What can cause elevation in creatinine level despite avoiding red meat?
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I am a 51 year old, Chinese man living in Malaysia. I am non diabetic, have no hypertension nor heart disease. I stopped smoking and drinking alcohol a year ago. My uric acid averages around 0.45 MMOL/L. My total cholesterol level is around 6 MMOL/L without any medication. Recent blood test reveals that I have high urine microalbumin : creatinine ratio. On 20/3/13, this ratio was 14.3 MG/MMOL which is way above the bench mark of 3.4 MG/MMOL. My doctor advised me to avoid red meat since my consumption of red meat and seafood is high. So I stuck to only a little chicken and fish. On 21/10/13, the ratio dropped to 9.8 MG/MMOL. After this, I started on a 2 meals per day diet, having only vegetables for the first meal and a little chicken and fish for the second. I also started brisk walking of 5 km in 50 minutes, 5 times a week. On the 14/11/13, the ratio bounced back to normal at 3.3 MG/MMOL. On the 28/11/13, the reading went up to 4.1 MG/MMOL. On the 1/1/14, it went up higher to 6.8 MG/MMOL. My question is why is this ratio keeps on increasing despite my efforts not to consume animal protein. My diet has not changed much since it fell to a normal level of 3.3 MG/MMOL on 14/11/13. How can I bring it back to normal again?
Posted Sat, 25 Jan 2014 in Kidney Conditions
Answered by Dr. Ravi Bansal 2 days later
Brief Answer: Protein creainine ratio in urine Detailed Answer: Hi XXXX, You need to understand what is this test of urine microalbumin /creatinine ratio- normal kidney should filter only 30mg per day of albumin. albumin is a good thing for body and if it is coming in urine it suggests that the kidney filter is getting damaged. so what are the factors that affect this test results. they include - 1. protein intake - you have decreased- keep it at 0.8gm/Kg body wt/day. 2. blood pressure- if BP is 140/90 or above urine protein will increase. even in normal range a person having BP 120 will have less protein in urine as compared to 140. 3. infection- suppose you have a viral or bacterial infection- the protein in urine will increase but will come back to normal once infection goes away. 4. stress- physical exertion, hectic lifestyle-increases protein in urine. 5. Diurnal variation. if you do the test in morning it may be different from a test done in evening the same day. 6. Obesity can increase protein in urine 7. lot of products like protein supplement, painkiller medicines and dietary supplements may contribute to protein in urine. So there are a lot of influences on urine protein and therefore there can be variation. So how do we interpret these results. You have to see a trend in the tests over next 6 months . do monthly testing. take care to give 2nd morning sample for the tests. do not get disheartening and do not stop the good effort which you have put in for the diet and exercise schedule. but do not give the urine sample after exercise. If you control all the influences which affect the urine protein things will bw fine. You have to be under regular follow up of your doctor for the same. Your uric acid is not to much but your cholesterol is definitely high if it is not improving you have to go for medication for the same. Best wishes. In case there is further query please write in.
Follow-up: What can cause elevation in creatinine level despite avoiding red meat? 11 hours later
Dear Dr. XXXXXXX Bansal, Thank you for the detailed explanation. I am enlightened and will carry out your advice. I have some doubts on my food intake that I hope you can help further. As I have mentioned previously, on 1/11/13, I went on a 2 meal per day diet. I was told that taking 2 meals will help my kidney recover. The amount of food I eat for the 2 meals is equivalent to the 3 meals that I used to consume. My weight decreased from 76kg to the current 69kg. Should I continue doing this 2 meal diet, which is a rather large amount or break it into 3 smaller meals? When you mentioned protein intake of 0.8gm/kg of body weight, are you referring to animal meat? What about fish and eggs? Or does it also include bean curd and nuts? Each day, I take 1 tablet of multi-vitamin, 1 tablet flaxseed oil 1000mg, 1 tablet fish oil 1200mg, 1 tablet of combining ginkgo biloba 80mg, hawthorn 150mg, bilberry 40mg, 1 tablet vitamin E 500IU, 1 tablet dandelion 187mg, 1 tablet vitamin D 400IU, 1 tablet Bio Quinone Q10 100mg, 1 tablet vitamin C 500mg. Should I continue taking them? Or should I stop any one of supplements? Are they affecting kidney function? In your experience, have you ever come across any patient with problem like mine and made complete recovery? Will I recover if I follow your recommendations strictly? Thanking you in advance and hope to hear from you soon. Best Regards, Leong Pit Tee
Answered by Dr. Ravi Bansal 10 hours later
Brief Answer: hello Detailed Answer: Hi You can break your meals into 2 or 3 times . the frequency of meal has no relation to kidney disease. The protein intake includes all possible forms including vegetarian proteins and fish also. The supplements you are taking are not known to produce proteins in urine. but as such you should take only those which are prescribed by your doctor. Anything which is not necessary should be removed.whatever you take in , has to be thrown out by the kidney and in this process it may get damaged. we should decrease the load on kidney. I see such patient every day, this is a very common occurrence. but you have to understand that each persons disease is separate. no one can predict how your disease will behave. We have to follow the scientific protocol. You should do serial testing and see if your proteinuria is improving or worsening. overall, your risk factors for progressive disease are very less and you should have good outcome. best wishes