Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Can Abnormal Creatinine And GFR Readings Affect Other Parts Of The Body?
Question: My question is: Would you consider that if the kidneys were operating with Creatinine and GFR readings between 275 / 22 and 450 / 12 for a full month – (the worst period being 11 days with creatinine being between 355 and 450) – that other body organs and systems might be affected by the contaminated blood flow?
I am a lay person but I cannot credit that almost all other systems could not be affected over that period of time.
What might be probable outcomes be from the above scenario?
I am a lay person but I cannot credit that almost all other systems could not be affected over that period of time.
What might be probable outcomes be from the above scenario?
Brief Answer:
all systems can be affected
Detailed Answer:
Hello,
when the kidneys fail to do their job all systems of the body can be negatively affected. Water and electrolyte balance is one of the most important aspects of renal failure. Impaired kidneys may be unable to excrete excess water or manage the electrolytes effectively and cause accumulation of water in various parts of the body (edema, pleural effusion, pulmonary edema due to increased blood volume and inability of the heart to take care of the increased load, etc so it may actually affect every part of the body), hyperkalemia (increased potassium levels) and other electrolyte disorders. Blood acidity may be affected as acids may accumulate and cause metabolic acidosis. All of the aforementioned disorders may impair the cardiovascular system and cause arrhythmias and even syncope and death.
Uremia is another aspect of renal failure as it may cause -on its own- various problems, like pericarditis, pleuritis, restless legs, fatigue, lethargy, etc.
When a patient experiences such problems hemodialysis is the only solution either as a temporary measure or for the rest of your life (it depends).
The GFR or creatinine measurements on their own are not sufficient indications for hemodialysis. More important indices include potassium levels, blood pH (acidity), water overload, symptoms of uremia.
So in conclusion, every system can be affected by decreased renal function. Whether they will be affected or not depends on the remaining functionality of your kidneys. Despite the low measurements, your kidneys may succeed to cope with the problems I've mentioned above. If you develop symptoms though (like shortness of breath or arrhythmias for example) then urgent reassessment would be required.
I hope you find my comments helpful!
Kind regards!
all systems can be affected
Detailed Answer:
Hello,
when the kidneys fail to do their job all systems of the body can be negatively affected. Water and electrolyte balance is one of the most important aspects of renal failure. Impaired kidneys may be unable to excrete excess water or manage the electrolytes effectively and cause accumulation of water in various parts of the body (edema, pleural effusion, pulmonary edema due to increased blood volume and inability of the heart to take care of the increased load, etc so it may actually affect every part of the body), hyperkalemia (increased potassium levels) and other electrolyte disorders. Blood acidity may be affected as acids may accumulate and cause metabolic acidosis. All of the aforementioned disorders may impair the cardiovascular system and cause arrhythmias and even syncope and death.
Uremia is another aspect of renal failure as it may cause -on its own- various problems, like pericarditis, pleuritis, restless legs, fatigue, lethargy, etc.
When a patient experiences such problems hemodialysis is the only solution either as a temporary measure or for the rest of your life (it depends).
The GFR or creatinine measurements on their own are not sufficient indications for hemodialysis. More important indices include potassium levels, blood pH (acidity), water overload, symptoms of uremia.
So in conclusion, every system can be affected by decreased renal function. Whether they will be affected or not depends on the remaining functionality of your kidneys. Despite the low measurements, your kidneys may succeed to cope with the problems I've mentioned above. If you develop symptoms though (like shortness of breath or arrhythmias for example) then urgent reassessment would be required.
I hope you find my comments helpful!
Kind regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Second question:
Hello Dr. Zografakis,
Many thanks for your answer. Our son had all you’re the above symptoms you mention and more. I relate back to our question “would a 28 day period of chronic renal failure damage other organs and systems of the body” perhaps I should have added “to such a degree as to dramatically affect his quality of life and possible premature death.
We are in fact just parents wanting to establish the reason our son passed just 21 weeks after an overdose of Vancomycin on top of already having serious diabetes problems (Type 1 for around 40 yrs). We are not wanting to lay blame, accidents happen to all of us, but we are wanting the system to acknowledge that maybe the reason for his demise was not simply “diabetic nephropathy” and co-morbid conditions. Everyone knew he had those, what we are saying/thinking is that although he was on the slippery slope of diabetic nephropathy, the overdose had immediate and serious affects on his body and created changes that brought about his early demise.
Both we and his local GP (who treated and knew him for around 20 years) have voiced this. The New Zealand system has brushed it off with many reasons for his death, saying that Vancomycin had no part in it and he was going to die anyway. Well, we agree with that but as a result of the Vancomycin overdose he suffered a horrible, painful and much earlier death than he should have. The last 5 months of his life were full of dry reaching, major skin and oedema problems, bleeding, itching, scratching, major incontinence (#1 & #2) and so on along with not wanting to eat and hypo’s.
What we are looking to do is show them we have (in this case) a possible valid viewpoint and the system needs to be more careful when dealing with diabetics
Should we find that the weight of opinion does not favour our viewpoint then we will accept that outcome and let the matter rest and be at peace with ourselves and our son.
I have a Xcel sheet with Adam’s numbers just prior, during and beyond the Vancomycin treatment and would be only too happy to forward it to you should you be prepared to look and comment.
If we have to pay extra for this please advise.
Hello Dr. Zografakis,
Many thanks for your answer. Our son had all you’re the above symptoms you mention and more. I relate back to our question “would a 28 day period of chronic renal failure damage other organs and systems of the body” perhaps I should have added “to such a degree as to dramatically affect his quality of life and possible premature death.
We are in fact just parents wanting to establish the reason our son passed just 21 weeks after an overdose of Vancomycin on top of already having serious diabetes problems (Type 1 for around 40 yrs). We are not wanting to lay blame, accidents happen to all of us, but we are wanting the system to acknowledge that maybe the reason for his demise was not simply “diabetic nephropathy” and co-morbid conditions. Everyone knew he had those, what we are saying/thinking is that although he was on the slippery slope of diabetic nephropathy, the overdose had immediate and serious affects on his body and created changes that brought about his early demise.
Both we and his local GP (who treated and knew him for around 20 years) have voiced this. The New Zealand system has brushed it off with many reasons for his death, saying that Vancomycin had no part in it and he was going to die anyway. Well, we agree with that but as a result of the Vancomycin overdose he suffered a horrible, painful and much earlier death than he should have. The last 5 months of his life were full of dry reaching, major skin and oedema problems, bleeding, itching, scratching, major incontinence (#1 & #2) and so on along with not wanting to eat and hypo’s.
What we are looking to do is show them we have (in this case) a possible valid viewpoint and the system needs to be more careful when dealing with diabetics
Should we find that the weight of opinion does not favour our viewpoint then we will accept that outcome and let the matter rest and be at peace with ourselves and our son.
I have a Xcel sheet with Adam’s numbers just prior, during and beyond the Vancomycin treatment and would be only too happy to forward it to you should you be prepared to look and comment.
If we have to pay extra for this please advise.
Brief Answer:
it's possible that vancomycin contributed to his problems
Detailed Answer:
Hello again,
I'm sorry to know about your son and I understand and sympathize your endeavor. I'm not sure I can help much though. I can say my opinion but only his doctors may know how his health problems got worse and led to his death.
Vancomycin may indeed cause kidney problems. Patients with pre-existing kidney problems should receive different dosages than healthy patients. The blood levels of vancomycin should be checked frequently to make sure the blood levels do not exceed the therapeutic range.
I don't have many details about the reason vancomycin was used (the diagnosis) and his kidney status at that time or how his kidney function ranged in the hospital. For example a patient with a serious infection may develop kidney malfunction when the infection gets out of control (severe sepsis or septic shock). Then the urine production is usually diminished and the renal indices may rise to high numbers. At that time prescribing the usual vancomycin dosage may may things worse. I'm very sure that his doctors did not do that because the way to use vancomycin is no secret! Handling vancomycin is something common for hospital doctors, so I doubt that such a serious mistake could have been done.
You can upload the excel if you want by attaching it to a follow-up question. If you can't attach it, ask the helpdesk for assistance. I'll be glad to have a look at it and share my thoughts with you.
Every doctor knows that patients with renal problems and diabetes require special care when it comes to drug dosing. If you're just doing this for your own peace of mind then it's OK but I don't believe you'll make any difference for future patients because this is common knowledge! They teach it at medical schools, it's over-emphasized in medical congresses, etc etc.
Please use your follow-up questions if you require more information or if you'd like to continue this discussion.
Kind Regards!
it's possible that vancomycin contributed to his problems
Detailed Answer:
Hello again,
I'm sorry to know about your son and I understand and sympathize your endeavor. I'm not sure I can help much though. I can say my opinion but only his doctors may know how his health problems got worse and led to his death.
Vancomycin may indeed cause kidney problems. Patients with pre-existing kidney problems should receive different dosages than healthy patients. The blood levels of vancomycin should be checked frequently to make sure the blood levels do not exceed the therapeutic range.
I don't have many details about the reason vancomycin was used (the diagnosis) and his kidney status at that time or how his kidney function ranged in the hospital. For example a patient with a serious infection may develop kidney malfunction when the infection gets out of control (severe sepsis or septic shock). Then the urine production is usually diminished and the renal indices may rise to high numbers. At that time prescribing the usual vancomycin dosage may may things worse. I'm very sure that his doctors did not do that because the way to use vancomycin is no secret! Handling vancomycin is something common for hospital doctors, so I doubt that such a serious mistake could have been done.
You can upload the excel if you want by attaching it to a follow-up question. If you can't attach it, ask the helpdesk for assistance. I'll be glad to have a look at it and share my thoughts with you.
Every doctor knows that patients with renal problems and diabetes require special care when it comes to drug dosing. If you're just doing this for your own peace of mind then it's OK but I don't believe you'll make any difference for future patients because this is common knowledge! They teach it at medical schools, it's over-emphasized in medical congresses, etc etc.
Please use your follow-up questions if you require more information or if you'd like to continue this discussion.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi there Dr.
We don't know why the team switched from Minocycline to Vancomycin when he 'appeared' to be responding to it.
The hospital have acknowledged the overdose.
I will contact the helpdesk to upload the Xcel sheet as I don't see any way to attach a document
Thank you for your comments. XXXXXXX (XXXX)
We don't know why the team switched from Minocycline to Vancomycin when he 'appeared' to be responding to it.
The hospital have acknowledged the overdose.
I will contact the helpdesk to upload the Xcel sheet as I don't see any way to attach a document
Thank you for your comments. XXXXXXX (XXXX)
Brief Answer:
please read the complete answer
Detailed Answer:
I've had a look at the tests. It's a little difficult for me to completely understand his situation as I don't have the clinical details and I have to do a lot of guessing. I understand that try tried to amputate the lower part of the leg and an infection of the stump dictated amputation below the knee. I couldn't possibly comment on his case without the clinical details. I can say that the loading dosage of vancomycin is right for a 85Kgr person taking into account his renal status. You haven't mentioned his weight so I'm guessing based on the dose... The maintenance dose may vary depending on vancomycin levels. A modest dosage may be as low as 165mg per day or as high as 1000mg every few days. The drug levels should guide further modifications of the dosage. So 453mg per day could have been a good dosage unless the drug levels were high... You haven't mentioned dialysis so I suppose he wasn't in end-stage renal disease (ESRD). ESRD patients require different dosing.
I can't say whether vancomycin is the cause of his problems as the amputation itself in patients with advanced renal disease carries a significant mortality risk on its own. Complicated amputations are even riskier. Vancomycin is well known for causing worsening of renal function and - as with every drug - it does more so to patients with pre-existing renal dysfunction. Nobody can tell whether this was the cause though, particularly since the dosage was not irrational (unless high drug levels were ignored).
I hope it helps. If you need any clarification or have more questions please ask.
Kind Regards!
please read the complete answer
Detailed Answer:
I've had a look at the tests. It's a little difficult for me to completely understand his situation as I don't have the clinical details and I have to do a lot of guessing. I understand that try tried to amputate the lower part of the leg and an infection of the stump dictated amputation below the knee. I couldn't possibly comment on his case without the clinical details. I can say that the loading dosage of vancomycin is right for a 85Kgr person taking into account his renal status. You haven't mentioned his weight so I'm guessing based on the dose... The maintenance dose may vary depending on vancomycin levels. A modest dosage may be as low as 165mg per day or as high as 1000mg every few days. The drug levels should guide further modifications of the dosage. So 453mg per day could have been a good dosage unless the drug levels were high... You haven't mentioned dialysis so I suppose he wasn't in end-stage renal disease (ESRD). ESRD patients require different dosing.
I can't say whether vancomycin is the cause of his problems as the amputation itself in patients with advanced renal disease carries a significant mortality risk on its own. Complicated amputations are even riskier. Vancomycin is well known for causing worsening of renal function and - as with every drug - it does more so to patients with pre-existing renal dysfunction. Nobody can tell whether this was the cause though, particularly since the dosage was not irrational (unless high drug levels were ignored).
I hope it helps. If you need any clarification or have more questions please ask.
Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
