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Diabetic with elevated creatinine level - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2009
Answered : 352 Questions
User :   i want to talk to a nephrologist
Doctor :   hello
Doctor :   i am Dr XXX here
User :   hi doctor
User :   im a diabetic for the last 15 years
User :   at present my age is 44
User :   im hypertensive also
Doctor :   i am a general physician here .. but if you want we can forward your query to a nephrologist for a fee and your this chat money will be refunded
User :   ya sure u plz forward it to a nephrologist
Doctor :   sure please hold on
User :   thanku..
Doctor :   your welcome
Doctor :   WWW.WWWW.WW
Doctor :   our team will help you in getting you a opinion from the expert
User :   but i want to live chat wid him?
Doctor :   you you have 2 options
User :   not an ans thru an email
User :   wht r the opt?
Doctor :   first is that you can send in your query and he will read all your reports and reply voa mail
Doctor :   and second that we can set up a phone call for you
User :   whn ll i get the phone call?
Doctor :   you have to tell us the time whats suits you . and we will verify with our specialist and come to a common ground
Doctor :   our customer care team will coordinate with you
User :   ryt now also i can talk to the specialist
Doctor :   right now there are only general physician here .. to talk to a specialist you have to go via our website
Doctor :   and every detail is given there
User :   but can u answer my queries? i can ask u also
Doctor :   yes sure i can help you within my expertise
User :   ok as i told u im a diabetic for 15 years n my age is 44
User :   weight is 81
Doctor :   ok
User :   im hypertensive also
Doctor :   ok
User :   im sending u my latest reports n mdicine details
Doctor :   sure you can mail at YYYY@YYYY
User :   im nt mailing im telling u
Doctor :   go ahead please
User :   TSH 4.46 Cholesterol 203.6 HDL Direct 49.5 Triglyceride 161.6 LDL 121.78 VLDL 33.32 Tryglyceride:HDL ratio 4.11 LDL:HDL ratio 2.46 Creatinine serum 1.4 Blood Urea Nitrogen 9.7 BUN:Serum Creatinine ratio 7.64 Sodium 141.96 Potassium 4.00 Chloride 106.4 Microalbumin
User :   plz go thru it
Doctor :   tell me your present symptoms
User :   there are no wrong symptoms
Doctor :   your tsh is ok
User :   there is no problem im concerned abt my creatinine which is 1.4 which myt be alarming
Doctor :   but cholesterol is high
Doctor :   but not very high
User :   ok
Doctor :   what all medications are you on ?
User :   my creatinine has been increasing at the rate of 0.1 per every 3 months
User :   amaryl 2mg morning
User :   1 mg evening
Doctor :   do you have high blood pressure ?
User :   glyciphage 500 mg 1/2 b4 breakfast 1 before lunch n 1 before dinner
User :   im hypertensive bt my blood pressure is v much controlled+
Doctor :   ok since you are taking the correct medication
Doctor :   let me tell you some lifestyle changes that you need to do
User :   losar 50 daily seloken xl 25 mg daily cardace 2.5 daily
Doctor :   to control your Creatinine
User :   clopivas AT 150mg daily
User :   ya sure
Doctor :   First of all make it clear, that the creatinine level is only an 'estimated' test to assess kidney function. It is influenced by a wide variety of factors eg your hydration status at the time of test etc.
Doctor :   However, a rising creatinine level is regarded as a worsening of kidney function.
Doctor :   For diabetics, a more important test to monitor along with creatinine is Urine complete analysis for proteins (results are as +,++,+++) or the more specific 24 hour urine proteins (results in specific value of mmol/l). I'd recommend to get this test done, or give the value here if already performed.
User :   but recently my diabatologist has shifted me to 10 units of insulin Lantus daily
User :   glynase xl 10mg daily
Doctor :   Drink 6 glasses of water every morning when u wake up.Try to avoid morning coffee, instead you can go for Green tea or Hibiscus tea which also helps in lowering cholesterol levels.
Doctor :   Avoid taking diary products, meat, fish, etc ..Avoid foods rich in protein.
Doctor :   Avoid foods rich in protein and have a steady walk every day and keep your self away from high protein foods and keep your kidney healthy.
Doctor :   Monitor the level of creatinine periodically. keep your protein levels in control and stay healthy.
User :   my protein in urine is zero and even micro albumin is less than 2.5
Doctor :   thats good
Doctor :   see with just lifestyle changes you will be able to control. the medications you are taking are correct and are standard
Doctor :   do you consume alcohol ?
User :   but my urine creatinine is 27.5 which is even below the recommended pathalogical range
User :   very occasionally around once in a month n only 90 ml
User :   i dnt smoke n take tobacco
Doctor :   ok what about smoking ?
User :   n dnt take tobacco
Doctor :   well since you have no pathological signs and symptoms so its not of mush concern
Doctor :   much **
User :   is trht 1.4 creatinine t o worry about? cuz its on borderine
Doctor :   as long as you follow the regime properly
Doctor :   its ok
Doctor :   dont worry
User :   is there no odr medicine to bring it down
Doctor :   no you are taking the correct medications with the right dose .. do cut on taking meat and pulses in your diet
User :   wht shud be the appropriate water intake keeping in mind the 1.4 creatinine level
Doctor :   cut down on them
User :   ok
Doctor :   you need minimum 7-8 glasses
Doctor :   to keep your body well hydrated
User :   u askedme to tk 6 glasses in morning so for the rest of the day i shud take only 2???
Doctor :   no the whole day
User :   wht amount of green veggies shud i take?//
Doctor :   but early morning is good
Doctor :   spinach is good for you
Doctor :   and for your kidneys
Doctor :   also have peas ( mattar)
User :   how much littre of water shud i tk in 1 complete day?
Doctor :   do cut on your salt intake
User :   i tk v less salt
Doctor :   7-8 glasses in a whole day is good
User :   peas ve protein??? n u ve asked me to cut down on protein intake??? so wht to do
Doctor :   Too much protein increases the strain on the kidneys because protein breakdown results in a buildup of urea in the bloodstream. Eating foods that are lower in protein can help to decrease levels of urea and improve . Replace high-protein foods like meat, eggs and milk products with lower-protein options like grains and vegetables.
Doctor :   peas have less protein and are suitable for kidneys
Doctor :   simple carbohydrates are found in fruits. Avoid products that contain refined sugar, such as cakes, pies, cookies, candies and pastries.
User :   y only creatinine is rising while all other renal tests lyk urea sodium pottasium calcium protein are normal
Doctor :   well follow h diet modifications and you will see the change
User :   i do not take any of these cakes n all as im allready diabetic
Doctor :   ok
Doctor :   Avoid bananas, broccoli, chocolate, tomatoes, cantaloupe, prunes and mushrooms, as they contain high levels of potassium. Low-potassium alternatives include apples, watermelon, pears, cucumbers, grapes, cranberries, cherries and carrots.
User :   acc to u wht is the reason for this periodic rise in creatinine level????
Doctor :   it only means that your kidneys are working over
Doctor :   thats why
User :   wht do u mean by kidneys r working over?
User :   i culd not understand this
Doctor :   that means with the diet control you will feel better
User :   my water intake is 16 glasses at present
User :   does working over means extra work/
Doctor :   yeah
Doctor :   but water is fine
User :   u said to tk 8 glasses of water now u r sayng tht 16 glasses is also fyn!!!
User :   im confused
Doctor :   we want to keep your bodt hydrated
User :   can i take milk??? and if yes then how much?3
Doctor :   1 glass per day
User :   bt there is a big difference btw 8 glasses n 16 glasses of water? wht is ryt?
User :   u asked me not to take dairy products? then how come 1 glass milk is ok?
Doctor :   i dont want you to over do it
Doctor :   thats whay i am telling you in moderation
User :   ok
Doctor :   its important that you take proper medications on time
User :   if its not necessary to drnk milk thn i can avoid it cuz i startd it recently only whn i stoppd pulses n nonveg
Doctor :   yes you nee to stop on pulses
User :   i was talkng abt milk?
Doctor :   one glass is ok
Doctor :   a small one
User :   wht level of creatinine shud i maintain?
User :   ok
User :   wht amount of green vegetable shud i take?
Doctor :   The typical reference ranges are 0.5 to 1.0 mg/dL (about 45-90 μmol/l)
Doctor :   th more you take the better it is
User :   but my pathology has given me the reference range is 0.7 t0 1.4
User :   ok.
Doctor :   just cut salt
Doctor :   and pulses
Doctor :   and red meat
Doctor :   also dont take cold drinks
User :   i dnt tk cold drnks at all
Doctor :   Make sure to use monounsaturated and polyunsaturated fats (olive oil, canola oil, safflower oil) to help protect your arteries.
User :   ok
Doctor :   do get regular checkups
User :   doc these days my blood pressure is going low around 100/60
User :   at wht tym intervals shud i get checked up?
Doctor :   maybe the dose might be high you need to discuss it with your physician .. please do get a checkup once every 3 weeks and if you have any symptoms you should get it done sooner
User :   so accordng to u my creatine level is high so is it a case of diadetic nephropathy?
Doctor :   its too early to say without tests but it can be reversed by diet and exercise that's why i am stressing on it
User :   wht test shud be done for it?
Doctor :   kidney function tests
User :   wht excercises shud i do? i walk regularly n practise pranayam shud i continue it???
Doctor :   yes please
Doctor :   thats good
User :   i ve told u the reports of all my kidney function tests? sugeest me if ny test is left
User :   ok
Doctor :   right now you nedd only what i have toldyou
Doctor :   just get regular test at 3 weeks
Doctor :   thats all
User :   ok ok
User :   how much total calories shud i take?
Doctor :   2500
User :   and wht all more shud i do?
Doctor :   well nothing much .. diet and exercise and taking your medications on time is all you need

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