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What Causes Elevated Serum Creatinine Levels?
Question: This refers to my elevated SERUM CREATININE and ALKALINE PHOSPHATE which have been found to be 1.67 mg/dl and 628.6 IU/Liter respectively. Please help me to take right action.
Other details about myself are as under :
Age : 53 years
Gender : Male
Diet : Strictly Vegetarian
Present Ailments : 1.Chronic migraine since last 25 years ,
2. Hypertension since last 5 years ,
3.Type 2 Diabetes since last 2 years ,
4. Depression since 7 years.
Medicines taken regularly : 1.Sumatriptan 25 mg sos since last 10 years,
2.Divalproex Sodium 500 mg ER since last 6 months
3. Amitriptyline 25 mg since last 6 months
4. Ramipril 5 mg and Atenolol 50 mg since last 5 years
5. Alprazolam 0.5 mg since last 15 years
Since last 4 days, I am suffering from acute dental pain for which I have been taking 4 times a day OTC drugs having combinations of Paracitamol 350 mg, Ibuprofane 400 mg and Serratiopeptidase 15 mg, alongwith regular medicines as above.
After taking these medicines, I observed since last 3 days swelling in the areas belows eye and hence got Serum Creatinine and ALP test done today and the results are attached with this mail. Since I live in a very remote area where Specialist doctors are not available and the nearest city is 200 km away, it is very difficult to get medical opinion. Please advise me about the condition of my Kidney and whether its normalcy can be restored as I am very much worried over the result of test report.
With regards.
XXXXXXXX
Other details about myself are as under :
Age : 53 years
Gender : Male
Diet : Strictly Vegetarian
Present Ailments : 1.Chronic migraine since last 25 years ,
2. Hypertension since last 5 years ,
3.Type 2 Diabetes since last 2 years ,
4. Depression since 7 years.
Medicines taken regularly : 1.Sumatriptan 25 mg sos since last 10 years,
2.Divalproex Sodium 500 mg ER since last 6 months
3. Amitriptyline 25 mg since last 6 months
4. Ramipril 5 mg and Atenolol 50 mg since last 5 years
5. Alprazolam 0.5 mg since last 15 years
Since last 4 days, I am suffering from acute dental pain for which I have been taking 4 times a day OTC drugs having combinations of Paracitamol 350 mg, Ibuprofane 400 mg and Serratiopeptidase 15 mg, alongwith regular medicines as above.
After taking these medicines, I observed since last 3 days swelling in the areas belows eye and hence got Serum Creatinine and ALP test done today and the results are attached with this mail. Since I live in a very remote area where Specialist doctors are not available and the nearest city is 200 km away, it is very difficult to get medical opinion. Please advise me about the condition of my Kidney and whether its normalcy can be restored as I am very much worried over the result of test report.
With regards.
XXXXXXXX
Brief Answer:
Need more details
Detailed Answer:
Hi XXXXXX,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Increased serum creatinine shows renal damage. Its due to damage related to diabetes and hypertension. At present levels are still rising. A GFR test is necessary to identify the amount of damage.
2. Your alkaline phosphatase is high. Not sure it is related to liver or bone. I am not sure why you got it done.
3. Increased direct bilirubin with alkaline phosphatase suggests obstructive jaundice. If bone cause then bone damages maybe occurring. If isoenzymes of alkaline phosphatase is available, I can be more specific. Based on available report, I would think of bone cause.
4. You are possibly going for chronic renal failure. Still very early stages. Initially diuretics, later on dialysis maybe necessary. Bone cause again requires evaluation.
Tests are necessary for further complete opinion.
Watch for serum creatinine levels, if its raising, then its ominous.
5. Continue treatment for complete control of diabetes and hypertension to avoid further renal damage. With good control, you can prevent further damage and maybe postpone dialysis by a decade.
Now diuretics maybe necessary to reduce face edema.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Need more details
Detailed Answer:
Hi XXXXXX,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Increased serum creatinine shows renal damage. Its due to damage related to diabetes and hypertension. At present levels are still rising. A GFR test is necessary to identify the amount of damage.
2. Your alkaline phosphatase is high. Not sure it is related to liver or bone. I am not sure why you got it done.
3. Increased direct bilirubin with alkaline phosphatase suggests obstructive jaundice. If bone cause then bone damages maybe occurring. If isoenzymes of alkaline phosphatase is available, I can be more specific. Based on available report, I would think of bone cause.
4. You are possibly going for chronic renal failure. Still very early stages. Initially diuretics, later on dialysis maybe necessary. Bone cause again requires evaluation.
Tests are necessary for further complete opinion.
Watch for serum creatinine levels, if its raising, then its ominous.
5. Continue treatment for complete control of diabetes and hypertension to avoid further renal damage. With good control, you can prevent further damage and maybe postpone dialysis by a decade.
Now diuretics maybe necessary to reduce face edema.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Thanks for kind reply and in answer to your points, I would like to say point wise that
1. I accept the facts and will get GFR test done tomorrow.
2. High ALP was found by a routine check for govt. employees by thyrocare lab which also mentions that 25-OH VITAMIN D (Total) in my case was 12.27 ng/dl on last February ‘ 14
3. You are right in thinking Bone cause in my case as I took no medication for Vit. D deficiency . Serum Bilirubin (Total) is 0.46 mg/dl normal as per report sent to you.
4. I value you opinion and request you to specify the necessary Bone test to be done now. Also please let me know when I should get Sr. Creatinine level tested again.
5. Can you suggest me any diuretic for symptomatic relief for the time being as I will go to city after 4 days. One year ago I was prescribed Lasilactone for mild hypertension though at that time I had no swelling on face area.
6. Should I reduce water intake as I consume 8-10 glass daily. I am not alcoholic which I forgot to mention earlier.
In addition to the above I would like to inform you that I have been taking NSAIDs like Diclomol and Combiflam for Dental pain relief 4 times a day since last 3 days. Can it also be the cause for elevated Creatinine ?
And at last I would like to know whether can I by proper medication, restore the normal Creatinine level and lead a healthy life.
Your point wise reply shall be highly appreciated.
With regards
XXXXXXX
1. I accept the facts and will get GFR test done tomorrow.
2. High ALP was found by a routine check for govt. employees by thyrocare lab which also mentions that 25-OH VITAMIN D (Total) in my case was 12.27 ng/dl on last February ‘ 14
3. You are right in thinking Bone cause in my case as I took no medication for Vit. D deficiency . Serum Bilirubin (Total) is 0.46 mg/dl normal as per report sent to you.
4. I value you opinion and request you to specify the necessary Bone test to be done now. Also please let me know when I should get Sr. Creatinine level tested again.
5. Can you suggest me any diuretic for symptomatic relief for the time being as I will go to city after 4 days. One year ago I was prescribed Lasilactone for mild hypertension though at that time I had no swelling on face area.
6. Should I reduce water intake as I consume 8-10 glass daily. I am not alcoholic which I forgot to mention earlier.
In addition to the above I would like to inform you that I have been taking NSAIDs like Diclomol and Combiflam for Dental pain relief 4 times a day since last 3 days. Can it also be the cause for elevated Creatinine ?
And at last I would like to know whether can I by proper medication, restore the normal Creatinine level and lead a healthy life.
Your point wise reply shall be highly appreciated.
With regards
XXXXXXX
Brief Answer:
Control of disease slows down progression.
Detailed Answer:
Hi XXXXXXX,
Thanks for asking again.
1. GFR will assess exact amount of renal disease
2. Your Vit D is low and has been low for some time. You will require vit D and calcium supplements.
3. Serum bilirubin's tests are normal. Not liver cause.
4. Healing fracture or bone damage are common causes of increased alkaline phosphatase due to bone cause. Bone mineral density test or X-ray of location, if anything specifically painful like back, etc could be helpful. Nutritional supplements would be helpful.
5. For reducing edema, diuretics like furosemide will be helpful. Need to take low dose to avoid hypotension or dizziness.
6. Water reduction not necessary, unless renal failure has occurred. Diuretics will reduce face swelling.
7. Those medications are not a problem at present.
Yes, with good control, further progression can be slowed down.
You need to take prescription from your doctor.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Control of disease slows down progression.
Detailed Answer:
Hi XXXXXXX,
Thanks for asking again.
1. GFR will assess exact amount of renal disease
2. Your Vit D is low and has been low for some time. You will require vit D and calcium supplements.
3. Serum bilirubin's tests are normal. Not liver cause.
4. Healing fracture or bone damage are common causes of increased alkaline phosphatase due to bone cause. Bone mineral density test or X-ray of location, if anything specifically painful like back, etc could be helpful. Nutritional supplements would be helpful.
5. For reducing edema, diuretics like furosemide will be helpful. Need to take low dose to avoid hypotension or dizziness.
6. Water reduction not necessary, unless renal failure has occurred. Diuretics will reduce face swelling.
7. Those medications are not a problem at present.
Yes, with good control, further progression can be slowed down.
You need to take prescription from your doctor.
Hope it helps.
Any further queries, happy to help again.
Dr. Prakash HM
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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