DEAR DR. GOTT: This is being written with the hope you will help me to understand a medical issue. For the past 2 ½ years I have had quarterly blood tests to monitor my liver enzymes and cholesterol levels. In November 2010 these tests also showed my creatinine level was 1.3 and there was a notation from the lab that such was high. When talking with my doctor, he agreed and said we should monitor it. The test in February 2011 was 1.4 but in May it was down to 1.3 again. Then in the August test, it had jumped to 1.8. At first I was told this indicated something serious was going on with my kidneys and my doctor ordered additional blood work to rule out a lab error and help determine the cause. Then those tests were canceled and I’ve been told it’s nothing to worry about. Should I be worried?
DEAR READER: When creatine (important for the production of muscle energy) is metabolized, it produces a waste product known as creatinine, a compound that is produced in the liver. This product is transported through the bloodstream to the kidneys that, in turn, filter it and excrete excesses out of the body through the process of urination. One function of the kidneys is to maintain a normal range of blood creatinine. When this normal process breaks down, levels rise and warn of possible kidney malfunction.
Laboratory results of blood are measured in milligrams (mg) per deciliter (dL). The normal level in the body is between 0.6 to 1.2 mg per dL for males and between 0.5 and 1.1 in females. There are normal variations from these figures for infants, adolescents and the elderly. Readings outside the levels given may occur in those who have experienced extreme weight loss, suffer from malnutrition, dehydration, have specific long-standing medical disorders, who use pain medication such as non-steroidal anti-inflammatories to include over-the-counter ibuprofen (Advil and Motrin). Levels that reach 2.0 or greater may be an indication of kidney impairment.
There may be instances where your physician chooses to test your urine for levels of creatinine. This may involve collecting urine for 24 hours in a special container to be submitted for analysis. If he or she suspects the presence of kidney failure, this may be a more accurate assessment than blood analysis.
Along with elevated creatinine levels, an individual may experience symptoms of fatigue, shortness-of-breath, low grade fever, and malaise. There may be a loss of appetite, weight loss, and the individual may appear confused. There may be pain in the lower back.
I don’t believe I would cancel any testing, unless a cause for the elevated levels was discovered. Although your levels are barely above the normal range, perhaps it would be in your best interests to request a referral to a nephrologist, a specialist in kidney disorders, due to the consistently elevated numbers. Bring your lab results (and your concerns) for review. If the specialist indicates there is nothing to be concerned about, then so be it.
Readers who would like related information can order my Health Report “Kidney Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website www.AskDrGottMD.com.
