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Nephrology/Elevated S.Creatinine

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Question
Dear Doctor,
I am a 64 year old male. I have a condition of raised  S.Creatinine level of 1.6 (average), with out any overt symptoms . My other conditions are mild  HTN and Lipid and I keep myself physically  fit and active. The Scr. value has not changed significantly since year 2008 when it was suddenly  found elevated, for no apparent reason, during  routine annual  medical (From  year 2002 till 2007,for which I have record, the value was always hovering  around 1.0) I had been taking  Aten 50 and Atorvastatin 5 mg  for  4 -5 years before this elevation was observed. I had been to a Nephrologist  for evaluation, who did everything except a biopsy and did not find anything significantly wrong with me, and only confirmed that the condition is stable.During this evaluation,I was found to have subclinical hypothyroidism too. I was thoroughly checked by an Ophalmologist for hypertensive retinopathy and found it to be of grade 1, Prostate enlargement also was found to be of grade 1, both the specialists attributing the respective  gradings  to my age. My question , Doctor, is, between year 2007 and 2008, how could my Scr. shoot up from 1.0 to 1.6 without any events and   then remains unchanged for the next  5-6 yrs ? Could  the HTN/Lipid medicines  be the culprits in this case ?  Secondly, would you say that if I really have stage 3 CKD ?

John

Answer
John,

Thanks for asking my help on Allexperts.

Without a careful history, physical examination and review of your past medical records, it won't be possible to hazard a guess why your s. creatinine value shot up.

You probably have Hypertensive Nephrosclerosis, which is a slowly progressive form of CKD. I am just curious why your Nephrologist did not perform a kidney biopsy then.

Sincerely,

Dr. Shah

Nephrology

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Dr. Shamik Shah, MD, DNB (Nephrology), ISN Fellow

Expertise

I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am an Indian-Board certified Nephrologist. 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.

Please mention the units in which your lab results were reported and the normal reference range for your laboratory.


Alternative Website
http://www.syndeohealth.com/doctors/shamik-shah/91

Experience

Ten years as a Critical Care & Transplant Nephrologist

Organizations
International Society of Nephrology
Indian Society of Nephrology
Indian Medical Association
European Renal Association


Publications
- Shah SH, Cerda J. Acute Tubular Necrosis; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4, pp. 191-198
- Shah SH, Cerda J. Management of Acute Kidney Injury; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4
- Cerda J, Tolwani A, Shah SH, Ronco C. Continuous Renal Replacement Therapies in Modeling and Control of Dialysis Systems edited by Azar AT, Springer-Verlag, Heidelberg, Germany (In Press)
- Shah SH, Cerda J, Kellum JA. Acute Kidney Injury in Special Circumstances. John Kellum, Jorge Cerda, eds. Renal and Metabolic Disorders, Oxford University Press (In press)
- Shah SH, Mehta RL. “Anticoagulation in CRRT: Is Citrate better?”; Vineet Nayyar Ed. Critical Care Update 2009, Jaypee Brothers (In press)
- Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
- Shah SH, Mehta RL. “Epidemiology of Community-acquired AKI”; Ronco C, Bellomo R, Kellum J Eds. Critical Care Nephrology, Saunders. ISBN 1-4160-4252-0
- 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, NY 2007. ISBN 0-8247-2920-X
- 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.
- Shah SH et al “Biochemical Nutritional Parameters in Non-vegetarian and Vegetarian CAPD patients” Perit Dial Int 2001; 21 Suppl 2: S1-182


Education/Credentials
MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology), ISN Fellow

Awards and Honors
Educational Ambassador of the International Society of Nephrology 2010
Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis 2001

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