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Any ideas what this could be?

I know this is an unfair question, but I'll ask it anyway!  LOL!

I am almost 5 years post kidney tx.  I've just had my labs done for my annual checkup, and I have also just had my appointment with my neph to discuss the results.

My numbers are all perfect EXCEPT for creatinine.  I've been steady for quite some time at just below 1.2, but last August, it spiked to 1.3 and now knocks around between 1.3 and 1.45 (the last 2 months were 1.24, an anomaly, and 1.41 respectively).

I don't have proteinuria.

I have no antibodies.

No BKV.

My blood pressure is perfect and is well-controlled.

No edema.

Feeling just fine.

So, my kidney is doing its job, but my creatinine has remained elevated.

My neph is not worried but wants to know what is going on, so she wants a biopsy done.  Fair enough.  It's not an emergency, so it has been scheduled for 1st June.

So, with all of this in mind, do any of you have any theories?  Have any of you experienced something like this before, and if so, what was your treatment plan?

Thank you very much for taking the time to read this. 

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Replies

  • Hi "MooseMom"

    I literally just got back from myu doc a few hours ago and my wife / donor has similar 'out of wack' increases.  Three comments;

    1)  The change is statistically the same for as reliable as these test are.

    2)  A 'new guy' at the lab could sway those things also (assuming same lab location).

    3)  Diet could somehow affect also.

    As mentioned prior - follow the trend.  One lab does not / should not spell doom.  Also, if you lab all of a sudden goes 'good' (or low) -- not reason to celebrate for the same reasons.  All in the ballpark.

    IMO - you're fine.  Enjoy but watch yourself.

    George

    • Thanks for that, George!  We are following the trend.  Well, it hasn't been a trend upward, rather, it was a sudden spike upward, and my creatinine has stayed elevated since August.  So, my kidney will be biopsied, and then we may have an answer!

  • Here's my theory, but first let me say that even since day 1, my creatinine has never been as good as yours (so I'm a bit jealous, but in a friendly, happy-for-you sort of way).

    You are currently using a 5 year old, used part. It was forcibly yanked from it's original home, and plunked into a very strange environment and then further subjected to all sorts of weird chemicals.

    Give the poor little thing a break. It's working very hard for you and doing an excellent job. You are splitting hairs with an increase of 0.25. Yes, it's an increase, but you should be grateful that you still have an excellent number and it's not creatinine creep (a slow but always steady increase over time). And I don't mean to be putting a guilt trip on you. But you should relax. To put it in perspective for you, my baseline runs roughly between 150 and 180 (1.7 - 2.05). It's always quite volatile, but it's been so since the beginning.

    These changes could be changes in your own body as you age, or the simple fact that the used part is getting older. As long as you don't see an ever-steady, never-stopping increase, you don't have that much to worry about.

    Hang in there. You're going to be fine.

    • Thank you very much, Cora, for your reply.  I agree 100% with everything you've said, and you're right to chastise me for forgetting to just feel grateful!

      As my neph said, it may indeed just be "nothing".  The fact that I AM getting older (I will hit a landmark age in July) has occurred to me as being a possible clue.

      Still, I guess I have to be fair and realize that it is my tx's teams responsibility to help me take care of my kidney and to ward off any problem before it becomes more difficult to treat.  I like to think that I am a "model patient", but I can't do this alone.  In their judgment, my kidney function has changed to the point that they want to investigate.  In the times that I am not concerned, I AM curious purely on an intellectual level.

      Anyway, thank you for your post!  I really appreciate it.

      • On the plus side, a biopsy is not such a bad thing. I've had a couple (creatinine creep which turned out to be prograf toxicity 2 Xs, suspected BK virus, and one done while I was having a surgery anyway) and they're not such a big deal. They warn you about all kinds of potential side effects, but I've never had a problem.

        Keeping my fingers crossed for you that it's nothing. And if it is, that there's something you can do about it.

        I have no doubts that you've done everything you can to treasure and baby your gift while still enjoying your life. That was the point of the gift after all.

        • Thanks again, Cora.  My coordinator called me this morning to go through with me when I should take my meds on the day of the biopsy, and she gave me a general overview of the procedure, the details of which I'd already printed out.  I know that biopsies are quite common in tx patients; it sounds like something of an assembly line.  There will be, I'm sure, several of us who are scheduled for the procedure on the same day.

          And yes, I have done everything for my new kidney.  I have been labelled a "model patient", which worries me because I can't imagine any tx patient doing anything less than what I've done.

  • These numbers are NOT a big move and well within the range of normal fluctuations for Creatinine.  The troubling part is that they represent a slowly rising trend.  The biopsy is really the only true way to determine if a rejection episode is beginning.

    No worries.....Your Tx team is well versed in corrective measures required,  it may be that further testing will be the plan to find the issue.  It is easier to correct a problem early on, rather then when it morphs into something larger.  Treatments range from medication adjustments to a short period of IV meds to reverse the trend.

    About the biopsy, it is a simple and quite painless procedure, with tissue samples being taken using local anesthetic.  The collection needle is guided by ultrasound, besides some pressure/prodding, cleaning off the "joy" jelly is the biggest annoyance.   Bed rest for 24 hrs after (possibly in-patient)  is common, to be sure there is no bleeding/infection or fever.  Good Luck.....Hoping for the best results!

    • Thank you, kidneyboy, for your very informative reply.  It was kind of you to take the time.

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