Elevated Creatinine Levels: When to See a Nephrologist

Creatinine levels exceed the standard?

Hello Doctor: In my blood test report, my creatinine level is 1.21 and my glomerular filtration rate (GFR) is 71.7.
Should I urgently see a nephrologist? What advice would you give me? My triglycerides are 160, total cholesterol is 210, high-density lipoprotein (HDL) is 41, and low-density lipoprotein (LDL) is 139.
I'm not sure if these levels might affect my elevated creatinine.
Thank you!

Xiao Hong, 30~39 year old female. Ask Date: 2022/06/23

Dr. Wu Jiyu reply Internal Medicine

For chronic kidney disease, a glomerular filtration rate (GFR) greater than 60, combined with proteinuria, hematuria, or renal parenchymal damage (such as stones, edema, or cysts), is required for a diagnosis of chronic kidney disease.
Based on the report you provided, while your creatinine levels suggest that your GFR is still within the normal range, your total cholesterol and low-density lipoprotein (LDL) cholesterol levels are elevated.
Additionally, blood pressure, blood sugar, and BMI were not mentioned, as these factors can also affect GFR.
It is recommended that you maintain good dietary habits and exercise regularly, and consistently monitor for hypertension, hyperglycemia, and renal function, as these are essential for kidney health.
Thank you for your inquiry; the Nephrology Department at Changhua Hospital is concerned about your well-being.

Reply Date: 2022/06/23

More Info

Elevated creatinine levels can be a concerning indicator of kidney function, and understanding when to see a nephrologist is crucial for maintaining kidney health. In your case, a creatinine level of 1.21 mg/dL and a glomerular filtration rate (GFR) of 71.7 mL/min suggest that your kidney function is somewhat reduced, as normal GFR values typically range from 90 to 120 mL/min in healthy adults.
Creatinine is a waste product generated from muscle metabolism and is usually filtered out of the blood by the kidneys. When kidney function declines, creatinine levels in the blood can rise. The GFR is a more comprehensive measure of kidney function, as it estimates how well your kidneys are filtering blood. A GFR below 60 mL/min for three months or more is generally considered indicative of chronic kidney disease (CKD).

Given your GFR of 71.7, you fall into the category of Stage 2 CKD, which is characterized by mild kidney damage with a GFR between 60 and 89 mL/min. While this is not immediately alarming, it does warrant monitoring and possibly further evaluation.
Your lipid profile, which includes triglycerides at 160 mg/dL, total cholesterol at 210 mg/dL, high-density lipoprotein (HDL) at 41 mg/dL, and low-density lipoprotein (LDL) at 139 mg/dL, indicates that you may have some cardiovascular risk factors. Elevated triglycerides and LDL cholesterol can contribute to atherosclerosis, which may indirectly affect kidney health by impairing blood flow to the kidneys over time.
Here are some recommendations based on your current health status:
1. Consult a Nephrologist: Given your elevated creatinine and reduced GFR, it would be prudent to see a nephrologist. They can provide a comprehensive assessment of your kidney function, determine the underlying causes of your elevated creatinine, and recommend appropriate management strategies.

2. Monitor Kidney Function: Regular monitoring of your kidney function through blood tests (creatinine and GFR) and urine tests (for protein and microalbumin) is essential. This will help track any changes in your kidney health over time.

3. Lifestyle Modifications: Implementing lifestyle changes can significantly impact both your kidney health and lipid levels. This includes:
- Diet: Adopt a kidney-friendly diet that is low in sodium, saturated fats, and processed foods. Focus on whole foods, including fruits, vegetables, whole grains, and lean proteins.

- Hydration: Ensure adequate hydration, as dehydration can worsen kidney function.

- Exercise: Regular physical activity can help manage weight, improve lipid profiles, and enhance overall health.

- Weight Management: If you are overweight, losing weight can help improve both your kidney function and lipid levels.

4. Medication Review: Discuss with your healthcare provider any medications you are taking that may affect kidney function. Certain medications, particularly nonsteroidal anti-inflammatory drugs (NSAIDs) and some antibiotics, can be harmful to the kidneys.

5. Control Blood Pressure and Blood Sugar: If you have hypertension or diabetes, managing these conditions is crucial for protecting your kidneys. Regular monitoring and adherence to prescribed medications can help maintain optimal levels.

In summary, while your current creatinine and GFR levels indicate mild kidney impairment, it is essential to take proactive steps to monitor and manage your kidney health. Consulting a nephrologist will provide you with tailored advice and treatment options to prevent further decline in kidney function. Additionally, addressing your lipid levels through lifestyle changes can contribute positively to your overall health and well-being.

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