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What Causes Elevated Creatinine Levels And Chronic Constipation?
Question: I am a 63 year old female. I do not have diabetes or high blood pressure. I eat well and exercise. For the past 2 years, i have shown mildly elevated creatinine in bloodwork. I do not have protein or urea and no overt symptoms of kidney disease. My doctor recommended an ultrasound and I had one last Friday. The nephrologist called me today and I read a very brief report, but I have to admit I am confused. The findings are bilateral kidneys show increased cortical echogenicity, which I thinks means the kidneys are more responsive to the echos transmitted.
The impression: medical renal disease with renal cortical thickening bilaterally. What is cortical thickening? Is it scarring or damaged tissue? The r renal cortex measures 7mm and the left 6.7.
I can think of a few possible causes. I have chronic constipation and have been laxative dependant for about 10 years, my docs know. it started when I began antidepressants and lamictal 15 years ago. Despite my complaints, no doctor told me constipation could be a side effect of these meds. I think many woman end up in this situation. I am trying to rehab with diet, probiotics and more fluids and minimize laxitive use, but I'm wondering, could chronic dehydration cause thickening. I also drank heavily from the age of 48-56 more or less. complicated reasons, lots of alcoholism in my family, I didnt drink until I had a very bad spell in my mid 40s. Ive been sober since. Long question, I know.
My nephrologist says don't worry, get my blood pressure up and don't eat red meat
The impression: medical renal disease with renal cortical thickening bilaterally. What is cortical thickening? Is it scarring or damaged tissue? The r renal cortex measures 7mm and the left 6.7.
I can think of a few possible causes. I have chronic constipation and have been laxative dependant for about 10 years, my docs know. it started when I began antidepressants and lamictal 15 years ago. Despite my complaints, no doctor told me constipation could be a side effect of these meds. I think many woman end up in this situation. I am trying to rehab with diet, probiotics and more fluids and minimize laxitive use, but I'm wondering, could chronic dehydration cause thickening. I also drank heavily from the age of 48-56 more or less. complicated reasons, lots of alcoholism in my family, I didnt drink until I had a very bad spell in my mid 40s. Ive been sober since. Long question, I know.
My nephrologist says don't worry, get my blood pressure up and don't eat red meat
Brief Answer:
Hello
Detailed Answer:
Hello,
Good day.
First of all, let me tell you that, your details will remain confidential.
Chronic dehydration certainly can rise the creatinine. Alcoholism affects kidney to a certain level, but it affects liver more than kidney.
Did you ever smoke?
Did you ever use pain killers like Inbuprofen, diclofenac ( votaren) etc for a long time. Any other chronic medications in past??
Any history of kidney stones or recurrent urinary infection?
I would like to know your height, weight and creatinine as well as race ( Caucasian/black etc). This is important to calculate the GFR. Glomerular filtration rate ( GFR) has more weightage over creatinine when we assess kidney disease.
Cortex is the outer part of kidney and medulla is the inner part. Cortical thickening means that, there is thickening on the outer layer of kidney. It may not necessarily mean scarring.
HAve you done a urine test to see if there is protein or casts?
I would appreciate a reply with above details
Regards
Binu
Hello
Detailed Answer:
Hello,
Good day.
First of all, let me tell you that, your details will remain confidential.
Chronic dehydration certainly can rise the creatinine. Alcoholism affects kidney to a certain level, but it affects liver more than kidney.
Did you ever smoke?
Did you ever use pain killers like Inbuprofen, diclofenac ( votaren) etc for a long time. Any other chronic medications in past??
Any history of kidney stones or recurrent urinary infection?
I would like to know your height, weight and creatinine as well as race ( Caucasian/black etc). This is important to calculate the GFR. Glomerular filtration rate ( GFR) has more weightage over creatinine when we assess kidney disease.
Cortex is the outer part of kidney and medulla is the inner part. Cortical thickening means that, there is thickening on the outer layer of kidney. It may not necessarily mean scarring.
HAve you done a urine test to see if there is protein or casts?
I would appreciate a reply with above details
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am 5'4" weigh 115 pounds. I'm Caucasian. I never used excessive pain killers. I have been on 200-300 mg of lamictal and 20 mg Prozac for 15 years. I take levothyroxine. My last blood work was all normal except for creatinine 1.22 egfr 47.11. Uric acid 4.9 normal, no protein phosphorus 5.0 a bit high. No other symptoms of kidney disease. I think the docs say this is moderate loss of function, but I don't know why. My liver is ok
Brief Answer:
Hello
Detailed Answer:
Hi,
Thank you for writing back.
The calculated GFR is around 47 ( you were right). At your age, we expect GFR to be around 60. Please understand that, there is a natural decrease in GFR by around 1% per year. That is natural. But beyond that, it is abnormal.
Since there are no obvious other urine abnormalities, the only other option is a kidney biopsy. HOWEVER, IT IS TOO EARLY TO EMBARK ON THAT PATH. It would be better to wait and watch.
Increase your fluid intake. Avoid dehydration. Avoid pain killers. Avoid holding urine for long time. Treat urinary infection promptly ( in the future).
Repeat Urine and blood works in a month and we will watch the trend. If the creatinine is worsening, we shall act further.
Kind regards
Binu
Hello
Detailed Answer:
Hi,
Thank you for writing back.
The calculated GFR is around 47 ( you were right). At your age, we expect GFR to be around 60. Please understand that, there is a natural decrease in GFR by around 1% per year. That is natural. But beyond that, it is abnormal.
Since there are no obvious other urine abnormalities, the only other option is a kidney biopsy. HOWEVER, IT IS TOO EARLY TO EMBARK ON THAT PATH. It would be better to wait and watch.
Increase your fluid intake. Avoid dehydration. Avoid pain killers. Avoid holding urine for long time. Treat urinary infection promptly ( in the future).
Repeat Urine and blood works in a month and we will watch the trend. If the creatinine is worsening, we shall act further.
Kind regards
Binu
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. Chakravarthy Mazumdar
Answered by
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