Dr. M Sivalingam
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
Hi doctor,
I have no family history of diabetes or high blood pressure. I went for my routine medical check-up and found out my reports were not normal. My GFR is 48, creatinine 1.2, and BUN 20. White blood cells and hemoglobin levels were normal. Last year the GFR level was 77, the creatinine level was 0.8, and the BUN level was 14. I consulted the doctor as I was worried because if my GFR is 48, that might be CKD III. According to her, I might have been dehydrated, and she asked me to recheck after two months. I am on tablet Metoprolol, tablet Bupropion, and tablet Singulair for POTS. Should I get a more comprehensive workup sooner than two months, and should I see a nephrologist? I am worried.
Welcome to icliniq.com.
I understand your concern.
The increase in creatinine from 0.8 to 1.2 is a significant change. The cause of this is unclear from the tests you have done. In the intervening period, have you taken any new medicines? Have you taken any painkillers or alternative medicine recently? Have you been ill lately, such as having any fever or cold? If creatinine remains high, repeatedly consult a Nephrologist (a doctor who specialize in conditions that affect the kidney).
The Probable causes
Investigations to be done
Treatment plan
Preventive measures
Patient's Query
Hi doctor,
Thank you for the reply.
I have not started any new medications since last year except for using over-the-counter Flonase spray once daily. I have not taken any painkillers. But I used to take vitamin supplements for a long time. Vitamin D 2000 IU, Calcium/Magnesium 1000/500 mg, fish oil, and probiotics. I have not been sick. Do you think my doctor's recommendation to recheck in two months is too long?
Hello,
Welcome back to icliniq.com.
I understand your concern.
Your calcium level is normal, so it is unlikely that the increase in creatinine level is related to using calcium and Vitamin D supplements. However, as I mentioned earlier, the increase in creatinine since your previous report is significant. Therefore, if it is persistent, it is better to identify the cause and treat it at the earliest. I would advise repeating the creatinine level about a week from the last lab test. If it is at similar levels or higher, it would be essential to evaluate at the earliest by consulting a Nephrologist so that any underlying cause can be identified and treated. However, no immediate evaluation is required if the creatinine level has improved from the previous levels. Urine routine analysis would also be helpful in this regard as it would provide additional information regarding the cause of increased creatinine.
The Probable causes
Investigations to be done
Probable diagnosis
Treatment plan
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Nephrology
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