AboutDr. Shamik Shah, MBBS, MD, DNB (Nephrology), ISN Fellow Expertise I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am a Board certified Nephrologist in India. I was a post-Doctoral Scholar at the Division of Nephrology & Hypertension,Department of Medicine, University of California, San Diego. My area of interest is Critical care Nephrology and Acute Kidney Injury.
Experience 8 years
Publications Shah SH, Mehta RL. Acute kidney injury in critical care: time for a paradigm shift? Curr Opin Nephrol Hypertens. 2006 Nov;15(6):561-5.
Shah, SH, Soroko S, Lischer E, Mehta RL. Delivered vs. Prescribed dose of Dialysis in Hospitalized Patients: Results of an Audit. J Am Soc Nephrol 17(Abstracts Issue): 2006, 107A.
Abdeen O, Shah SH, Mehta RL; “Dialysis therapies in the surgical intensive care unit”; William Wilson, Christopher Grande, David Hoyt Eds. Trauma: Resuscitation, Anesthesia, and Critical Care, Informa Healthcare 2007. ISBN 08247-2920-X
Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
Education/Credentials MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology)
Awards and Honors Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis, June 2001
Question I’ve been having pain, weakness and fatigue over the past 4 years. I get sever stiffness in my neck and upper back pretty much all the time. I deal with burning sensations in my hands and feet during the night—while sleeping. I also get very brief warm feelings on my lower leg. The last few months, I’ve been experiencing dizziness when I get up from bed and when I bend down and then stand straight up. A month or so ago, I stood up from picking something up off the floor and fell backwards—this happened twice in one day. Whenever I get these weird symptoms, I feel as though poison is all over my body—that I’m literally toxic from head to toe. I refer to this as my “poison” days.
I’m a fit 42 year old female—5’3”, 125 pounds. I run/walk and sometimes (not much) lift low weights. I’m told quite often that I’m in very good shape. If they only knew!!!
I recently volunteered for a psychiatric fibromyalgia study for the drug roboxetine. When they did my blood work it came back with a ANA of 1:320. The blood work was done 3 times and all with the same result. I could not be part of the study because of this and I was referred to a rheumatologist.
On April 16th, I had blood work ordered by my rheumatologist—14 vials and also a urine sample. This was NOT the 24 hour urine collection. My ANA was positive once again and all other antibody tests were negative for Lupus, etc. My doctor thinks that I have Sjrogen’s because of my very dry eyes and mouth- he says I’m borderline for Lupus.
On my metabolic panel, my blood creatinine is 1.02 and my eGFR is 59. Because everything was normal, my doctor told me that he thinks the reason for my high creatinine is because I am a “substantial woman”. This kind of blew me away because I’m not overly muscular—my muscles are defined mainly in my legs. I’ve never really had a lot of upper body strength. I’m actually very petite. He did not think this was a concern.
My doctor prescribed me Plaquenil that I took for 9 days before I had a serious reaction: bruising underneath my toenails and protrusion of the veins in my feet. I could see dark veins under the bruises. I was told to stop the med immediately.
I have a friend who is head of pathology at a large hospital where I live—he’s been there for 30 years. He is also with the lab that did my recent blood work. He told me that a creatinine clearance of 59 is not normal and that I need to follow up. He did not agree with my rheumatologist and was quite annoyed at the “substantial woman” comment.
I’m so confused and concerned that I might be ignoring a possibility of something that could cause a serious kidney problem down the road.
Could you give me an opinion on the slightly elevated blood creatinine result? Thanks very much.
Answer Hi Kelley,
Thanks for asking my opinion on "Allexperts".
I agree with your pathologist friend. A creatinine clearance of 59 is not normal. However, estimated GFR is not the best way to measure creatinine clearance.
Whenever in doubt, I order a 24 hour urinary creatinine clearance for my patients. I suggest that you should also undergo this test. If this result is abnormal as well, take the opinion of a Nephrologist.
An elevated creatinine can be due to several reasons. Some of the common ones are:
1. Increase in dietary meat.
2. Ingestion of creatine supplements (for body building)
3. Dehydration
4. Obstruction
5. Certain medications
