Nephrology/Probable kidney damage.
Hello doctor !
I've wrote down 2 texts about my condition, i hope it's okay if i reveal both, should make it easier for you to understand what i mean as my first text is pretty much wrapped up and i don't go deep into details. anyway, here they are
My name is Matis and im 20 years old guy from Estonia. Firstly i'll mention that i go to gym and i work out like 4 days a week or i used to. Since December, i started to feel that something was wrong. My pulse went off, i did some warming up at the beginning of my training and my pulse instantly hit 180 within 2-3 minutes, it recovered fairly fast. It didn't matter whether i was lifting the weights or doing some cardio. Pulse just went to 180.. was very confused and decided to go see doc. He did the tests and decided first to go see heart doctor, did so, did some tests(echo,ekg,fitness test etc.). Results were pretty okay for my age, but blood pressure(especially sys.)recovered for a long time and so did the pulse. Every other test was okay, so i tryed changing my lifestyle a bit, sleeping more, eating regularly and more vegetables/fruits etc... Results went even better, but still had that pulse/blood pressure problem. Currently if i move and give my body a little pressure, my heart rate instantly goes up very fast, it doesn't reach 180 in a matter of time now, but still it goes significantly faster whenever i try to pressure my body. Forgot to add that i used to take some creatine/protein while working out. Now back to the real point, my eGFR is is 64.77 ml/min and creatinine 115 mkmmol/L. I have been told to go see urologist, but it takes time, lines are too long. Might add that my body mass index is like 28-29~, im 181 tall and 93-95kgs. I am a bit overweight i guess, but i think people view me as muscular, i have my upper and lower body pretty ripped and muscular, but having problems with my stomach, so i think im a lifter, who doesn't like cardio very much.
About the creatinine level, i have done 2 tests so far, span of approx. 2 months and the creatinine level has stayed the same(115). I think i expressed my condition a bit wrong. I forgot to add that almost every movement takes my pulse up to the sky. I mean, it doesn't reach 180 anymore.. when it did then i just felt how my heart was beating out of my body, i had a feeling that heart wants to pop out of my body. The interesting fact that bothers me the most is that stairs or any kind of regular pressure to my body, takes my pulse up to 120-140, that makes me feel very concerned. For example, if i take a stairs of like 30 steps with a bit faster walk than normal, then after the action, i feel that my pulse has increased significantly, also my beats have gone much stronger, so if i place my hand on my heart or nearby, then i can actually feel very strong beats and it is no problem for me to read the pulse after some movement by placing my hand near heart.
I haven't done any nuclear medicine GFR either 24 hour urine yet, but i hope i' ll get to it when i finally manage to see my nephrologist.
If you need any more information about my current situation, then please ask.
Can you please give me some tips or any useful information what to do and what might be wrong ?
Thank you in advance,
Good morning, Matis.
Firstly, your complaints regarding your heart rate and activity are more in the field of cardiology than Nephrology. However, I think you would be best served by having a through and comprehensive physical exam, to define and sort out your medical issues first.
You didn't me much to go on regarding your kidney function either, but what you did mentioned seems quite normal. Your blood creatinine of 115 mmol/L translates to 1.15 mg% (this is how we express the value in the USA). This is within the normal range as is your calculated GFR. The calculated GFR becomes inaccurate when the result is above 60 and yours is clearly in the above 60 range and, therefore, quite normal. Additionally, if you are a body builder and have used creatine, your production of creatinine should be well above normal, making your measures levels even "more normal".
My recommendations to you would be to, NOT see a urologist, but rather, either a primary care physician or a nephrologist and have the following tests performed:
1. A comprehensive physical exam with a blood pressure measurement.
2. A careful 24 hour urine collection for a calculated creatinine clearance (a measure of GFR) and protein excretion.
3. A urinalysis.
If these tests are normal then you have essentially ruled any significant kidney disease.
I don't feel you need any kidney imaging it this point or a radioisotopic GFR measurement.
Hope this is of some use to you.