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What Causes Loose Stools And Elevated Creatinine Levels?

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Posted on Mon, 21 Jul 2014
Question: my brother had undergone kidney transplant and healthy from last 2 and half years recently form last one month he is suffering from loose motions and creatanin level has increased to 3.8 doctors were not able to identify the problem even after many tests related to digestive system all the tests like usd and virus shows normal, since you have large experience kindly suggest necessary action in this case.
doctor
Answered by Dr. Sree Bhushan Raju (10 hours later)
Brief Answer:
Need clarifications..

Detailed Answer:
Acute gastroenteritis ( AGE) is a common problem for many after renal transplantation. Most of the times it is self limiting and subsides of its own.

The frequent causes are the routine viral infections and they subsides with conservative treatment like the way a normal person responds. The drugs like Mycophenolate mofetil (MMF) also can cause and it responds after stopping therapy. Viral infections like CMV ( cytomegalo virus) also can cause and interesting thing is that though the test CMV PCR is negative, still the patient can have CMV infection especially when the intestines are affected. It is well known. It also can damage the kidney as evidenced by elevated creatinine. So, as you said, viral infection tests are negative , doesn't meant that the presence of CMV infection is ruled out totally.

Also, in your country, infections like Cholera etc should be ruled out. Several parasitic infections also can cause such problems.
Can you please answer me few questions
1. Is he on MMF therapy?? did he stop after the AGE is set in
2. Did you check CMV test like PCR etc
3. did you stop milk and milk products
4. was he given any drugs like ciprofloxacin and metronidazole?
5. Did you check for serology for Clostridium difficle ( either in the blood or stool)?
6. Did you check hanging drop test for cholera?

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sree Bhushan Raju (2 hours later)
Sir thanks a lot for the support & following are the answers
1. yes
2. yes
3. milk is stopped youghurt is in use
4. yes
5. Not aware
6. no

Also pls suggest does he need biopsy and can he survive on medication if the transplanted kidney has problems

Thanks again & Best Regards
XXXXXX
doctor
Answered by Dr. Sree Bhushan Raju (2 hours later)
Brief Answer:
Other tests also required.

Detailed Answer:
Please get the other tests also as required. There won't be any problem to kidney as it will be AKI due to sepsis (infection) / dehydration etc. However, you get graft (new kidney) biopsy ( taking a small piece from graft) and get it tested for any ongoing problem. His nephrologist will know about this test.

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sree Bhushan Raju (20 hours later)
Sir what is clostridium difficle and pls explain the significance of test as the test facilities are not available in my home town Vizag

Thanks & Regards
XXXXXX
doctor
Answered by Dr. Sree Bhushan Raju (3 hours later)
Brief Answer:
Good labs do tests for it.

Detailed Answer:
you can check with local labs or national level labs like SRL labs or lals path lab. Your doctor will also know about this condition, you can discuss about it.

Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Sree Bhushan Raju

Nephrologist

Practicing since :1994

Answered : 92 Questions

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What Causes Loose Stools And Elevated Creatinine Levels?

Brief Answer: Need clarifications.. Detailed Answer: Acute gastroenteritis ( AGE) is a common problem for many after renal transplantation. Most of the times it is self limiting and subsides of its own. The frequent causes are the routine viral infections and they subsides with conservative treatment like the way a normal person responds. The drugs like Mycophenolate mofetil (MMF) also can cause and it responds after stopping therapy. Viral infections like CMV ( cytomegalo virus) also can cause and interesting thing is that though the test CMV PCR is negative, still the patient can have CMV infection especially when the intestines are affected. It is well known. It also can damage the kidney as evidenced by elevated creatinine. So, as you said, viral infection tests are negative , doesn't meant that the presence of CMV infection is ruled out totally. Also, in your country, infections like Cholera etc should be ruled out. Several parasitic infections also can cause such problems. Can you please answer me few questions 1. Is he on MMF therapy?? did he stop after the AGE is set in 2. Did you check CMV test like PCR etc 3. did you stop milk and milk products 4. was he given any drugs like ciprofloxacin and metronidazole? 5. Did you check for serology for Clostridium difficle ( either in the blood or stool)? 6. Did you check hanging drop test for cholera?