Dr. Manzoor Ahmad Parry
Nephrology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 35-year-old male. I am 70 inches tall and weigh around 195 pounds. I go to the gym and frequently exercise, mostly weightlifting. I take 5 g of creatine monohydrate daily. I also take 40 mg of Pantoprazole daily and 40 mg of Famotidine daily for acid reflux. I have been on this combination of acid reducers for nearly ten years. A recent routine blood test indicates a serum creatinine level of 1.54 and an eGFR of 58. My creatinine has been above range for the past two years (I have taken creatine supplements for as long). This was the first time, however, where mg eGFR dropped below 60. With the exception of a slightly high LDL (low-density lipoprotiens) and low vitamin D, all other labs were normal, including electrolytes, BUN (blood urea nitrogen), and BUN or creatinine ratio. Urinalysis was within range for protein (trace). I am very concerned that I have developed chronic kidney disease, especially due to my long course on Pantoprazole. I have stopped taking creatine supplements and expect to repeat the test. However, I am looking for some information as to whether my strength or gym routine and creatine supplementation may have boosted the serum creatinine (and lowered eGFR).
Hello,
Welcome to icliniq.com.
People who take creatine supplements are expected to have higher creatinine levels that do not necessarily mean low eGFR (estimated glomerular filtration rate). However, you have slightly hazy protein in urine examination. All other investigations look normal to me. Since you have stopped taking creatine supplements, repeating creatinine levels, you should inform us better about your kidney function. I would also suggest you get urine for albumin: creatinine ratio to be done. But I do not think you have developed chronic kidney disease
Patient's Query
Thank you doctor,
I am not sure if the full four-page laboratory report was properly uploaded, so I have uploaded the other pages. In follow up, I would like to ask if you could hypothesize what may have contributed to the elevated creatinine. Strenuous weight lifting, creatine supplementation (wherein I probably do not consume enough water), or otherwise? I have also seen versions of the eGFR formula that account for body size, height, and weight. Those formulas ostensibly show a higher eGFR. Any further help would be appreciated, as would your general impression that I have not developed CKD (chronic kidney disease).
Hello,
Welcome back to icliniq.com.
I had seen your reports (attachment removed to protect the patient's identity). Serum creatinine is produced from creatine in the body. So naturally, people having supplements of creatine can have higher serum creatinine levels. Deducing eGFR from this elevated creatinine can not be accurate. Once we stop creatine supplements, I expect serum creatinine level to decrease, and then we can check eGFR from the new creatinine level. Your reports also show low vitamin D levels, for which I would suggest you take vitamin D supplements (cholecalciferol 60 k weekly for eight weeks). Also, I would suggest you do urine for albumin creatinine ratio, as urine analysis showed hazy urine.
Patient's Query
Thank you doctor,
I will follow up as you have suggested. In the meantime, for my own peace of mind, does it remain your thought that I have not developed chronic kidney disease?
Hello,
Welcome back to icliniq.com.
Yes, I think so.
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Nephrology
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