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Had stroke, blood clots, kidney stones. Had open heart surgery to replace aortic valve. On cuomandine. Why is there back pain?

I am 44 years old, had open heart surgery in 2008 to replace aortic valve with a mechanical one. Im on coumandine, I had a major stroke in 2010, 2 blood clots flew off my mechanical vale and went into my brain. My kidneys shut down for a week, almost had to start dialysis but kidneys started working again. I have passed 50 kidney stones since age of 10, have had a few mini strokes, high blood pressure etc. I had blood tests last week my creatinine was 1.42, EGFR not AFA was 45 and my EGFR if AFA was 52 my doctor said its a sign of kidney disease. Is the correct, and is 1.42 high for creatinine levels? I have had flank back pain, and pain in my sides, been very tired lately, nauseas sometimes, loss of appetite, etc. How worried should I be?
Asked On : Thu, 17 Oct 2013
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General & Family Physician 's  Response
Welcome to HealthCareMagic. My name is Doctor Saleem Ur Rehman and I will answer your question.

I feel urged to congratulate you on facing your many ailments with a positive view and I hope you will continue doing the same whenever you face a problem.

You have a history of passing multiple stones since childhood which indicates that the problem may be long-lasting, even since birth (important risk factors include hypercalciuria: passing more calcium in urine, family history of kidney stones, and cystic kidney disease: fluid filled sacs are formed within the kidney).

Kidney stones can cause derangements in kidney function, thus causing an increase in creatinine and a decreased GFR if they are located at he outlet of urine from kidneys. They can cause infection in kidneys if present for a long time.

Your flank and back pain is consistent with kidney infection/stone. your fatigue, nausea, loss of appetite are consistent with increased creatine and urea in your blood due to either stones in kidneys or chronic inflammations.

If I were your doctor, I would have ordered an ultrasound to look at your kidneys for any stones, or changes in their shape and size that might help me in ruling out kidney stones and chronic kidney disease. I would have ordered a urine test to rule out infection of the kidneys. Then considering the results, I would either have started treating you or ordered further investigations like Xray KUB, CT scan, kidney biopsy etc.

As for your current test results your conditions seems to be mild to moderate. Creatinine is not raised much and the GFR is still far above the level recommended for dialysis ( 10 - 15 ).

It can not be predicted at the moment whether your kidney problem is due to chronic stones or due to another pathology. It is, therefore, recommended that you make an appointment with your doctor for follow up and discuss this in detail with him. He will manage you the best.

Wishing you best of Luck.
Answered: Fri, 18 Oct 2013
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