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Dr. Andrew Rynne

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What causes elevated creatine levels in an elderly woman?

Answered by
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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10119 Questions

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Posted on Tue, 13 Sep 2016 in Kidney Conditions
Question: Hello, my mother has been suffering from high fever from quite sometime. She is 76 years of age and has the following long term diseases (diabetic since 1993, high blood pressure, hypothyroidism). As her health condition deteriorated, we got her admitted to a local hospital where she was diagnosed as being suffering from urosepsis. Her heart condition was also told to be poor and her EF was around 45%. She was in ITU for about 8 days and finally recovered after being administered the correct antibiotics for ecoli.

Eventually she was discharged however every evening she was having high fever. We waited for 10 days and then got her readmitted. All the while, her diabetes was tending towards normal. She was again diagnosed with infection and was put on antibiotics. An USG of the kidneys revealed that there was a constriction in the lest ureter which was resulting in the kidney retaining urine which was probably causing the infection. She was hence operated and a stent was put in her left ureter on the 17th of April. Just after this, her creatine levels have been shooting upwards from 1.3 to 6.3 as on 22nd. Also her urea is around 165. The doctors suggest that since she is passing a lot of urine, hence they would watch some more time and incase the creatinine reaches 8 and urea 200, they would go for a dialysis.
Other parameters have improved as in sugar levels are around 150, EF is 60%

I am not sure if this is the only a wait and watch scenario and hence seeking your suggestion.
doctor
Answered by Dr. P. T. Patil 17 hours later
Brief Answer:
Please provide few more details

Detailed Answer:
Hello
Thanks for query .Based on the facts that you have posted I would summarize the history of your mother's illness as under
-
A 76 years old female known to have diabetes,hypertension ,hypothyroidism having fever since months admitted in ICU and on investigations found to have UTI the causative organisms being E coli and was successfully treated with appropriate antibiotic as per culture report and recovered to some extent .However she again had fever hence was readmitted and had undergone endoscopic surgery (You have not mentioned any thing about ,the cause of narrowing of ureter and nature of surgery etc)and Stent was placed in left renal unit .Since then her creatinine levels are gradually raising up and has reached to the level of 6.3 and the concerned physician has decided to wait and watch and take a call for Dialysis if it reaches up to 8.

I shall be happy if you can post me few more details to help me in making precise comments on her problem.
1) Urine culture report and antibiotics given
2) Ultrasound scanning report
3) Nature of endoscopic procedure (Surgery)done
4) Whether stent is still in place or removed

There is no doubt that she has renal failure due to urosepsis .However since her diabetes , ejection factor and urine output has improved satisfactorily you can expect to improve her renal function in a week or two Hence there is no harm in waiting for two more weeks and take a call for going for dialysis .

In the meanwhile continue giving her antibiotics as per culture report and hydrate her properly .

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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