Can heart failure affect kidney function levels?

Hello doctor,

I am a 48-year-old female. I have LMNA-related cardiomyopathy and right-sided heart failure (HF with preserved EF) and psoriatic arthritis. I have a dual-chamber pacer/ICD. I am paced 100 % in both the upper and lower chambers.

I take Amiodarone, Metoprolol, Ranexa, Warfarin, Bumex, HCTZ, Spironolactone, Leflunomide, Methotrexate, Remicade, potassium, Folic Acid, Oxycontin, Lyrica, Satellite, Zolpidem, Hydroxyzine, Melatonin, FeSO4, Vitamin E, Vitamin D3, and L-Carnitine.

Three weeks ago, I went to the ED on the orders of a cardiologist. I have been quite SOB with activity, substernal CP, severe fatigue and muscle weakness, headache, all worse than my baseline. In ED, it was noted that I had potassium with a critical value of 2.9 (3.5-5.1). Other abnormal labs at that time were as follows.

1. Na⁺ (Sodium): 134 mmol/L (136–145).
2. Cl⁻ (Chloride): 94 mmol/L (98–107).
3. K⁺ (Potassium): 3.4 mmol/L (3.5–5.1).
4. CO₂ (Bicarbonate): 35 mmol/L (22–30).
5. BUN (Blood Urea Nitrogen): 25 mg/dL (7–19).
6. Creatinine: 1.20 mg/dL (0.55–1.02).
7. eGFR: 47.95 mL/min/1.73 m² (60–120).
8. ALT: 52 U/L (0–34).
9. AST: 50 U/L (14–36).
10. Alkaline Phosphatase (ALP): 75 U/L (38–126).
11. Total Bilirubin: 0.4 mg/dL (0.2–1.3).
12. Direct Bilirubin: 0.2 mg/dL (0.0–0.4).
13. Albumin: 4.2 g/dL (3.5–5.0).
14. Total Protein: 8.1 g/dL (6.3–8.2).

My question is, are these readings concerning? My primary provider posted those labs with no comment other than to now double my Spironolactone dose to 25 mg BD in order to raise my K+. The CMP was requested from a Bariatric surgeon. I received a call from that office after the labs had been processed for them. I was being removed from the program until the surgeon had time to consider my case and decide if I was a good candidate.

My eGFR has never dipped below 60. And while I do take a fair amount of diuretics, my potassium has never been low. I have noticed my CO2 is climbing, and chloride dropping. CT chest notes ground glass nodules in the left greater than the right upper lobes.

Etiology is felt to be infectious. My WBC has been perfectly normal, and no fevers. So I am asking a nephrologist about this liver/kidney stuff.

1. Maybe it is all related?
2. Do I need to do anything about these labs?
3. Is it fine to just ignore them as long as I am urinating?

Any information is greatly appreciated.

Please help.

Thank you.

Hi doctor,

Thank you for your reply.

My labs were drawn about 90 minutes before the CT scan with contrast. Also, more labs were drawn yesterday and today. I am attaching them here.

The heart failure causes me to be concerned about liver and kidney function. Again, what can I do to help the health of my liver and kidneys? I do not drink, smoke, take drugs, or use OTC supplements.

Thank you.