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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Diabetes And Hypertension. History Of Stroke, Urethra Stricture. Treatment For High Creatinine Levels?

Hi,

Could you please suggest the treatment of high creatinine and what can be changed in medicines ?


Diseases-

Old MI - 1992
Diabetese - 2000 onwards
Hypertension
Stroke on left side - 2006 and 2013
Urethra stricture
Left kidney is of small size by birth






Surgeries-


OIU - feb 2004
Angioplasty - may 2012
OIU - may 2013




Medicines -


Janumet 50/500 BD
GP1 BD
METOLOR XR 0.125 BD
ECOSPRIN GOLD 20 MG OD
DONEP 5 MG OD
NEXITO 10MG OD
ACITROM 3MG OD
HOMOCHEK OD
ROLIFLO 4+0.4 MG OD


Test reports -


Sample - 3rd AUG 2013


PT - 15.6 , INR - 1.35
S. CREATININE - 2.0
SUGAR FASTING - 124
SUGAR PP - 114

BLOOD PRESSURE - 110/80
WEIGHT - 80 KG
Age - 57 years
Tue, 13 Aug 2013
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General & Family Physician,  's  Response
Hello,
Your creatine values are slightly high and considering your weight and age your eGFR is around 46 ( COCKROFT AND GAULT EQUATION ) which denotes moderate stage of kidney failure.
It is very important for you to be very cautious and try not to let your kidneys deteriorate.Creatinine starts rising in blood only after if at least 50% of kidney nephrons are dead.
Do's for you.
It is better to switch to injection insulin
You must control your blood sugar blood pressure and serum lipids meticulously.
Instead of METOPROLOL,you should be put on ACE INHIBITORS OR ARB's.
Reduce the consumption of mutton,beef etc
Reduce your exercises
Avoid pain killers
Avoid nephrotoxic antibiotics like gentamicin etc
Reduce citrus fruits
Get 24 hour urine estimation of protein
Consult a nephrologist and it would be best on your part if you are jointly managed by a diabetologist and a nephrologist.
Thanks
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General & Family Physician,  Dr. Het Ram Bishnoi 's  Response
Hello,
Thanks for the query to H.C.M. Forum.
Since , you mentioned that serum creatinine is 2 ( pretty high ) ,but what is the reason .
As left kidney is small congenital , but still require the size of kidney .
Also write down the size and echotexture of right kidney.
About the infection in kidney or due to any other reason serum creatinine is high.
What was the reason of stricture in urethra .
Upload all reports, and also scanned ultrasound over this site.
Good luck.
Dr. HET
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Have Diabetes And Hypertension. History Of Stroke, Urethra Stricture. Treatment For High Creatinine Levels?

Hello, Your creatine values are slightly high and considering your weight and age your eGFR is around 46 ( COCKROFT AND GAULT EQUATION ) which denotes moderate stage of kidney failure. It is very important for you to be very cautious and try not to let your kidneys deteriorate.Creatinine starts rising in blood only after if at least 50% of kidney nephrons are dead. Do s for you. It is better to switch to injection insulin You must control your blood sugar blood pressure and serum lipids meticulously. Instead of METOPROLOL,you should be put on ACE INHIBITORS OR ARB s. Reduce the consumption of mutton,beef etc Reduce your exercises Avoid pain killers Avoid nephrotoxic antibiotics like gentamicin etc Reduce citrus fruits Get 24 hour urine estimation of protein Consult a nephrologist and it would be best on your part if you are jointly managed by a diabetologist and a nephrologist. Thanks