What causes elevated creatinine levels in a diabetic patient?

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Posted on Mon, 15 Jun 2015 in Diabetes
Question: I have diabetes. Lately my creatine level is going up. what causes that. it went from 139 to 193
What can I do to help it go down?
I forgot to tell you that I am 5' 6" and weigh 220. I know that does not help
my overall situation.

Thank you.

I will wait for your answer.
doctor
Answered by Dr. Abhay A Mali 1 hour later
Brief Answer:
You should control your diabetes, blood pressure, lipids.

Detailed Answer:
Hi XXXX,

Thanks for your question.
As you have mentioned you have diabetes.
It is usual with diabetic patient to have elevated serum creatinine level, it is usully due to diabetic nephropathy.

Following factors accelerate the progression of diabetic nephropathy leading to rise in serum creatinine-
1) Duration of diabetes.
2) Uncontrolled blood sugar levels.
3) Uncontrolled blood pressure level.
4) Uncontrolled lipid levels.
5) Short term illness like dehydration, infections urinary infections are common in female and in diabetics.
6) Medicines like painkillers, some medicines for high blood pressure.
7) Habits like smoking.

Also rather than serum creatinine alone, estimated glomerular filtration rate (eGFR) is more reliable indicator of progression of diabetic nephropathy.
eGFR is calculated as
Estimated CrCl = (140 - age) x actual body weight (kg) x
1.23/ Serum creatinine level (┬Ámol/l) (x 0.85 for female )

For you calculated eGFR is around 35 which is in CKD (Chronic Kidney Disease) stage 3.

So to prevent or to slow the progression of diabetic nephropathy and rise of serum creatinine there should be-
1) Strict control of blood sugar levels with medicines safe in CKD.
2) Blood pressure control (target blood pressure in CKD stage 3 is <125/75 with Ace inhibitors or ARBs with potassium monitoring.
3) Lipid control with satins (Target LDL level <100).
4) Avoid use of nephrotoxic medicines like pain killers (NSAIDS- Non Steroidal Anti Inflammatory Drugs)
5) You should monitor serum electrolytes, calcium, phosphorus, uric acid, vitamin D level, Haemglobin level.
6) Maintain adequate hydration.
7) Intake of vegetarian proteins upto 0.8 gram per Kg of body weight.

Also you should consult your doctor for clinical examination and further evaluation. Ultrasonography of kidneys, urine examination, fundoscopy for evaluation of diabetic and hypertensive retinopathy, and other blood tests as mentioned above may be helpful in estimating the cause for increasing serum creatinine and action to be taken.

Hope I have answered your question.
I will be happy to answer your follow up question if any.
Otherwise close the question and rate the answer.

Regards,
Dr. Abhay Mali.
Diabetologist.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
Answered by
Dr.
Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 805 Questions

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