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What Causes Raised Serum Creatinine Level?
Question: Iam a dibetic for last 20 years. Dibetic control is erratic. 4 months back HbA1c was 10.5 and creatinine 2.26. Now when I checked cratinine is 3.4 and HbA1c 9.3. Last one month I have been trying to control BS by walking 90 mnts and dieting. Result the BS has come down to 100/150 level from earlier 250/300 level. But creatinine has gone up. BUN also gone up to 38. Colestrol and Triglycerides are well within normal. Hemaoglobin is low at 9.9 and it was always below 11. As per Nephrologist prescription Iam taking Dytor 10 mg 1-0-0 and Olmy 40 1-1-1 apart from Vitamin B12, Calcium and Iron tablets. I have no swelling anywhere including legs or face. No other discomfort. After the diet and activity regime in last 30 days I was feeling better and active. What is the reason for creatinine going up? Iam mostly vegetarian and protien in take is low. Should I take a GFR test?
Brief Answer:
You need further evaluation.
Detailed Answer:
Hi,
Thanks for your question.
I can understand your concern, after going through your question.
There may be following reasons for raised serum creatinine level in you-
1) Diabetic nephropathy which is aggravated by poor blood glucose control.
2) Uncontrolled Blood pressure.
Both these factors lead to chronic kidney disease (CKD) which leads to gradual increase in serum creatinine level depending upon blood sugar and blood pressure control.
Following factors may cause sudden rise in serum creatinine level in case of base line CKD.
1) Any type of infection like urinary infection.
2) Drugs like pain killers ie. NSAIDs (Diclofenac, Ibuprofen), acrtain antibiotics like amikacin.
3) Kidney stones.
4) Dehydration.
5) Any cause leading to low blood pressure.
6) Blood vessel changes in kidney vessels.
Low Hemoglobin is apart of CKD.
You should have adequate vegetarian protein intake 0.8 gram per Kg per day.
You should undergo following investigations-
- Serum electrolytes, calcium, phosphorus, uric acid.
- Urine examination.
- Urine albumin creatinine ratio.
- eGFR
- Ultrasonography of abdomen and pelvis for kidney size, shape, echotexture.
- Arterial blood gas (ABG) analysis.
- Fundoscopy to know presence of diabetic or hypertensive retinopathy.
Depending upon all above investigations and clinical examination appropriate measure can be taken to revert or to prevent the progression or to slow the progression in deterioration of kidney function,
You should discuss all these issues with your nephrologist and diabetologist.
Hope I have answered your question.
Regards,
Dr. Abhay Mali.
Diabetologist.
You need further evaluation.
Detailed Answer:
Hi,
Thanks for your question.
I can understand your concern, after going through your question.
There may be following reasons for raised serum creatinine level in you-
1) Diabetic nephropathy which is aggravated by poor blood glucose control.
2) Uncontrolled Blood pressure.
Both these factors lead to chronic kidney disease (CKD) which leads to gradual increase in serum creatinine level depending upon blood sugar and blood pressure control.
Following factors may cause sudden rise in serum creatinine level in case of base line CKD.
1) Any type of infection like urinary infection.
2) Drugs like pain killers ie. NSAIDs (Diclofenac, Ibuprofen), acrtain antibiotics like amikacin.
3) Kidney stones.
4) Dehydration.
5) Any cause leading to low blood pressure.
6) Blood vessel changes in kidney vessels.
Low Hemoglobin is apart of CKD.
You should have adequate vegetarian protein intake 0.8 gram per Kg per day.
You should undergo following investigations-
- Serum electrolytes, calcium, phosphorus, uric acid.
- Urine examination.
- Urine albumin creatinine ratio.
- eGFR
- Ultrasonography of abdomen and pelvis for kidney size, shape, echotexture.
- Arterial blood gas (ABG) analysis.
- Fundoscopy to know presence of diabetic or hypertensive retinopathy.
Depending upon all above investigations and clinical examination appropriate measure can be taken to revert or to prevent the progression or to slow the progression in deterioration of kidney function,
You should discuss all these issues with your nephrologist and diabetologist.
Hope I have answered your question.
Regards,
Dr. Abhay Mali.
Diabetologist.
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. Vaishalee Punj
Answered by
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