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Urology (Expert Forum)
Increase Creatinine/Prior Interstitial Nephritis
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Increase Creatinine/Prior Interstitial Nephritis
by Dresher, Feb 06, 2004 12:00AM
In April 2002 I was diagnosed with Interstitial Nephritis (kidney biopsy was done) and BUN was extremely elevated, protein in urine and creatinine of 4.5. (Normal range for my lab is approx 0.5 to 1.2) (not sure of the low end of the range but 1.2 is the top of the "normal range").
After approximately 5-6 months of prednisone my creatinine went to 4.5 and stayed there fairly steadly. I had follow up bloodwork in late Aug/early Sept. of 2003 and BUN was in normal range and creatinine was 1.2.
During my last blood test, Jan. 31, 2004 my BUN was Normal (23), but creatinine was 1.4 (an increase of .2 since early Sept). There was a trace of blood and some bacteria in my urine but no protein (this is the 3rd result with no protein). A CBC with diff/UA and complete metabolic panel was run. (FYI - potassium has always been in the normal range as is glucose, etc) (No other health problems). Prior cholesterol was 225, on last report it was 208 - the only thing out of range besides creatinine.
My Nephrologist wants me to have basic metabolic and UA next month (I was already scheduled for a 1 yr checkup prior to the latest results noted above).
The only thing I have done differently is to start exercising within the past 4 weeks, approximately 4-5 times per week. This consists of 30 minutes of aerobics on either Precor machine or swimming, and 45-50 minutes on weight machines, usually followed by the sauna or hot tub. No weight change (49 year old female, 185lbs, 5'8.5")but loss of inches, and increased muscle and toning.
I worked out the night prior to my bloodwork - ended workout approx 9:30-10pm with bloodwork (fasting) at 8am the following morning. Could this have falsely increased my creatinine reading of 1.4? (Since, I now carry a water bottle with me and drink 16-24 ozs. during my workout. Previously only took small drinks at the water fountain).
My creatinine at 1.4 is still lower then a year ago at 1.5. How concerned should I be? How normal is it for the creatinine range to flucuate between bloodtests?
I'm hoping the creatinine goes back down when retested next month and will be sure I am hydrated prior to bloodwork and will not workout for two days prior. Is that reasonable? If numbers are the same or slightly increased what should I expect?
FYI - I feel fine. When I had nephritis I was very sick and threw up constantly (lost 20-25 pounds). Appetite, etc. are fine and weight (although I need to lose and am working on that)is where it was prior to nephritis (after steroids I put the weight back on).
Thank you.
After approximately 5-6 months of prednisone my creatinine went to 4.5 and stayed there fairly steadly. I had follow up bloodwork in late Aug/early Sept. of 2003 and BUN was in normal range and creatinine was 1.2.
During my last blood test, Jan. 31, 2004 my BUN was Normal (23), but creatinine was 1.4 (an increase of .2 since early Sept). There was a trace of blood and some bacteria in my urine but no protein (this is the 3rd result with no protein). A CBC with diff/UA and complete metabolic panel was run. (FYI - potassium has always been in the normal range as is glucose, etc) (No other health problems). Prior cholesterol was 225, on last report it was 208 - the only thing out of range besides creatinine.
My Nephrologist wants me to have basic metabolic and UA next month (I was already scheduled for a 1 yr checkup prior to the latest results noted above).
The only thing I have done differently is to start exercising within the past 4 weeks, approximately 4-5 times per week. This consists of 30 minutes of aerobics on either Precor machine or swimming, and 45-50 minutes on weight machines, usually followed by the sauna or hot tub. No weight change (49 year old female, 185lbs, 5'8.5")but loss of inches, and increased muscle and toning.
I worked out the night prior to my bloodwork - ended workout approx 9:30-10pm with bloodwork (fasting) at 8am the following morning. Could this have falsely increased my creatinine reading of 1.4? (Since, I now carry a water bottle with me and drink 16-24 ozs. during my workout. Previously only took small drinks at the water fountain).
My creatinine at 1.4 is still lower then a year ago at 1.5. How concerned should I be? How normal is it for the creatinine range to flucuate between bloodtests?
I'm hoping the creatinine goes back down when retested next month and will be sure I am hydrated prior to bloodwork and will not workout for two days prior. Is that reasonable? If numbers are the same or slightly increased what should I expect?
FYI - I feel fine. When I had nephritis I was very sick and threw up constantly (lost 20-25 pounds). Appetite, etc. are fine and weight (although I need to lose and am working on that)is where it was prior to nephritis (after steroids I put the weight back on).
Thank you.
Doctor's Answer
by Kevin Pho, MD, Feb 07, 2004 12:00AM
, Feb 07, 2004 12:00AM
To answer your questions:
1) In general, moderate exercise will not affect your creatinine levels. As you continue to exercise and build muscle mass, your creatinine levels may increase slightly, but not to abnormal levels.
2) It is normal for creatinine to fluctuate over several tests. Variations such as fluid status, exercise, and laboratory error can all cause the creatinine to vary.
3) Repeating the creatinine after making sure you are hydrated is certainly reasonable. There may be some variation from the present value. If the creatinine is increasing, I would suggest a referral to a kidney specialist to ensure that the nephritis isn't progressing.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
1) In general, moderate exercise will not affect your creatinine levels. As you continue to exercise and build muscle mass, your creatinine levels may increase slightly, but not to abnormal levels.
2) It is normal for creatinine to fluctuate over several tests. Variations such as fluid status, exercise, and laboratory error can all cause the creatinine to vary.
3) Repeating the creatinine after making sure you are hydrated is certainly reasonable. There may be some variation from the present value. If the creatinine is increasing, I would suggest a referral to a kidney specialist to ensure that the nephritis isn't progressing.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
