Niel Flamm Niel Flamm

Monthly Dialysis Labs: A Surprising Number I Haven't Seen Since 2025

Every month during dialysis, I have a full set of lab work done. The nice part? No extra needle stick. The blood is drawn directly through the dialysis tubing while I'm already connected.

The monthly labs help monitor many aspects of living with End Stage Renal Disease (ESRD), including:

  • Potassium – helps reduce the risk of dangerous heart rhythm problems.

  • Creatinine – shows how well my kidneys are filtering waste.

  • Phosphorus – high levels can pull calcium from the bones, while levels that are too low can affect oxygen delivery to muscles and lead to weakness.

  • Iron

  • Hemoglobin

  • Sodium

  • Chloride

  • Carbon Dioxide

  • Total Serum Protein

  • Albumin

  • Magnesium

  • Platelet Count

  • White Blood Cell Count

The number I paid the closest attention to this month was BUN (Blood Urea Nitrogen).

Here's the simple version. When we eat protein, our bodies break it down, producing ammonia, which is toxic. The liver converts that ammonia into urea. Urea travels through the bloodstream to the kidneys, where healthy kidneys filter it into urine.

With ESRD, that process doesn't work very well, so BUN levels can rise because waste isn't being removed efficiently.

During dialysis, my care team measures BUN before treatment and after treatment to see how effectively the dialysis removes that waste.

When I reviewed my results on Saturday, July 18, something caught my attention.

For the first time, when my monthly labs were tracked starting in October 2025, my pre-dialysis BUN was in the normal (green) range.

Even more interesting, my post-dialysis BUN wasn't dramatically lower. Normally, I'd expect to see a much bigger drop after treatment.

So now I'm left with a few questions:

  • Are my kidneys somehow recovering a little?

  • Was this simply an unusually good month?

  • Did my diet or hydration affect the result?

  • Or was it just one of those lab quirks that occasionally happens?

The answer is... I don't know.

One lab result doesn't establish a trend, especially with ESRD. But after months of watching these numbers, seeing that green result definitely made me stop and smile.

I'll be watching closely next month to see whether this was the beginning of a trend or simply a one-time surprise.

Either way, I'll keep sharing the journey.

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Niel Flamm Niel Flamm

Waiting for the Call

Three days a week, dialysis keeps me going. It also serves as a constant reminder that I'm waiting for something bigger.

This week, a fellow patient received a kidney transplant after about two years on the waiting list. Hearing that news gives hope to the rest of us still waiting for our turn.

I'm now keeping an overnight backpack ready so that when the call finally comes, I can grab it and head to the hospital.

Watch the full vlog:
https://www.nielflamm.com/videos/esrd

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