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What Could Cause Elevated Creatinine Levels While On Lisinopril-HCTZ?
Question: I got blood results back and my Dr called and said my creatinine was elevated to 1.6 and my Bun was 40. A year ago he had put me on lisinopril-hctz 20-25 mg and when he called me he said he wanted me to cut the pill in half and take it. I am 70 years old and have never had bad lab results until now. Would this medication cause this and should I go off it totally? I am very worried.
Brief Answer:
maybe due to excess fluid loss due to meds- correctable
Detailed Answer:
Hi,
Your medication is a combination of an ACE inhibitor and a diuretic (HCTZ).
The diuretic would cause the loss of fluid from the body, this is one of the ways of reducing high blood pressure but excess fluid loss can cause problems.
It can reduce the amount of blood going to the kidneys and this affects what the kidneys absorb (take back to send back to the blood and body).
Excess fluid loss can cause slight dehydration and dehydration can cause an increase in BUN particularly.
It is said that if the ratio of BUN to creatinine (in your case, 40 /1.6= 25) is more than 20 it means that the blood to the kidneys is reduced and one of the most common reason for this is dehydration.
Since the tablets can cause dehydration in some persons, if you reduce your doctor, your body will possibly lose less fluids and the levels may improve. You can also consider slightly increasing your fluid intake.
Your doctor may recheck the levels to see if there is any change
Summary-- may be due to excess fluid loss due to the medication- which is correctable
I hope this helps, feel free to ask any other questions
maybe due to excess fluid loss due to meds- correctable
Detailed Answer:
Hi,
Your medication is a combination of an ACE inhibitor and a diuretic (HCTZ).
The diuretic would cause the loss of fluid from the body, this is one of the ways of reducing high blood pressure but excess fluid loss can cause problems.
It can reduce the amount of blood going to the kidneys and this affects what the kidneys absorb (take back to send back to the blood and body).
Excess fluid loss can cause slight dehydration and dehydration can cause an increase in BUN particularly.
It is said that if the ratio of BUN to creatinine (in your case, 40 /1.6= 25) is more than 20 it means that the blood to the kidneys is reduced and one of the most common reason for this is dehydration.
Since the tablets can cause dehydration in some persons, if you reduce your doctor, your body will possibly lose less fluids and the levels may improve. You can also consider slightly increasing your fluid intake.
Your doctor may recheck the levels to see if there is any change
Summary-- may be due to excess fluid loss due to the medication- which is correctable
I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
so my concerns are three things
1 Would this have possibly caused permanent damage to the kidneys
2. The Doctor wants me to cut the pill in half shouldn't I go off it all together.
3. When I saw the Dr this week I told him I still was having some swelling in my ankles. I have had this for 25 years and is nothing new. HE Put me on 25 mg of lasicks. When I asked him today about that he said it was ok to continue that. This makes no sense that I would continue that.
4 Are these levels really considered high. Should I see a kidney Dr or wait and see next lab results. He said 3 to 6 months. I don't want to wait that long.
1 Would this have possibly caused permanent damage to the kidneys
2. The Doctor wants me to cut the pill in half shouldn't I go off it all together.
3. When I saw the Dr this week I told him I still was having some swelling in my ankles. I have had this for 25 years and is nothing new. HE Put me on 25 mg of lasicks. When I asked him today about that he said it was ok to continue that. This makes no sense that I would continue that.
4 Are these levels really considered high. Should I see a kidney Dr or wait and see next lab results. He said 3 to 6 months. I don't want to wait that long.
Brief Answer:
no not high enough to indicate severe kidney damage- monitoring for now
Detailed Answer:
HI
The medication may have been the cause of the increase but this would need to be confirmed when you reassessed
If it is the cause, then it is not permanent, only requires increased fluid intake and decreased loss (less diuretic)
If discontinued completely there may be an increase in blood pressure though other meds can be used instead. Reducing may be enough to see changes.
That is very true, makes no since if believes that the increased BUN/ratio is related to fluid intake because the lasix would be even more likely to cause fluid loss
No the levels are no high to indicate that there is severe kidney damage particularly since your previous tests were okay, this is the reason that monitoring and repeat testing was suggested by your doctor. You can ask whether it is possible to repeat in a months time instead of 3 months.
Your doctor will understand your concern
no not high enough to indicate severe kidney damage- monitoring for now
Detailed Answer:
HI
The medication may have been the cause of the increase but this would need to be confirmed when you reassessed
If it is the cause, then it is not permanent, only requires increased fluid intake and decreased loss (less diuretic)
If discontinued completely there may be an increase in blood pressure though other meds can be used instead. Reducing may be enough to see changes.
That is very true, makes no since if believes that the increased BUN/ratio is related to fluid intake because the lasix would be even more likely to cause fluid loss
No the levels are no high to indicate that there is severe kidney damage particularly since your previous tests were okay, this is the reason that monitoring and repeat testing was suggested by your doctor. You can ask whether it is possible to repeat in a months time instead of 3 months.
Your doctor will understand your concern
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I talked with the nurse at the DR. Office today about my pills. She didn't seem to understand my big concern on the elevated lab numbers. SHe said is wasn't anything to worry about they see XXXXXXX lab numbers everyday. I then asked her what my labs were last year. TO my XXXXXXX the BUN was 30 and the Cretanine was 1.1 I was never told last year the BUN was elevated then. Now I am more concerned and not as likely to feel this is the blood pressure medicine.
Could I possibly have Chronic Kidney disease. It says your labs go up slowly.
Could I possibly have Chronic Kidney disease. It says your labs go up slowly.
Brief Answer:
consider asking your doctors about your GFR (how the kidneys are filtering
Detailed Answer:
hi
Okay so now we know that there was an increase before this point. You should have been told.
With the new info, if the BP meds were not started then, it cannot be the meds as you correctly stated.
EGFR is estimated glomerular filtration rate, I mention this because the level of the glomerular filtration rate (how well the kidneys are filtering or getting rid of toxins) determines if a person has significant kidney disease and also is used to stage the degree of kidney disease.
It normally decreases with age somewhat.
You should consider asking your doctor or the nurse about your GFR to see if there is a significant issue
consider asking your doctors about your GFR (how the kidneys are filtering
Detailed Answer:
hi
Okay so now we know that there was an increase before this point. You should have been told.
With the new info, if the BP meds were not started then, it cannot be the meds as you correctly stated.
EGFR is estimated glomerular filtration rate, I mention this because the level of the glomerular filtration rate (how well the kidneys are filtering or getting rid of toxins) determines if a person has significant kidney disease and also is used to stage the degree of kidney disease.
It normally decreases with age somewhat.
You should consider asking your doctor or the nurse about your GFR to see if there is a significant issue
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I know the gfr as I got the results from the hospital it says gfr non XXXXXXX XXXXXXX
32 is the number. I am 70 years old. I take it I am probably in trouble ?
32 is the number. I am 70 years old. I take it I am probably in trouble ?
Brief Answer:
it decreases with age but a little lower than expected
Detailed Answer:
HI
It is low, as mentioned, it does decrease with age but the value of 32 is lower than we would normally like to see.
It is important to remember that kidney function has to decrease by a significant amount to cause problems, this is the reason that some persons survive with only one kidney.
Persons with significant kidney disease have changes in potassium, calcium, vitamin d levels, hemoglobin (from complete blood count). There are also other electrolytes that may change as well
If these are normal then it is possible that the kidney issue is not have a significant effect on you and you are doing okay.
it decreases with age but a little lower than expected
Detailed Answer:
HI
It is low, as mentioned, it does decrease with age but the value of 32 is lower than we would normally like to see.
It is important to remember that kidney function has to decrease by a significant amount to cause problems, this is the reason that some persons survive with only one kidney.
Persons with significant kidney disease have changes in potassium, calcium, vitamin d levels, hemoglobin (from complete blood count). There are also other electrolytes that may change as well
If these are normal then it is possible that the kidney issue is not have a significant effect on you and you are doing okay.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Calcium is 9.9. Hemoglobin 12.2. Potassium 4.2. Hematocrit 38.7 triglycerides 125
These seemed ok according to lab report..how would vitamin d levels be listed?
Am I possibly ok?
So I sent you my other labs and they all look fine. I guess I was wondering if you feel I do have a kidney problem or perhaps I am ok . I wasn't sure what you meant.
If I have a kidney problem can this be helped with diet and medication ?Thank you
These seemed ok according to lab report..how would vitamin d levels be listed?
Am I possibly ok?
So I sent you my other labs and they all look fine. I guess I was wondering if you feel I do have a kidney problem or perhaps I am ok . I wasn't sure what you meant.
If I have a kidney problem can this be helped with diet and medication ?Thank you
Brief Answer:
if these are okay then that's good
Detailed Answer:
Hi
There are different stages of kidney disease, when it is severe it causes abnormal electrolytes.
With slight or moderate decrease in kidney function, it may still be able to maintain normal levels of electrolytes and there may be no significant change in body function.
Maintaining tight control on blood pressure and blood sugar would help to prevent any further damage if either of these is an issue.
In addition, cessation of smoking if this is an issue, would also help as well
A healthy diet is important and would also help as well.This would contain a wide range of fruits and vegetables.
if these are okay then that's good
Detailed Answer:
Hi
There are different stages of kidney disease, when it is severe it causes abnormal electrolytes.
With slight or moderate decrease in kidney function, it may still be able to maintain normal levels of electrolytes and there may be no significant change in body function.
Maintaining tight control on blood pressure and blood sugar would help to prevent any further damage if either of these is an issue.
In addition, cessation of smoking if this is an issue, would also help as well
A healthy diet is important and would also help as well.This would contain a wide range of fruits and vegetables.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I think I have one more question I can ask. I have noticed occasionally when I urinate there may be 2 or 3 bubbles in the water. The urine is clear but since I am so aware of everything now was wondering if this is normal. Would the color be different if I were having kidney issues. Thanks
Brief Answer:
can understand being extra careful
Detailed Answer:
HI
Only some kidney diseases cause a change in color or odor of the urine. Chronic kidney disease is not usually associated with changes unless protein is present in the urine or there is also an infection or stone.
Protein can cause frothy or foamy urine.
The bubbles are not an indicator of chronic kidney disease but I can certainly understand becoming hypervigilant, anyone would be.
can understand being extra careful
Detailed Answer:
HI
Only some kidney diseases cause a change in color or odor of the urine. Chronic kidney disease is not usually associated with changes unless protein is present in the urine or there is also an infection or stone.
Protein can cause frothy or foamy urine.
The bubbles are not an indicator of chronic kidney disease but I can certainly understand becoming hypervigilant, anyone would be.
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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