LOW CREATIN LEVEL

[Down In Miami]

I am in my mid-50's and I was recently told after the 24-hour urine test that I had a slightly low creatine level.  Not sure specifics/levels, but I had a comprehensive metabolic panel w/egfr in March 2007 (3 months earlier than the current 24-hour test).  At the time my Urea Nitrogen (BUN) was 14; my creatine was 1.0; and my Bun/Creatine Ratio was 14.  Calcium level was 9.7.  Protein, Total was 7.2.

I don't have another appointment with my urologist until October 2007.  Is this something I should try to make an earlier appointment for, or does this appear to be normal.

My family doctor told me it's probably nothing to worry about, but I had prostate cancer surgery last year, and am worried about possibly having something more serious.

I also have Gilberts' Syndrome which makes my bilirubin total always a little high.  

Appreciate your input.

[Ash Tewari, MD, M.Ch.]

Your serum creatinine is in the normal range, and this is therefore not worrisome at this point of time. You will need to monitor this periodically.

There are two additional tests (which may have been already done)- your urine could be checked for proteinuria, and additionally a renal scan with calculation of total and split GFRs could  be done. The former is a simple test and can be readily done (qualitative- and then followed up with 24-H quantitative if required), the latter although a relatively simple test, is usually done only when the kidney function needs to be calculated. If the scan is done it will form a useful baseline to follow-up the renal function.

There are different ways to manage a patient. With a repeat serum creatinine of 1.0 and no other abnormalities on physical or labs, it would be fair to NOT get a renal scan done at this point of time, unless you specifically state that you are worried and require it to be done.

[Down In Miami]

Thanks for your previous response.  I have just received my results for the 24-Hour Urine 5-HIAA test that I didn't have at the time of my email yesterday.

Results are as follows:

24 HR Urine Volume               10
5-HIAA, 24 HR Urine               0.0
Creatine, 24 Hour Urine           0.02L

Since the full metabolic panel 3 months earlier were within range, would this change anything from your previous comments.

Again, appreciate your response/assistance.