Jane
There really isnt much I can add to the discussion. Alkaline Phosphatase has several origins. Not all are to do with the kidney or with kidney disease. For example, it can be elevated in all sorts of bone diseases - Pagets disease of bone is but one that quickly comes to mind. Liver disease needs consideration too. And, Peter is right - it is usually reasonable simple to work this out. Maybe this is the 1st simple step to take.
In addition … and I cannot stress this enough … a doctor (and his/her patient) must always be careful, in medicine, not to just ‘treat a test’. It really should be incorporated into the Hippocratic Oath!
OK, OK - I know I am being a bit tongue-in-cheek there - but it really can be misleading, and even dangerous, to treat a test. It is the patient that must be treated. A test result must be interpreted, not in isolation, but in the context of the patient as a whole. Sadly, the medical defensiveness that is sometimes forced by insurance and litigation can bias and warp this simple tenet … ‘don’t treat a test, treat the patient’.
Please don’t misinterpret what I am saying here … laboratory tests are beaut, but only up to a point. We have come to depend on them enormously … as we should … but this dependence must, in the end, always be tempered by a combination of wisdom and sane, careful thought. ‘First, do no harm …etc’’
Not every abnormal test or change in test results will indicate a problem.
So, as I tell my students … test and check, by all means … but always, always bring common sense and wisdom to the table when interpreting the result you find.
John Agar
http://www.nocturnaldialysis.org