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Are elevated creatinine levels signs of kidney failure?

Answered by
Dr.
Dr. Rakesh Madhyastha

Nephrologist

Practicing since :2009

Answered : 4360 Questions

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Posted on Tue, 10 May 2016 in Kidney Conditions
Question: I am a 50 year old male. I just had my physical exam and routine blood work. The creatinine came back elevated at 1.4. BUN was normal at 23. Urinalysis was also normal (no protein). My blood pressure is normal below 120/80. My GP sent me for abdominal ultrasound or kidney ultrasound and that came back normal. Then we reported the blood work 6 weeks after the first one and again, the creatinine is high at 1.4. BUN is still normal at 19. Urinalysis was normal again. Now I am to see a nephrologist, but I am getting worried. Are my kidneys failing ?
doctor
Answered by Dr. Rakesh Madhyastha 1 hour later
Brief Answer:
Need more info

Detailed Answer:
Hello

Thanks for the query

I understand you are concerned about your slightly high creatinine. However if i were to be your doctor I wouldn't worry about it as you have no other signs or symptoms of kidney disease for example protein loss in Urine , hypertension, size of the kidney is also normal.
Slightly higher creat is seen in a few conditions, please get back to me with the following

1. are you heavily built and do you exercise daily or lift heavy weights?
2. do you have any family history of kidney disease?
3. do you have history of recurrent urinary tract infections
4. please mention any drugs you might be on, including recreational drugs ( if any)

Please get back to me , I am awaiting your reply

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rakesh Madhyastha 1 hour later
Thanks for your reply. I am 148 lbs and 5' 8" tall. I run regularly about 15 miles a week. I am not particularly muscular, but athletic and in good shape. No history of kidney disease in my family. No history of urinary tract infection. I don't use drugs at all. I used to take occasional inbuprofen for headache, only regular recommended dose. I have not taken any now for several months.


I was also wondering how often do you see elevated creatinine without changes in urinalysis and normal BUN in early stages of renal failure? I thought the BUN and creatinine should be raising simultaneously as the renal function declines. Is that true? Thank you for your help.
Best regards
doctor
Answered by Dr. Rakesh Madhyastha 10 hours later
Brief Answer:
Dont see it often

Detailed Answer:
Hello

Thanks for getting back. I understand how tensed you might be. Here are the answer to your questions. I will address them one by one so that I dont miss any

1. Occasional ibuprofen should not lead to kidney disease. Even otherwise urine analysis would have shown positive findings if it all anlagesics were to be the cause of kidney injury
2. We do see slightly elevated creat in normal individuals. I have 4 such patients, 1 has no apparent cause, 2 are from the army and 1 is a body builder. Higher creat is often seen in muscular men
3. BUN and creat usually increase simultaneously as renal function declines. That is correct

Now, to solve your apprehension I suggest you to get a DTPA scan done, this will tell us the exact functioning of your kidneys. If this is normal then you have nothing to worry about. Please speak to your doctor regarding this.

I hope I was of help, if you have any further queries please get back to me

Regards
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
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Follow up: Dr. Rakesh Madhyastha 32 minutes later
Thank you ! Just one more question if I may. My eGFR was also low at 58. My understanding that this is a calculated number based on age, body weight, and more importantly the serum creatinine level so it will be falsely calculated low in individuals like body builders with increased muscle mass and higher than normal creatinine level with normally functioning kidneys. Just wanted to know if my understanding is correct about this. Thank you again.


Am I still to expect an answer or we are out of time and questions? Either way, thank you for your answers, it really made me feel better about this.
Thanks again

Best regards
doctor
Answered by Dr. Rakesh Madhyastha 22 hours later
Brief Answer:
Explanation of eGFR

Detailed Answer:
Hello

Thanks for getting back, I am sorry for the short delay in reply. There were two transplants happening in our unit so I got held up.
Now, 'e'gfr means that they have come to the conclusion of gfr by using a formula which has several variables like you have mentioned. It also includes race. It is just an estimate and not a true value.
I still recommend you to undergo Dtpa scan however the gold standard would be to do a renal biopsy but that's an invasive procedure so I wouldn't advice that right away

I am sorry for the short delay once again

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Rakesh Madhyastha 29 minutes later
Thank you again.
doctor
Answered by Dr. Rakesh Madhyastha 3 minutes later
Brief Answer:
Welcome note

Detailed Answer:
Hello

Please get back to me on what your doctor had to say. Please discuss my suggestion with your doctor

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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