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Why Is Creatinine Level Constantly Increasing When Diagnosed With Hepatits-C And Hypertension?

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Posted on Tue, 24 Oct 2023
Question: Hello,
My son has hep C he got since he was born from blood transfusion. He is 24 years old, student, no complains at all. No alcohol (2-5 per year), no smoking, no drugs.
We have every year annual check up in liver clinic with professionals, blood work and fibroscan during annual checkups. All results were normal for many years.
On March 28, 2018 we visited clinic, completed blood work and were ready for Zepatier treatment.
Everything came back ok, except creatinine level 114 ( XXXXXXX 110). I reviewed level of creatinine for last 4 years and found that that creatinine was increasing within 3-4 years from 85 to 114
On March 28, 2018 albumin was 38 ( min 38)
We came to start the treatment and get our first batch of medication on May 02, 2018 (36 days later) and did routine blood test. Creatinine lever jumped to 131 and albumin dropped from 38 to 37
I started panicking. Called to nurse, she ordered urine test and creatinine test today.
There is protein in urine 3 g/L, moderate blood, creatinine increased during 1 day from 131 to 135
GFR on May 2 was 65, GFR today 63
Electrolytes plasma-normal, anion gap 12 ( XXXXXXX 11),bicarbonate 18 ( min 23)
Magnesium 0,7 ( min 0,7)
Phosphate 1,05 ( range 0,8-1,4)
Calcium 2.26 ( range 2,2-2,6)
Glucose fasting 4.4, no glucose in urine
Spec gravity 1.01
Ph 5.5
Urobilinogen 3.2 (max 16)
Urine colour yellow
Clarity clear
Nitrite negative
Leukocyte negative
Bilirubin negative
My son has very light hypertension which we discover last year by doing routine test at home, however, he went to family physician office twice, he measured blood pressure - 127/80
Ultrasound abdomen exam was done last year in April, no fining
Stress test-ok
Today I measure blood pressure, 140-90
Please help!!!
Thank you

doctor
Answered by Dr. Ravi Bansal (27 hours later)
Brief Answer:
Hi, Please do not panic

Detailed Answer:

Hi,

The most significant report is the urine protein report. Try to recheck urine protein report.

Urine protein creatinine ration >3.0 or
24 hrs urine protein > 3gm per day in 24 hrs collection

definitely points to presence of nephrotic syndrome which has to be confirmed and treated. serum creatinine and borderline hypertension may be related to kidney involvement.

In any case best is to take opinion of your treating nephrologist. but simultaneously do not withhold treatment of HEP C.

Treatment of Hep C may help you in recovery of kidney function.

best wishes

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Ravi Bansal (14 hours later)
We will definitely continue with investigation on this numbers. But as Mom I am very nervous right now.

We continue treatment for hep C. My question is can hep C be key for all this abnormal numbers? For many year we had good blood work.
Thank you in advance,
XXXX
doctor
Answered by Dr. Ravi Bansal (41 hours later)
Brief Answer:
yes hep c can cause kidney disease

Detailed Answer:

Hi,

Hepatitis C can lead to kidney disease with proteinuria. Only way is to confirm the kidney involvement by doing spot p/c ratio and if needed kidney biopsy ( if there is more than 3 gm protein in urine )

best wishes
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ravi Bansal (1 hour later)
We continue hep C treatment.
Is any chance that if we are successful with the treatment, his kidneys will be ok?
Thank you
doctor
Answered by Dr. Ravi Bansal (15 hours later)
Brief Answer:
yes

Detailed Answer:

Yes there is a chance , but we can say for sure. In any case treatment of hep C is important to save life of the patient also . So go ahead for the same and re access kidney function on monthly basis

Best wishes


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ravi Bansal (13 hours later)
Hello Doctor,
We just received results for the following tests:
Anti-Myeloperoxidase (MPO)-normal
Anti-Proteinase 3 (PR3)-normal
Antinuclear Antibody-negative
Glomerular Basement Membrane-normal
Protein plasma-65 (range from 65-80)
Ultrasound: Liver, gallbladder, biliary duct, pancreas, kidneys, aorta, ivc -normal
Intraperitoneal free fluid: Yes, trace free fluid at midline
Other findings: none
Opinion:
OPINION:
Normal kidneys and other organs.
Mild splenomegaly (14.8 cm) We always have mild splenomegaly. Small volume of pelvic ascites

I want to mention that since my son started his treatment he has diarrhea, gas etc.

What is you opinion?

Thank you!

XXXX
doctor
Answered by Dr. Ravi Bansal (6 hours later)
Brief Answer:
Reports are ok

Detailed Answer:
hi,
these reports do not change line of treatment.

please continue hep c treatment
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. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Ravi Bansal

Nephrologist

Practicing since :1996

Answered : 359 Questions

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Why Is Creatinine Level Constantly Increasing When Diagnosed With Hepatits-C And Hypertension?

Brief Answer: Hi, Please do not panic Detailed Answer: Hi, The most significant report is the urine protein report. Try to recheck urine protein report. Urine protein creatinine ration >3.0 or 24 hrs urine protein > 3gm per day in 24 hrs collection definitely points to presence of nephrotic syndrome which has to be confirmed and treated. serum creatinine and borderline hypertension may be related to kidney involvement. In any case best is to take opinion of your treating nephrologist. but simultaneously do not withhold treatment of HEP C. Treatment of Hep C may help you in recovery of kidney function. best wishes