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Suggest Ways To Lower Creatinine Levels In Blood
Question: Dear Dr
I am a 39 yr old male with H/O hypertension and hypothyroidism since last 20 yrs..I started with nebivolol which did nothing contolling hypertension..My BP was always 150/90 before starting therapy..My current dose of levothyroxine is 75mcg and TSH is 0.5.Then doctor switched me to Telma R for few years and then switched to Telma Am H 40 for few years..Then i saw an endocrinologist he started me on a combination of olmesartan+clinidipine +chlorathalidone..I lost 20 kgs of weight and after few months he stopped all medication of BP..My BP was controlled for few months and then it started to rise again after few months..Then i started on olmecip 40mg and it was under control..Then my weight started rising again..I am now on TELMA H 80 and BP is controlled it remains below 130/90..
MY SUGAR IS NORMAL BOTH FASTING AND PP..MY PP IS LESS THAN PP ALWAYS..I CONSULTED AN ENDOCRINOLOGIST AND HE SAID ITS NORMAL TILL SUGAR IS WITHIN NORMAL LIMITS AND ASKED ME TO START EXERCISE AND CUT ON CARBS..
MY PROBLEM IS HIGH CREATININE.IN 2006 IT WAS 1.5MG..THEN AFTER A WHILE I TOOK A COMBINATION OF STATINS+ FENOFIBRATES AND IT WENT UPTO 1.7MG..I STOPPED CHOLESTROL DRUG IT DROPPED TO 1.4MG..
MY LAST FEW YEAR READINGS ARE 1.4MG -- 2014
1.3 -- 2015
1.20 - 2016
1.13 - 2016
1.28-2017
1.28(REPEAT TEST)
MY UREA WAS NEVER MORE THAN 24 MG/DL..URIC ACID IS BETWEEN 5 & 6 ALWAYS..ELECTROLYTES ARE NORMAL..RENAL USG NORMAL..I GOT BLOOD IN URINE IN 2004 WHICH WAS A UTI TREATED WITH ANTIBIOTICS..IN 2006 URINE CULTURE SHOWED KLEBSIELLA WHICH WAS TREATED BY NITROFURANTOIN..AFTER THAT NO ISSUES BUT CREATININE IS ALWAYS HIGH..CURRENTLY IT IS 1.28MG ON TELMA H 80MG PER DAY..
I AM ALSO HAVING ANXIETY FOR WHICH I TAKE FLUVOXAMINE 300MG A DAY.
KINDLY SUGGEST WHAT NEEDS TO BE DONE FOR HIGH CREATININE?
SHOULD I CHANGE MY BP MEDICINE TELMISARTAN+ HCTZ..
I WANT TO KNOW ESPECIALLY IS TELMISARTAN SAFE? I HAVE HEARD ABOUT A CONNECTION OF TELMISARTAN ASSOCIATED WITH FEW CANCERS..IS IT TRUE?
WHAT MEDICINE WILL YOU SUGGEST FOR BP..I AM CUTTING DOWN ON SALTS AND CARBS+SUGARS..DOING YOGA..
I am a 39 yr old male with H/O hypertension and hypothyroidism since last 20 yrs..I started with nebivolol which did nothing contolling hypertension..My BP was always 150/90 before starting therapy..My current dose of levothyroxine is 75mcg and TSH is 0.5.Then doctor switched me to Telma R for few years and then switched to Telma Am H 40 for few years..Then i saw an endocrinologist he started me on a combination of olmesartan+clinidipine +chlorathalidone..I lost 20 kgs of weight and after few months he stopped all medication of BP..My BP was controlled for few months and then it started to rise again after few months..Then i started on olmecip 40mg and it was under control..Then my weight started rising again..I am now on TELMA H 80 and BP is controlled it remains below 130/90..
MY SUGAR IS NORMAL BOTH FASTING AND PP..MY PP IS LESS THAN PP ALWAYS..I CONSULTED AN ENDOCRINOLOGIST AND HE SAID ITS NORMAL TILL SUGAR IS WITHIN NORMAL LIMITS AND ASKED ME TO START EXERCISE AND CUT ON CARBS..
MY PROBLEM IS HIGH CREATININE.IN 2006 IT WAS 1.5MG..THEN AFTER A WHILE I TOOK A COMBINATION OF STATINS+ FENOFIBRATES AND IT WENT UPTO 1.7MG..I STOPPED CHOLESTROL DRUG IT DROPPED TO 1.4MG..
MY LAST FEW YEAR READINGS ARE 1.4MG -- 2014
1.3 -- 2015
1.20 - 2016
1.13 - 2016
1.28-2017
1.28(REPEAT TEST)
MY UREA WAS NEVER MORE THAN 24 MG/DL..URIC ACID IS BETWEEN 5 & 6 ALWAYS..ELECTROLYTES ARE NORMAL..RENAL USG NORMAL..I GOT BLOOD IN URINE IN 2004 WHICH WAS A UTI TREATED WITH ANTIBIOTICS..IN 2006 URINE CULTURE SHOWED KLEBSIELLA WHICH WAS TREATED BY NITROFURANTOIN..AFTER THAT NO ISSUES BUT CREATININE IS ALWAYS HIGH..CURRENTLY IT IS 1.28MG ON TELMA H 80MG PER DAY..
I AM ALSO HAVING ANXIETY FOR WHICH I TAKE FLUVOXAMINE 300MG A DAY.
KINDLY SUGGEST WHAT NEEDS TO BE DONE FOR HIGH CREATININE?
SHOULD I CHANGE MY BP MEDICINE TELMISARTAN+ HCTZ..
I WANT TO KNOW ESPECIALLY IS TELMISARTAN SAFE? I HAVE HEARD ABOUT A CONNECTION OF TELMISARTAN ASSOCIATED WITH FEW CANCERS..IS IT TRUE?
WHAT MEDICINE WILL YOU SUGGEST FOR BP..I AM CUTTING DOWN ON SALTS AND CARBS+SUGARS..DOING YOGA..
Brief Answer:
why change the drug?
Detailed Answer:
Hello,
I've read your text and I understand that you're doing OK with telmisartan alone. Therefore I don't see the need to change your regimen. Telmisartan is as safe as most antihypertensives. I don't know of any connection with cancer and haven't found anything worth considering after doing some research. When considering a change from a drug to another you should only take into account documented side effects like those you can find on the drug's SPC (summary of product characteristics) that comes with the drug.
Reducing salt intake is helpful to most patients with hypertension. If your blood pressure is under control then I suggest to avoid changing the regimen. Physical activity is very helpful as well...
Kind Regards!
why change the drug?
Detailed Answer:
Hello,
I've read your text and I understand that you're doing OK with telmisartan alone. Therefore I don't see the need to change your regimen. Telmisartan is as safe as most antihypertensives. I don't know of any connection with cancer and haven't found anything worth considering after doing some research. When considering a change from a drug to another you should only take into account documented side effects like those you can find on the drug's SPC (summary of product characteristics) that comes with the drug.
Reducing salt intake is helpful to most patients with hypertension. If your blood pressure is under control then I suggest to avoid changing the regimen. Physical activity is very helpful as well...
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
what is the reason of high creatinine sir? All urine tests.including URINE ROUTINE MICROALBUMIN CREATININE RATIO URINE CULTURE ARE NORMAL..NO PROTEIN OR GLUCOSE IN.URINE...RENAL ULTRASOUND IS NORMAL..Blood sugar normal..Hemoglobin RBC count normal...Urea uric acid and serum electrolytes normal...I have not found the reason for high creatinine? Is it CKD because high creatinine?
Brief Answer:
investigation is required
Detailed Answer:
Your creatinine seems to be higher than expected for most individuals but creatinine levels depend a lot on body weight and muscular mass. For example muscular individuals with large body weights may have as high as 1.5 or even more without any renal problems. For a 37 years old male with a eGFR 100mL/min and creatinine 1.7mg/dL it would require almost 120Kg of body weight to consider 1.7 'normal'. If your body weight was close to that then this is not necessarily chronic kidney disease. More detailed tests that measure both blood and urine indices (24h measurements are better in this regard) may calculate the glomerular filtration rate more accurately.
The normal uric acid and electrolytes are against chronic kidney disease as well.
I hope you find my comments helpful!
Kind Regards!
investigation is required
Detailed Answer:
Your creatinine seems to be higher than expected for most individuals but creatinine levels depend a lot on body weight and muscular mass. For example muscular individuals with large body weights may have as high as 1.5 or even more without any renal problems. For a 37 years old male with a eGFR 100mL/min and creatinine 1.7mg/dL it would require almost 120Kg of body weight to consider 1.7 'normal'. If your body weight was close to that then this is not necessarily chronic kidney disease. More detailed tests that measure both blood and urine indices (24h measurements are better in this regard) may calculate the glomerular filtration rate more accurately.
The normal uric acid and electrolytes are against chronic kidney disease as well.
I hope you find my comments helpful!
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My weight is 115kg height 6 feet 1.inches...So i guess 1.28 currently on a combination of telmisartan + HCTZ is slightly higher...Secondly i.would like to know an important thing..IS drug telmisartan safe for long term use..Some studies suggest that its long term.use is associated with certain cancers and on contrary some have showed that it has antitumor effects...Whats your opinion.on this? Do you prescribe it in your routine clinical practice sir?
Brief Answer:
it seems to be safe
Detailed Answer:
For your weight your creatinine is not that high. It's OK. Telmisartan may raise creatinine levels a bit so your real creatinine may be even lower. Regarding cancer as I said in my first answer, there are no documented associations with it. I can't judge a drug based on 'suggestive' data. Proof is required for that...
I have many patients that take telmisartan without any serious problems but this is not important. What's more important is that there is no evidence that telmisartan causes cancer... On the contrary there is evidence that it may help with some biochemical processes that may lead to cancer, although there is no evidence that it can be used as treatment for cancer. Keep in mind that clinical studies are more important than an individual doctor's experience and that we need solid evidence to condemn a drug or consider it safe.
Kind Regards!
it seems to be safe
Detailed Answer:
For your weight your creatinine is not that high. It's OK. Telmisartan may raise creatinine levels a bit so your real creatinine may be even lower. Regarding cancer as I said in my first answer, there are no documented associations with it. I can't judge a drug based on 'suggestive' data. Proof is required for that...
I have many patients that take telmisartan without any serious problems but this is not important. What's more important is that there is no evidence that telmisartan causes cancer... On the contrary there is evidence that it may help with some biochemical processes that may lead to cancer, although there is no evidence that it can be used as treatment for cancer. Keep in mind that clinical studies are more important than an individual doctor's experience and that we need solid evidence to condemn a drug or consider it safe.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your assistance doctor..You are a great help.
Regards
Regards
Brief Answer:
You're welcome!
Detailed Answer:
Glad to help! You're welcome!
You're welcome!
Detailed Answer:
Glad to help! You're welcome!
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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