Category Archives: Serum Creatinine

Hi, I’m considering a trip to Madagascar where malaria prophylaxis is recommended but I’m worried that these drugs are not kidney-friendly. The drugs listed by the CDC Travel Health site are: Atovaquone-proguanil, doxycycline, mefloquine, or tafenoquine. I have had one kidney removed almost two years ago (renal carcinoma totally encapsulated) and my numbers are good if a little toward the low side (GFR has climbed from 43 to 47, Creatinine improving from 1.31 to 1.21, BUN in normal range). Would I be able to take any of these or should I give up on traveling to malaria-infested countries? Thanks much!

Tafenoquine does not have any dosing information for patients with chronic kidney disease (CKD). Atovaquone/Proguanil should not be used if the creatinine clearance is less than 30 milliliters per minute. The rest of the medications that you mention do not … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Serum Creatinine

Hello. I’m a 32 year old female and I’ve been having numbness in my hands and feet that doesn’t go away. I’ve gone to my PCP and she ordered blood work to check blood counts, diabetes, kidney function, liver function. She stated that all the results were normal but I’m concerned about the eGFR rate. The current blood work done on 6/14/19 shows a rate of 75 mL/min/1.73m2 with creatinine of 1.0 mg/dL. But when I had this same blood work done on 4/15/16, the rate was 124 mL/min/1.73m2 with creatinine of 0.60 mg/dL. Should I be concerned about the major drop in the eGFR rate? What would cause it to drop so much?

This may represent laboratory variation. I don’t know the accuracy of the laboratory that measured your serum creatinine. In normal laboratory variation, it is generally recognized that the serum creatinine can vary by 0.2 milligrams per deciliter (mg/dl) from day … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Serum Creatinine

Hello Dr. I am a male 36 yrs old, who recently found out he was born with one kidney. Can you tell me what are the guidelines for creatinine levels for a patient with one kidney? Mines is currently 1.4. Thank You.

Having a single kidney should result in approximately one half to two thirds of normal kidney function. This would mean that there would be an estimated glomerular filtration rate (eGFR) in the range of 50 to 75 milliliters per minute … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Nephrectomy / One kidney, Serum Creatinine

Is 2.0 level life threatening?

I do not know what level you are referring to. A serum creatinine of 2.0 milligrams per deciliter (mg/dl) is abnormal but I would not characterized this as “life threatening”.

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions, Serum Creatinine

Hello, I have had chronic kidney stone disease since about age 23. I’m 48 yrs old now. I have had reoccurring UTIs, hydronephrosis, and/or pyelonephritis about every year or two at most, since my late teens. My family has a very high incidence of renal failure on my paternal side, while the kidney stone disease is very prevalent on my maternal side. I frequently have protein detected in my urine as long as I can remember. I sometimes have very dark bloody to brown urine, very frequently cloudy, and on/off pale foamy urine. I worry that most of this is being passed off as side effects from my kidney stones. I also have hyperparathyroidism secondary to vit D deficiency and I have a genetic Connective Tissue Disease called Ehlers-Danlos Syndrome Hypermobility Type(hEDS) with some overwhelming of Classic Type, Delta Granule Storage Pool Deficiency Platelet Dysfunction, POTS, MCAD, and multiple other Autoimmune Disorders … I’ve seen what used to be called Bright’s Disease show up on numerous family death certificates while compiling our family’s genealogy, so I am concerned that my Urologist hasn’t followed up with more specific testing to evaluate my actual kidney function aside from BMP, CMP, U/A with the frequent culture sent for analysisa. I am concerned especially with my right kidney because it drops a bit low and doesn’t drain well with the ureter arched a bit higher anatomically. I’ve had about 6 ESWL procedures, a Percutaneous Lithotomy( due to high stone volume, 30+ Ranging 1mm-9mm and some high density type stones) with a temp nephrostomy drain/bag, and most recently a Ureteroscopy with laser Lithotripsy and stent placement x 1 1/2 wk(I couldn’t have tolerated the stent any longer), all of these have been about UA showed something new for me that upset, a rare budding yeast which also showed up in a 2nd clean catch sample several days later. I am worried more so because both of my children have hEDS also, they both inherited my Platelet Dysfunction. My son, the younger at 23 yrs, has started passing kidney stones at the same age that I did. My daughter has had a few bad infections also. I can no longer take sulfonamide antibiotics or Nitro furan Antibacterials, due to an allergy to them. Since my last infection and procedure, I have been so tired, bruising, more than usual, with notable Petechia that I don’t recall occurring so much before, itching intensely,(especially at night) and notable increased swelling of my feet, ankles, and sometimes hands. I made an appt with a nephrologist, but have a fairly long wait of a few more weeks until I can get in to see them. I am just concerned and interested in your thoughts. I do have HTN, have had intermittently since my 20’s, was treated in my 30’s with a hydrachlorithiazide until no longer required after significant weight loss with gastric bypass, I have since been treating with a beta blocker in mid 40’s which also treats my POTS …keeping my HR in control. I take sublingual B12 to treat anemia also. I take a lot of medications for my various conditions.

Your medical condition sounds very complex and I am unable to make a specific diagnosis based on the information that you present. Most of the problems that you describe for your kidneys are urological problems and should be addressed by … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney Biopsy, Kidney Stones, Kidney-Related Health Questions, Nephrologist, Serum Creatinine

After receiving my latest blood results, I went back and looked at my results from my previous two labs. After seeing an increasing trend for 6 months, I informed my neurologist who told me to inform my primary care doctor. I receive 150g of IVIGs every other week and I am concerned that it might be doing something to my kidneys. Don’t you think that looking at the below that I should see a nephrologist? My primary care did make an appointment but I had to convince her. CREATININE 1.08 mg/dL (High), MARCH WAS 1.18, MAY WAS 1.3 Date: Jan 09, 2019 03:05 p.m. EST Reference Range: 0.51 mg/dL – 0.95 mg/dL Est. GFR Non-African American 53 mL/min/1.73_m2 (Low), MARCH WAS 48, MAY WAS 47 Date: Jan 09, 2019 03:05 p.m. EST Reference Range: > 59 mL/min/1.73_m2 Total Protein 8.8 g/dL (High), MARCH WAS 9.0, MAY WAS 9.4 Date: Jan 09, 2019 03:05 p.m. EST Reference Range: 6.6 g/dL – 8.3 g/dL Thank you!

The serum creatinine can vary from day to day based on normal laboratory variation. The variation can be 0.2 milligrams per deciliter (mg/dl) up or down from day to day. Hence, the numbers that you quote are not statistically different … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions, Serum Creatinine

85 year old patient with 30% kidney function and congestive heart failure is admitted to the hospital for pneumonia. Also has ascites and enlarged liver which the doctors cannot determine the cause of without CT scan. They are unable to do a CT scan until creatinine level is down to 110. Creatinine level is at 125 from 150 several days ago. They are currently only using saline IV in order to lower creatinine. Would it be beneficial to use trimethoprim-sulfamethoxazole or Cimetidine to lower the creatinine more quickly?

Cimetidine and Trimethoprim both increase serum creatinine by interfering with the secretion of creatinine by the kidney. Hence, these drugs would be of no help and actually worsen the finding that is being sought. I am not able to make … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Nephrologist, Serum Creatinine

Good morning, this was your response to my question. If the creatinine clearance is high and the elevated serum level is also high why is that? You said it was creatinine generation. Is it due to kidney size at all? I have 10.9 and 10.7 kidney size. I was at 1.7mg/dl and I had eaten a meal with chicken a few hours before. The 1.4mg level was when I was so scared I practically cut out all meat. I am just curious how this can still be normal? Please describe normal for me in Depth. Can normal still be reduced?? How can one have a low gfr and still have normal function that doesn’t make sense. Please explain this to me as well. I appreciate it. Response: If this is the case, then your serum creatinine is elevated because you have an increased creatinine generation rate. This is most commonly due to increased muscle mass as compared to the average individual. An increased intake of red meat can also increase the creatinine generation rate and lead to an elevated serum creatinine. The equations that we use to estimate the glomerular filtration rate (eGFR) are not very accurate or reproducible with values above 60 milliliters per minute per 1.73 meters squared. There are other ways of measuring the glomerular filtration rate but if you are using a serum creatinine and the estimating equation, anything above 60 is considered a normal GFR. Stage 2 chronic kidney disease (CKD) requires a eGFR between 60 and 89 for at least three months AND the presence of abnormal urinary findings (blood, protein, or infection), abnormal ultrasound examination, or abnormal kidney biopsy that is also present for at least three months. For eGFR’s above 60, you need more than just the eGFR in order to diagnose CKD. It is true that an accurately measured glomerular filtration rate (GFR) should be greater than 120 milliliters per minute per 1.73 meters squared.

I am not sure I can explain this any better. If your kidneys are clearing creatinine from your body at an elevated rate, then they are doing their job and they are normal. If your blood creatinine is still elevated, … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Serum Creatinine

Hello Dr. It was recently diagnosed that my left kidney is larger than the right. Is it common? And What are the causes and consequences?

In most people, the right kidney is slightly larger than the left, but having one kidney larger than the other is likely normal. It is more important to know your total function. Size of the kidney can be important, where … Continue reading

Posted in Ask the Doctor, GFR, Kidney-Related Health Questions, Serum Creatinine

I am 10 year post transplant patient with recurring IgA nephropathy and using following medicine: Cyclosporine 50mg + 50mg, Cellcept 500mg + 500mg, Deltacortril 5mg, and Omsana 40 mg. I want to shift from cyclosporine to tacrolimus, kindly help me out with dosage adjustment procedure. My age is 31, weight 7 kg, creatinine 1.9 , urine RE is clear with 300mg protein/day. My cyclosporine trough level is down to 20, which supposed to be between 100 to 250, that’s why I wanna change medicine.

I am unable to give medical advice without performing a complete history and physical examination. There are many considerations in switching from cyclosporine to tacrolimus. Careful monitoring of drug levels, serum creatinine and blood sugars are necessary. I suggest that … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Serum Creatinine