How to prevent creatinine rise?

Question

Hi doctor,

I am a 74 year old male. For the past two years I am house-ridden, but not bedridden yet. I feel tired after walking a mere half a kilometer. I walk with the help of a walking stick, because I lose balance while walking. Sometimes I feel orthostatic hypotension. I consulted a cardiologist, a pulmonologist, an endocrinologist and a urologist. Cardiologist took an ECG and an echocardiogram. He ruled out heart trouble even though I had undergone aortic valve replacement six years back. Pulmonologist asked me to take a thoracic CT scan and did not find any significant malignancy of the lungs. Urologist, who 10 years ago diagnosed me having GU AFB and cured me with a six month course of AFB treatment, ruled out recurrence of AFB in GU area. Endocrinologist prescribed various tests like serum cortisol test, thyroid test, ACTH test and ruled out Addison’s or Cushing’s disease. Last week, when I was going through those records, I read in the thoracic CT scan report that my right adrenal gland has hyperplasia. On the internet, I found that hyperplasia means growth of additional cells. Since the previous CT scan was one and a half years old, I decided to have another CT scan of abdomen to find out the condition of my right adrenal gland hyperplasia. I knew that I cannot have an MRI scan as I had a replaced aortic valve. The radiologist had my serum creatinine tested before administering me with the liquid necessary for contrast. The new CT scan report appeared to me as a death sentence. The report did not find any change in adrenal hyperplasia. But, the report of my kidneys appeared to be concerned.

I consulted a nephrologist in a renowned leading hospital in my area. He did not prescribe any treatment for me at all. He even chastised me for taking a CT scan telling me about the radiation effect of the scan and effect on kidneys of the contrast liquid. He asked me to come back after six months. After thinking about it for the past one week I have come to the conclusion that the honorable doctor decided that my kidney condition is terminal and it is futile to prescribe anything. As I spend lots of time surfing on the internet I had a whim of having a second opinion online.

Answer 1

Hi,

Welcome to icliniq.com.

Please attach all your CT (computed tomography) reports and your blood profile for my best opinion. Thanks.

Revert back with the reports to a nephrologist online.

Answer 2

Hi,

Welcome back to icliniq.com.

Thank you for the reports (attachment removed to protect patient identity). First of all please do not get so tensed. Nothing is scary or life-threatening.

The shrunken kidney is mostly due to GU TB (genitourinary tuberculosis), which happened earlier.

Creatinine of 1.4 means there is some mild dysfunction of normal sized kidney, but it can be controlled.

What is your blood pressure? Are you diabetic?

Regarding your adrenal hyperplasia, I need to know some other reports also like serum electrolytes and uric acid.

Does your BP fall while supine to standing. How is your appetite?

To rule out GU TB, have you done urine TB culture by MGIT (Mycobacteria growth indicator tube)? If not, then please do it.

Finally, every person can live an absolutely healthy life with a single functioning kidney. The best example is kidney donors. So, chill and do send me the above asked reports.

Mainstay of preventing your creatinine to rise is control of your BP, salt restriction in diet, avoid all sorts of painkillers and take at least 3-4 liters of fluids every day.

Revert back with the answers to the above questions to a nephrologist online.