Creatinine Levels and Kidney Function Concerns

Q: Creatinine Levels and Kidney Function Concerns

Based on your description, your creatinine level is 1.34 mg/dL (reference range 0.7-1.5), and your glomerular filtration rate (GFR) is 66.9 (reference value > 60). <br>Given your age, your GFR is slightly low, and the most common risk factors affecting kidney function are hyperte

Creatinine and Kidney Function Related Issues

Hello, Doctor.
I apologize for the lengthy description of my issue.
Here are the results from my blood and urine tests conducted at the clinic two weeks ago:
Fasting blood glucose: 100 mg/dL (reference range: 70-100)
Blood urea nitrogen: 13.9 mg/dL (reference range: 7-22)
Creatinine: 1.34 mg/dL (reference range: 0.7-1.5)
Glomerular filtration rate: 66.9 (reference range: >60)
Uric acid: 7.5 mg/dL (reference range: 3.6-8.2)
Total cholesterol: 203 mg/dL (reference range: <200)
Triglycerides: 112 mg/dL (reference range: <150)
High-density lipoprotein (HDL) cholesterol: 32 mg/dL (reference range: >40)
Low-density lipoprotein (LDL) cholesterol: 134 mg/dL (reference range: <130)
White blood cells: 8,800/uL
Urinalysis results:
Specific gravity: 1.025 (reference range: 1.005-1.030)
pH: 5.5 (reference range: 5.0-8.0)
Urine glucose: negative
Ketones: negative
Occult blood: positive
Protein: negative
Urobilinogen: normal
Nitrites: negative
Red blood cells: 6-8 HPF (reference range: 0-5)
White blood cells: 0-2 HPF
Epithelial cells: 0-2 HPF
The clinic doctor mentioned that although my cholesterol and blood glucose levels were abnormal, they were close to the threshold and did not require treatment.
He advised me to lose weight and change my dietary habits, which should help lower these levels naturally.
Regarding the positive occult blood in my urine, he suggested it might be due to minor urinary tract injury and recommended that I drink more water.
He did not mention anything about my kidney function.
Since I have a history of kidney stones (three times), I researched my kidney function and found that my creatinine level is elevated, and my glomerular filtration rate indicates stage 2 chronic kidney disease.
Therefore, I visited a urology department at a medical center for further evaluation.
The kidney ultrasound showed no significant abnormalities and no edema, and the X-ray was normal with no stones.
Additionally, my urine no longer showed occult blood.
The hospital doctor mentioned that the previous positive result might have been due to small stones causing irritation, but he noted that my kidney function was abnormal at 1.4 (presumably referring to creatinine).
He inquired about diabetes or hypertension, which I do not have, and suggested that it might be due to insufficient water intake, advising me to eat a lighter diet and allowing me to go home without treatment.
I would like to ask if I still need to see a nephrologist for a more detailed examination.

Hong Cha, 30~39 year old female. Ask Date: 2017/06/16

Dr. Wu Jiyu reply Internal Medicine

Based on your description, your creatinine level is 1.34 mg/dL (reference range 0.7-1.5), and your glomerular filtration rate (GFR) is 66.9 (reference value > 60).
Given your age, your GFR is slightly low, and the most common risk factors affecting kidney function are hypertension, diabetes, and obesity.
Although your weight was not mentioned, it was noted that you need to lose weight, and both total cholesterol and low-density lipoprotein (LDL) cholesterol levels are elevated.
It is recommended that you focus on weight management and dietary control, and return to the nephrology department for follow-up testing in three months.
Thank you for your inquiry; Changhua Hospital cares about your health.

Reply Date: 2017/06/16

More Info

Understanding creatinine levels and kidney function is crucial for assessing overall health, particularly for individuals with a history of kidney stones or other renal issues. Based on the information provided, your recent lab results indicate a creatinine level of 1.34 mg/dL, which is within the normal range but on the higher side. The estimated glomerular filtration rate (eGFR) of 66.9 mL/min suggests a mild reduction in kidney function, categorized as Stage 2 chronic kidney disease (CKD).
Creatinine is a waste product generated from muscle metabolism, and its levels in the blood can provide insight into kidney function. The kidneys filter creatinine from the blood, and elevated levels may indicate impaired kidney function. However, it's important to consider that creatinine levels can be influenced by various factors, including muscle mass, hydration status, and dietary protein intake.
Your BUN (Blood Urea Nitrogen) level of 13.9 mg/dL is within the normal range, which is a good sign, as it suggests that your kidneys are still effectively filtering waste products. The normal BUN level, combined with a mildly elevated creatinine level, may indicate that your kidneys are functioning adequately but could be under some stress, possibly due to dehydration or dietary factors.

The presence of blood in your urine (hematuria) could be attributed to several causes, including urinary tract infections, kidney stones, or even minor trauma to the urinary tract. Since your recent urine tests showed no hematuria, it is possible that the previous positive result was a transient issue, perhaps related to small stones or irritation in the urinary tract.
Given your history of kidney stones, it is wise to remain vigilant about your kidney health. While the urologist you consulted did not find any immediate concerns, and your kidney ultrasound and X-ray were normal, it may still be beneficial to follow up with a nephrologist (kidney specialist) for a more comprehensive evaluation. A nephrologist can provide a detailed assessment of your kidney function, including additional tests such as urine protein levels, imaging studies, or even a kidney biopsy if necessary.

In addition to consulting a nephrologist, consider implementing lifestyle changes that can support kidney health. Staying well-hydrated is essential, especially for someone with a history of kidney stones. Aim to drink plenty of fluids throughout the day, as this can help dilute urine and reduce the risk of stone formation. A balanced diet low in sodium and processed foods, along with regular physical activity, can also contribute to better overall health and potentially improve kidney function.

Monitoring your blood pressure and blood sugar levels is crucial, even if they are currently normal. High blood pressure and diabetes are significant risk factors for kidney disease, and managing these conditions can help protect your kidney function in the long term.

In summary, while your current kidney function appears to be stable, it is advisable to continue monitoring your creatinine levels and overall kidney health. A follow-up with a nephrologist could provide further reassurance and guidance tailored to your specific health needs. Remember, proactive management and lifestyle adjustments can play a significant role in maintaining kidney health and preventing further complications.

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