Dr. Madhav Tiwari
General Surgery
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Patient's Query
Hello doctor,
I am 54 years old and do not have any habit of smoking or drinking. I underwent regular checkups for cough and the doctor noticed an increase in the BP as well as creatinine count of 110 mkmol/L two months back. After a month, this was repeated and BP still was high and creatinine level was 150. I have undergone ultrasound on kidneys, bladder, and prostate and 1 cm^2 calcification along with a three milli meter increase in the prostate size was seen. No urine flow, or cadence issue during the day or night. I was also tested for cancer and reports were normal. Nothing could explain the levels of high creatinine (not high but above normal). I am currently taking Eltroxin every day for Graves disease for the past 20 years and started 5 mg medication for blood pressure one month back which increased to 10 mg this month and the BP came down from an average of 150/95 mmHg to 135/75 mmg Hg. How should I manage my high creatinine assuming that all my reports are in order, do I need to get more tests done?
Kindly suggest.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern. Please help me with a few details so that I can understand the problem better: Since how long has your creatinine value been going up? Do you have any other illnesses except hypertension? Have you had any surgeries in the past? Do you have any trouble in passing urine such as - urgency, increased frequency, or straining to pee? Has your urine speed worsened over the last few months or years? I can see you underwent a CT scan (attachments removed to protect the patient's identity), where the contrast was injected. Creatinine levels prior to the CT scan were 110 and I would like to know if this has been progressively rising ever since. How is your urine output? Is it at least a liter and a half a day? Is there any swelling in your legs?
Based on looking at your history and results, my first interpretation is that this rise in creatinine can be due to one of two reasons: High blood pressure has damaged your kidneys over the years and this rise in creatinine is due to age-related kidney disease (exaggerated by hypertension). You have developed contrast-induced nephropathy due to the contrast you were given during your CT (this stands true if your creatinine has only risen after the CT scan).
Please revert back with the details and I will do my best to guide you further.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
I only have the two creatinine test results since two months. I had lower back surgery for herniated discs (L3/L4) six years back. After surgery, I have normal body function and am still active. I can do calisthenics, long hikes, and rowing on a regular basis every week. I have no issue with peeing. The more I drink, the more I urinate. I got my blood test and urine analysis test done a day before and the results are due. The scan reports were also normal indicating no blockages in the urinary duct from the kidneys to the bladder and from the bladder out. The speed of urine is based on how full my bladder is and certainly no dribbling. If I drink enough water and not too much coffee, I urinate at least 0.032 gallons in a day. No swelling in my legs, except for having a slight overweight problem around my waist.
Thank you.
Hello,
Glad to have you back!
I am here to help you get the best medical advice. At the beginning of the conversation, it is mentioned that the creatinine level was 110. However, the reports that you have attached (attachments removed to protect the patient's identity), show the creatinine to be 127 and, 150. I do not see any report for creatinine being 110. This rising creatinine can be due to medical renal disease, which can occur in people as they grow older. Most people who have this problem, and are diagnosed quite early on can be effectively managed with lifestyle, modification and medications. In addition to the urine and blood tests that are still pending, I suggest you get an ultrasound of your kidneys (including color Doppler) to look for signs of medical renal disease. In my opinion, it is best to get this ultrasound done by an experienced sonologist. Take tablet Nefrosave (Taurine Acetylcysteine) once a day for one month. Consult a nephrologist to discuss further course of action, including lifestyle changes (which include regular exercise, lowering your salt consumption, and managing water intake) as well as any medications that you may benefit from. Management of hypertension effectively as hypertension is a leading cause of medical renal disease.
I hope this has helped you. Thank you.
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General Surgery
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