Sudden Increase in Creatinine Levels: Causes and Concerns

Short-term rapid increase in creatinine levels?

Hello Dr.
Wu,
On August 28, 2021, I went to the hospital for a blood test.
On that day, I checked the report online and found that my creatinine level had risen to 1.28.
The creatinine levels from the previous four months were 1.09, 0.99, 1.08, and 1.04.
The interval between this blood test and the last one was only two and a half months, and my lifestyle during these two and a half months has been the same as before.
I haven't had any binge eating, nor have I had my days and nights reversed, and I certainly haven't taken any pain medications.
The only medication I have been taking is a proton pump inhibitor (PPI) prescribed by the hospital for gastroesophageal reflux disease and a gastric ulcer.
I am puzzled by this increase.
The only thing I can think of is that I usually ride a motorcycle to the hospital for blood tests, but this time I decided to walk for some exercise, covering about three kilometers.
I waited for half an hour before having my blood drawn.
Additionally, I forgot to fast before the blood test and took levothyroxine in the morning.
This year, I have been feeling fatigued due to increased workload and overtime.
I apologize for the somewhat disorganized explanation.

Also, regarding my urine test, the protein level was 50 mg/dL.
I have consistently had trace amounts of protein in my urine, but doctors have said it is within the normal range.
There was only one instance where it exceeded 300 mg/dL, which was two or three years ago.
All other urine test results have been normal or negative.
My fasting blood glucose levels have been fluctuating between 100 and 110 mg/dL.

Thank you, Dr.
Wu.

A Mao, 40~49 year old female. Ask Date: 2021/09/04

Dr. Wu Jiyu reply Internal Medicine

Regarding the definition of chronic kidney disease (CKD), you mentioned that the five data points you provided indicated the presence of urinary protein, which alerted you to your kidney function.
The four measurements of glomerular filtration rate (GFR) were 75, 83, 75, and 79 ml/min/1.73m², which suggest that you are in stage 2 of chronic kidney disease.
It is possible that the slight dehydration you experienced after walking that day affected the results, and a single data point is insufficient to determine if there has been any deterioration; therefore, further monitoring is necessary.
(The text did not mention blood pressure or lipid levels, but if they are elevated, they should also be managed or monitored.
Additionally, the protein level in urine was 50 mg/dl, and without a urine creatinine measurement for correction, it is important to check if it exceeds the normal range.) Thank you for your inquiry; the Nephrology Department at Changhua Hospital is concerned about your health.

Reply Date: 2021/09/04

More Info

The sudden increase in creatinine levels, as you've observed, can be concerning, especially when there is no apparent change in lifestyle or medication. Creatinine is a waste product generated from muscle metabolism and is typically filtered out of the blood by the kidneys. An increase in creatinine levels can indicate a decline in kidney function, but it is essential to consider various factors that could contribute to this change.

Firstly, let's examine the potential causes of your elevated creatinine level of 1.28 mg/dL compared to your previous readings. While your lifestyle has remained consistent, several factors could still influence kidney function:
1. Dehydration: Even mild dehydration can lead to increased creatinine levels. If you have been busy with work and not drinking enough fluids, this could be a contributing factor. The fact that you walked to the hospital before your blood test could have also temporarily affected your hydration status.

2. Physical Activity: Engaging in physical activity, such as walking three kilometers, can temporarily elevate creatinine levels due to increased muscle metabolism. This is particularly relevant if you are not accustomed to such activity.

3. Dietary Factors: Although you mentioned no significant changes in your diet, it's worth noting that high protein intake can lead to increased creatinine levels. If there were any unintentional changes in your diet, this could be a factor.

4. Medications: You mentioned taking a proton pump inhibitor (PPI) for gastroesophageal reflux disease and peptic ulcers. While PPIs are generally safe, they can sometimes affect kidney function, particularly with long-term use. It's essential to discuss this with your healthcare provider.

5. Underlying Health Conditions: Conditions such as hypertension or diabetes can impact kidney function. You noted that your fasting blood glucose levels are hovering around 100-110 mg/dL, which is at the upper limit of normal and may indicate a risk for developing diabetes. Monitoring your blood sugar levels and discussing them with your doctor is crucial.

Regarding the protein in your urine, a level of 50 mg/dL is considered mild proteinuria. While you have had instances of higher protein levels in the past, consistent monitoring is essential. Persistent proteinuria can indicate kidney damage, so it’s important to keep track of this with your healthcare provider.

Given your situation, here are some recommendations:
- Hydration: Ensure you are adequately hydrated, especially before blood tests. Drinking enough water can help maintain kidney function and may lower creatinine levels.

- Follow-Up Testing: It would be prudent to have follow-up blood tests to monitor your creatinine levels and assess kidney function over time. This will help determine if the increase is a temporary fluctuation or a sign of a more significant issue.

- Lifestyle Modifications: Continue to maintain a balanced diet, manage stress, and engage in regular physical activity. If you have concerns about your blood sugar levels, consider consulting a nutritionist for dietary advice.

- Medication Review: Discuss your current medications with your healthcare provider to ensure they are not adversely affecting your kidney function.

In summary, while an increase in creatinine levels can be concerning, it is essential to consider various factors that may contribute to this change. Regular monitoring, hydration, and open communication with your healthcare provider will be crucial in managing your kidney health and addressing any underlying issues.

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