Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

122 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

CKD patient. Getting fluctuate creatinine level. What should be done?

Answered by
Dr. Ravi Bansal


Practicing since :1996

Answered : 339 Questions

Posted on Tue, 29 Jan 2013 in Kidney Conditions
Question: My father is a CKD patient from 2009. His creatinine level was fluctuating between 3 and 4 till December 2012. On 24th december he was admitted to a nearby hospital with complaints of nausea. Then his creatinine level was found to be 13. From 24 till 7th January 2013 after 5 dialysis the creatinine level has come down to 7. His urea level was 167, now it is 97. His hemoglobin level was 8.5 on 24th but now it is 7.9. He has been having mild fever from 20th December 2012. His ESR level was 82 (normal lvl 1-10) on 27th December 2012. WBC count was 0000 cells/cmm and Platelets count was 3.11 lakhs/cmm. He had measles induced nephritis when was 6 years old. Today he was having a fever of 101 f. I would like to know if this spike in the creatinine level is due to some infection.
Answered by Dr. Ravi Bansal 11 hours later

Your father is suffering from advanced renal failure and dialysis is indicated. Now there are two things to understand.

1. Why did the creatinine rise suddenly?
When the creatinine is around 4.0, the kidney works only around 15% of its normal capacity. Any small insult in the form of - infection (chest or urine), use of pain killer medicines, high blood pressure or high blood sugar, diarrhoea or vomiting, unknown desi medicines - can result in sudden jump of creatinine level.
To diagnose all these we need complete patient history and run battery of tests - especially urine routine, urine culture, blood culture, and ultrasound abdomen, chest x-ray.

All these are missing from the reports supplied. The Total leucocyte count is borderline high 0000 and patient has fever - this shows patient definitely has an infection now. ESR has not much relevance; it can be high even with anemia.

We might be able to predict the cause of this spike in creatinine level if all the aforementioned data is available.

2. Whether the kidney will improve or not?
This is hard to predict. 70 to 80% patient’s serum creatinine will fall back to pre-illness level, while other will remain on dialysis. His treating nephrologist would know about it - may be not now but few days during his treatment.

Hope I have addressed your concern. Feel free to ask any other question

Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,   ,  
Lab Tests
Medical Topics

Recent questions on  Anemia

doctor1 MD

Hi, i am writing on behalf of a friend. He had been diagnosed with having IBS when he was 13, without a colonoscopy, and now he is 25. He has been having abdominal pain and interchanges of diarrhea and constipation all these years but a month ago it suddenly got really worse (after having some fish, but even if it was bad, he had never experienced such excruciating pain again), as in one day he started to ache so much he couldn't get up off the floor. It was like stabbing and ripping him apart. He went to the hospital and had blood work done and an X-ray and they said it was normal but suggested a colonoscopy but he didn't go through with it. Ever since he has been having really severe abdominal pain and interchanges of diarrhea and constipation and he has been to several doctors, one prescribing him with amitriptyline and antibiotics for the intestine, and another after that giving him mebeverine hydrochloride alone. He took the antibiotics and amitriptyline for almost a month and it helped him a bit but in the evening he would none the less have the return of the severe pain in his entire abdomen, sometimes centering on the left upper side of it. Then he went to the other doctor who perscribed mebeverine hydrochloride, telling him it would instantly help, without that being the case when he tried it. He had extensive blood work done and everything was normal, no inflammation or anemia, and the doctor said he didn't need anything else and should just take the mebeverine. But he is still in pain and i was wondering if it could be something else with these symptoms. Should he have a colonoscopy or some other less painful test? He also has Gastroesophageal Reflux Disease.

doctor1 MD

My heart flutters constantly. The doctors in the ER called them PVC and put me on a heart monitor to see why I'm having them so frequently. They are not painful just irritating.My blood pressure is low thyroid is good and I use to have anemia but that's good as well. All lab work came out good including X-rays So why is my heart skipping beats?

doctor1 MD

I have MS and several times a year, i take venefor infusions for anemia (not related to the MS). within a week of the infusion, my left foot always swells enormously and is painful to walk on. my doctors keep saying its not from the venefor, as venofer is just iron. However, I know this swelling occurs each time. Does venofer cause foot swelling?

doctor1 MD

hi i used to have anemia about a year ago. now i am all better, however, when i last checked my heart rate, it was in the 80s. i checked again today while sitting down cause i thought that the machines at walmart may be lying or i could of been a bit active before hand, however it still was in the 80s.

doctor1 MD

getting pain in some parts of chest in random time any type of injections for D3 and B12 and dose for same as per reports

doctor1 MD

Do you think at ESA therapy is a good option for a 90 yo male with CKD stage 3A? RBC count is 2.91; HGB 9.9; HCT 29.1; platelet count 104; GFR est non-AA 58; Micralb/Crea ratio (ug/mg creat) 59.0; Pt is always cold , extremely fatigued-sleeps 15...

doctor1 MD

I had routine bloodwork done and all tests came back normal except for a raised ferratin 575. When tested again 6 weeks later it came back at another high value 445. No other tests for inflammation were done. CBC with differential all normal. I'm...