Swelling/fatigue w/ bun/crea ratio high at 26, but normal crea & bun levels. i'm also a sjogrens & ostoearthritis patient. what does this mean?

Swelling: More information is needed about your swelling. If it's edema of the lower legs it could stem from venous insufficiency, liver disease, protein loss through the kidneys, heart failure, excessive salt intake, protein deficiency, certain medications,etc. Your MD will take a thorough history, perform a physical examination and order appropriate tests in order to make a diagnosis.