.0-60.0]
Lymphocyte  16.1 Low    [20.0-40.0]
Chloride    100 Low     [102-110]
UA RBC       26 High    [0-2]
UA Bacteria    1+       [None]
UA Protein    Trace     [Negative]
UA Blood       2+       [Negative]
UA Casts,Hyaline 5 High [0-2]
I was told I had a pulled muscle, given Norco pain pills and muscle relaxants and told if symptoms persist greater than seven days to return or see my doctor (I have none).  What should I do? I think antibiotics or further workup should have been done.  Thank you for your time and assistance in answering my question.


Thanks for asking my opinion on Allexperts.

Based on your lab results, I would order a urine culture and sensitivity test to rule out urinary tract infection. I would also start you on oral antibiotics empirically while waiting for the culture results.

Please get yourself evaluated by a primary care physician.


Dr. Shah


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Dr. Shamik Shah, MD, DNB (Nephrology), ISN Fellow


I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am an Indian-Board certified Nephrologist. I was a post-Doctoral Scholar at the Division of Nephrology & Hypertension,Department of Medicine, University of California, San Diego. My area of interest is Critical care Nephrology and Acute Kidney Injury.

Please mention the units in which your lab results were reported and the normal reference range for your laboratory.

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Ten years as a Critical Care & Transplant Nephrologist

International Society of Nephrology
Indian Society of Nephrology
Indian Medical Association
European Renal Association

- Shah SH, Cerda J. Acute Tubular Necrosis; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4, pp. 191-198
- Shah SH, Cerda J. Management of Acute Kidney Injury; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4
- Cerda J, Tolwani A, Shah SH, Ronco C. Continuous Renal Replacement Therapies in Modeling and Control of Dialysis Systems edited by Azar AT, Springer-Verlag, Heidelberg, Germany (In Press)
- Shah SH, Cerda J, Kellum JA. Acute Kidney Injury in Special Circumstances. John Kellum, Jorge Cerda, eds. Renal and Metabolic Disorders, Oxford University Press (In press)
- Shah SH, Mehta RL. “Anticoagulation in CRRT: Is Citrate better?”; Vineet Nayyar Ed. Critical Care Update 2009, Jaypee Brothers (In press)
- Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
- Shah SH, Mehta RL. “Epidemiology of Community-acquired AKI”; Ronco C, Bellomo R, Kellum J Eds. Critical Care Nephrology, Saunders. ISBN 1-4160-4252-0
- Abdeen O, Shah SH, Mehta RL; “Dialysis therapies in the surgical intensive care unit”; William Wilson, Christopher Grande, David Hoyt Eds. Trauma: Resuscitation, Anesthesia, and Critical Care, Informa Healthcare, NY 2007. ISBN 0-8247-2920-X
- Shah SH, Mehta RL. Acute kidney injury in critical care: time for a paradigm shift? Curr Opin Nephrol Hypertens. 2006 Nov;15(6):561-5.
- Shah, SH, Soroko S, Lischer E, Mehta RL. Delivered vs. Prescribed dose of Dialysis in Hospitalized Patients: Results of an Audit. J Am Soc Nephrol 17(Abstracts Issue): 2006, 107A.
- Shah SH et al “Biochemical Nutritional Parameters in Non-vegetarian and Vegetarian CAPD patients” Perit Dial Int 2001; 21 Suppl 2: S1-182

MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology), ISN Fellow

Awards and Honors
Educational Ambassador of the International Society of Nephrology 2010
Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis 2001

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