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Can Hepatitis C And Chronic Liver Disease Cause Low Creatinine Levels?

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Posted on Thu, 12 Jun 2014
Question: My nephew is continuously be accused of diluting on his drug tests due to his low creatinine level. He has been diagnosed and was treated with GI bleeding, liver disease and Hepatitis C. Can these medical conditions account for low creatinine levels?
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Answered by Dr. Hardik Thakker (11 hours later)
Brief Answer:
DTPA scan

Detailed Answer:

Dear XXXXXXX
Greetings from health care magic!!! I am Dr Thakker and shall be answering your question.

I can understand your concerns about your nephews health.

Hepatitis c, Upper GI bleed and chronic liver disease eventually affect the kindney functioning. A known complication called as the hepato-renal syndrome occurs in all the 3 conditions wherein the kidney functions deteriorates with time. Ascites also add to the renal vein compression. All these together lead to an increase in the serum creatinine levels. Thus these conditions do not explain the low serum creatinine levels for your nephew.

There is a possibility of alleged dilution of serum taken for blood tests.

An alternate way of assessing his renal function is to do the DTPA scan. This will estimate the GFR ; glomerular filtration rate. This is the nest marker for renal function even better than serum creatinine.

I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Hardik Thakker (4 hours later)
Just to clarify, my nephew was being given urine tests instead of blood tests. I read that Low Values of creatinine could be due to liver disease, diet that is very low in protein, dehydration or cirrhosis. Question: Would having a UA instead of the blood test effect the creatinine level. In addition he has a very physically demanding job as a lineman working outdoors and in the heat of the day drinks a lot of water. I also read doing strenuous exercise 2 days before a test could impact the creatinine clearance test. The article I read also added that eating more than 8oz of meat in the 24 hours before a creatinine clearance urine test. Question: Can these situations lead to a low creatinine level. Thank you.
doctor
Answered by Dr. Hardik Thakker (2 hours later)
Brief Answer:
Pleaser read the detailed response

Detailed Answer:
Dear XXXXXXX

Thank you for clarifying that the tests were urine and not blood. This makes a major difference in interpretation.

In current day medicine, the renal functions are determined by serum creatinine levels and GFR estimate by DTPA scan. We do not use urine tests unless there is a very specific indication. For eg you wish to estimate the 24 hr urinary protein. In such a scenario we need to know the amount of creatinine in 24 hrs of urine.

I would like the know the exact indication as why the urine tests were done instead of blood. Also if someone is suspecting of diluting his tests, I would rather do a DTPA scan which is foolproof and accurately measure renal function and GFR rather than the unreliable urine tests which depend on the state of protein intake and hydration.

Diet which is very low in protein can lead to lower urinary creatinine levels, so does dehydration. However they do not accurately represent renal functioning which is of paramount importance.

I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.

Yours sincerely,
Dr Thakker.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Hardik Thakker

Internal Medicine Specialist

Practicing since :2006

Answered : 161 Questions

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Can Hepatitis C And Chronic Liver Disease Cause Low Creatinine Levels?

Brief Answer: DTPA scan Detailed Answer: Dear XXXXXXX Greetings from health care magic!!! I am Dr Thakker and shall be answering your question. I can understand your concerns about your nephews health. Hepatitis c, Upper GI bleed and chronic liver disease eventually affect the kindney functioning. A known complication called as the hepato-renal syndrome occurs in all the 3 conditions wherein the kidney functions deteriorates with time. Ascites also add to the renal vein compression. All these together lead to an increase in the serum creatinine levels. Thus these conditions do not explain the low serum creatinine levels for your nephew. There is a possibility of alleged dilution of serum taken for blood tests. An alternate way of assessing his renal function is to do the DTPA scan. This will estimate the GFR ; glomerular filtration rate. This is the nest marker for renal function even better than serum creatinine. I hope this helps you out. If you have any more questions, please do not hesitate to write back to me. Yours sincerely, Dr Thakker.