Q: I am a 38 years old man, 157 cm tall and weigh 48 kg. I was diagnosed with chronic kidney disease (CKD) two years back. Since then my creatinine ranges between 2 and 2.3. But my BUN, sodium and potassium levels have decreased gradually. I am taking these medicines - Metolar XR 25, Shelcal 500 X 2, Livogen X2, Folvite, Alpha D3 (0.25 mg) on alternate days. My blood pressure remains under control after taking the prescribed medicine. Two years back, my BUN was 35, sodium level was 140 mg/dl and potassium level was 4.9 mg/dl. Now, my BUN level is 22, sodium is 127 mg/dl and potassium is 3.4 mg/dl. Two years back, I was asked to reduce sodium and potassium intake. Do I need to follow the same diet restriction? If all other parameters are showing a downward trend, why isn't my creatinine level decreasing? Sometimes I have palpitations. Are they linked to any of the above mentioned numbers? I am planning to move abroad for a job. I am single and would be of my own there. Is it OK to move out of home in this case?

A:First we have to determine the cause of low sodium and low potassium. Based on the list of medicines you provided, you are not any medicines that can cause these. It seems that your weight is on the lower side for your height of 5'2". Are you losing weight recently by restricting food intake? Malnutrition can explain why your BUN is low while there is no change in kidney function (as estimated by creatinine) and it can also explain low sodium and low potassium. If it is indeed the case, I would liberalize dietary intake including sodium and potassium. Abnormalities in electrolyte concentrations can cause heart palpitations. Also, you are on metolar xr 25 which can cause slow heart rate (bradycardia) that you may feel as palpitations. I recommend you see your nephrologist as soon as possible and travel only after everything is sorted out.