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What Does Elevated Creatinine Level Even After PCN Procedure Indicate?

Posted on Tue, 9 Jun 2015

Question: I had recently undergone Nephrostomy(PCN) locally as the diagnosis was Obstructive Uropathy with CKD and Cystitis.The Creatininine before the procedure was 4.95 while it is 5.4, a week after the procedure.I am 62 years male who had earlier undergone two major operations for Pelvic lipamatosis and subsequently Augmentation Cystoplasty in the years 2008 and 2009.I was doing selfcatherisation (CIC) prior to my Nephrostomy. My Abdominal ultrasound shows gross Hydronephrosis bilaterally of ureters and also stenosis.Also, multiple cysts in left kidney largest being 2cm are present.My question is why there is no improvement in S.Creatinine even after the PCN procedure and what is the prognosis for my case? Can my creatinine levels be managed and brought down somewhat by any other means or I may have to prepare for Dialysis in near future?

Answered by Dr. Goswami Debopom (2 hours later)

Brief Answer:
You may require dialysis in future.

Detailed Answer:
Hi.
Welcome to Healthcare Magic . Thank you for posting your query.
I can understand your concern.

Hydronephrosis is the swelling of a kidney due to a build-up of urine.
The causes are -
Kidney stone
Scarring of tissue (from injury or previous surgery)
Tumor or cancer (examples include bladder, cervical, colon, or prostate)
Enlarged prostate (noncancerous)
Urinary tract infection

Hydronephrosis is usually treated by eliminating the actual cause.
In cases of severe blockage and hydronephrosis, excess urine may need to be removed using either a catheter to drain urine from the bladder or a special tube called a nephrostomy that drains urine from the kidney.

Percutaneous nephrostomy catheter placement has been the primary option for the temporary drainage of an obstructed collecting system.
The serum creatinine level reflects the actual renal function.
The high serum creatinine is probably due to the long standing CKD and long standing hydronephrosis which has led to compromised renal function.

Nephrostomy , being a temporary diversion procedure can relieve the hydronephrosis but it cannot revert back the already compromised renal function , hence the persistent high creatinine level.

Prognosis actually depends on both the stage of CKD and the status of hydronephrosis currently.

I would suggest you to
- not to panic
- Yes you need to get prepared for dialysis in future
- Keep in touch with your urologist . he/she can examine you and correlate clinically.

Hope this helps.
post any other question.
regards.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Goswami Debopom (26 minutes later)

Hi Dr, What are the "appropriate" tests if Enlarged Prostrate is the cause ?

Answered by Dr. Goswami Debopom (16 minutes later)

Brief Answer:
There are many tests for detecting an enlarged prostate.

Detailed Answer:
The " appropriate" tests for enlarged prostate are -

- DRE ( Direct rectal examination) by the doctor
- Ultrasound of the Kidney, ureter , bladder region
- Uroflowmetry to look at the urine flow
- PSA level in blood

Hope this helps.
Post any other question.
I will be happy to help.
Regards.

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Yogesh D