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Kidney function elevated will an ultrasound be any benefit?

Discussion in 'Gastrointestinal and Urinary' started by rd123, Dec 1, 2015.

  1. rd123

    rd123

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    My kidney function has been elevated for awhile now, Creatine is the main one, from what I have read previously it is just a normal side effect of ME/CFS which I have told my Dr. as I didn't think there was much to be done for it. My labs from last Wed. came in today and they want me to do a kidney ultrasound now, but I just highly doubt that will be of any benefit from what I have read.

    Are there any other more specific tests to do before doing that? and would it help to get the ultrasound?

    Any thoughts? Thanks in advance, it is nasty weather here, so that effects me so bad as well.
     
  2. barbc56

    barbc56 Senior Member

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    AFAIK, it isn't. There have been several times I thought symptoms were caused by this DD and it turned out to be something else that needed treating.

    An ultra sound is not invasive, fairly quick and painless, relatively speaking. You are not exposed to radiation.

    I've been having some kidney issues and was surprised how much detailed information you can get from an ultra sound. It can also indicate if you need other testing.

    It's best if this is done through a urologist as he/she will take another look at the results.

    Kidney issues are not anything to fool around with nor delay. If nothing is found then you at least have peace of mind.

    Good luck and keep us posted.


    .
     
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  3. Kati

    Kati Patient in training

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    The test you mentioned is probably creatinine and not creatine.

    i concur with @barbc56, it is not a normal symptom of ME/CFS, and should be invvestigated further.
    An ultrasound sounds very reasonable and is painless and least invasive. The good news is that physicians know kidneys and kidney function.

    Sending best wishes, let us know what happens! If you want to.
     
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  4. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    I think you mean creatinine, not creatine. Elevated creatinine is not just a normal side effect of ME/CFS. Do you know your serum creatinine level or how about your eGFR, estimated Glomerular Filtration Rate? If so, you can stage the level of your kidney disease here:

    http://www.qxmd.com/calculate-online/nephrology/ckd-epi-egfr

    Use mg/dL if you are in the US. I don't know which countries might use μmol/L.

    Use this to determine the stage you're at:
    • Stage 1 with normal or high GFR (GFR > 90 mL/min)
    • Stage 2 Mild CKD (GFR = 60-89 mL/min)
    • Stage 3A Moderate CKD (GFR = 45-59 mL/min)
    • Stage 3B Moderate CKD (GFR = 30-44 mL/min)
    • Stage 4 Severe CKD (GFR = 15-29 mL/min)
    • Stage 5 End Stage CKD (GFR <15 mL/min)
    This is written to be patient-friendly:
    http://www.davita.com/kidney-disease/overview/stages-of-kidney-disease

    Once the results of your ultrasound are in, your doctor may refer you to a nephrologist for further treatment.

    Urologists specialize in the treatment of the male reproductive organs and male and female urinary tract, which does not include the kidneys. Nephrologists specialize in the treatment of the kidney.
     
    Last edited: Dec 1, 2015
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  5. rd123

    rd123

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    Hi Barb & all,

    thanks for the responses, I had the ultrasound done last Fri. will get the results at next visit. I just looked it up again, there are several things about the elevated creatinine from creatine due to CFS/infections. I have only a mildly elevated level, so I do not think kidney disease is at all involved.

    It is more likely the CFS/methyl. block/infections/medications. I have taken hydrocodone/acet. for the last 7 yrs due to bone pain/CFS along with other meds. Here are a couple mentions of infections/CFS effecting creatine/creatinine levels. To me this is what it is going on. But with this DD who knows.


    Rhabdomyolysis is the medical term to describe the destruction or breakdown of the skeletal muscle; it can cause a high creatinine level in the urine. It can happen from long-distance running, muscle trauma, electrical shock and as a result of some infections - See more at: http://www.livestrong.com/article/4...reatine-levels-in-urine/#sthash.sePgZVag.dpuf

    http://forums.prohealth.com/forums/index.php?threads/creatine-is-amazing.196554/

    Some creatine comes in from the diet, and some is also produced in the kidneys, liver, and pancreas. It is synthesized from glycine and arginine, which form guanidinoacetate, followed by methylation by SAMe. The synthesis of creatine is one of the two main demands for methylation in the body, the other being the conversion of ethanolamine to choline. If there is a partial methylation cycle block, one would expect that the synthesis of creatine would be below normal.
    Creatine is carried via the blood to the organs where it is needed, primarily the skeletal muscles, the heart muscle, and the brain. In these organs, it serves as a storage molecule for high energy phosphate groups, forming creatine phosphate. When there is a big, sudden demand for ATP, to operate the muscles in vigorous exercise, for example, the rate of production of ATP by the mitochondria is not high enough to meet the demand. In that case, the creatine phosphate supplies phosphate groups to ADP to regenerate ATP, forming creatine again. ATP produced by the mitochondria eventually recharges the creatine to creatine phosphate, forming ADP. So the creatine acts as an energy buffer for the organs in which it is abundant.
    Creatine phosphate spontaneously (without the help of an enzyme) degrades to form creatinine and a phosphate group. This occurs at the rate of about 1 to 2% of the total creatine phosphate per day. The creatinine is carried by the blood to the kidneys and is excreted into the urine. The ratio of creatinine in the blood to that in the urine is used as a measure of kidney function. The amount of creatinine produced per unit time is approximately proportional to the amount of skeletal muscle in the body, i.e. the lean body mass. In urine analysis, it is common to divide the concentrations of various species by the concentration of creatinine in order to normalize them and correct for varying amounts of dilution by water in the urine. The assumption behind this practice is that the rate of production of creatinine is not affected by health problems. This does not appear to be true in CFS and autism, because of the partial methylation cycle block.
    It is also common practice when doing magnetic resonance spectroscopy studies on the brain to take ratios of the peak heights for the other substances observed to the peak height for creatine, again based on the assumption that the creatine level should be more or less constant. This is done because it is much easier to take ratios than to measure accurate values for absolute amounts of these substances using MRS. Again, this constancy is probably not true in CFS, because of the partial methylation cycle block. We do not have absolute measurements of brain creatine in CFS, but MRS studies in CFS have found abnormal values of the ratio of choline to creatine. Since the syntheses of both choline and creatine require methylation, I think a partial methylation cycle block is the explanation for these observations.
    I suspect that supplementing creatine would give some benefit in many people with CFS in terms of storing energy for relatively short-term high demands. However, I think that in a short time, the creatine phosphate will be converted to creatine, and then the problem will be that the mitochondria are not able to regenerate ADP to ATP fast enough, and the person will "run out of energy" to operate their muscles.
    As you know, there are many things that block the proper operation of the mitochondria in CFS, including depleted magnesium, toxins, and infections. In my view, these problems begin with glutathione depletion. Glutathione depletion also allows the rise of oxidizing free radicals in the mitochondria, and these block the Krebs cycle and probably also the respiratory chain. In addition, in CFS there are shortages of Coenzyme Q-10, carnitine, and creatine (the latter is not actually in the mitochondria). These require methylation for their synthesis, so I think their shortages can be traced back to the partial methylation cycle block. So, ultimately, the partial methylation cycle block and glutathione depletion can be shown to be responsible for the mitochondrial dysfunction and the shortage of ATP in CFS.
    One more thing, just for completeness, though it isn't directly related to the issue we are discussing: The enzyme that catalyzes the reaction between creatine and phosphate is called creatine phosphokinase or just creatine kinase. This enzyme is normally found inside the types of cells where creatine is abundant. As these cells break down, this enzyme is released to the blood stream. There are different types of creatine kinase found in the skeletal muscles, the heart muscle and the brain. These types of creatine kinase are used as a diagnostic to determine whether these various types of cells are dying at a higher than normal rate in these different organs.
     
  6. barbc56

    barbc56 Senior Member

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    That's the strict definition but there's some overlap. Urologist are also surgeons where nephrologist arent. Their training is different.

    However, looking at my health providers two departments some of the nephrologst also do surgery as well as kidney stones. So maybe there can be have some cross training?

    It does look like the nephrologist treat more serious, relatively speaking, conditions such as kidney cancer, kidney failure.

    I wonder if patients, unless they already have a condition like cancer or diabetes, are first referred to a urologist?

    I'm no expert for sure!

    Thanks.

    Barb

    ETA Now I'm even more confused as this says urologist treat kidney cancer. According to this site:

    .

    http://blog.mysanantonio.com/urolog...rence-between-a-urologist-and-a-nephrologist/
    :thumbdown:
     
    Last edited: Dec 9, 2015
  7. barbc56

    barbc56 Senior Member

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    @rd123
    The first part of your post is nicely broken into to readable paragraphs. Would you mind breaking up the rest of your post. It just makes things more readable. You're new so you may not have known that.

    .
    My understanding is this is not a proven theory, or is it?

    Thanks and welcome to Phoenix Rising!

    Barb
     
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  8. CFS_for_19_years

    CFS_for_19_years Hoarder of biscuits

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    Rhabdomyolysis can be confirmed with an elevated serum CK (creatine kinase) and/or urinary myoglobin. If CK is negative, rhabdomyolysis is unlikely. If your doctor doesn't suspect rhabdomyolysis, it's unlikely they would run a CK. CK is a common test, but mainly used to rule out a heart attack, which is damaged muscle.

    When looking for medical information, I rely on medical sources, such as Medscape, rather than LiveStrong, a content farm, for medical information:
    http://emedicine.medscape.com/article/1007814-overview (rhabdomyolsis)

    @rd123, similar to you, I have a long history (10 years) of taking hydrocodone/acetaminophen for chronic pain. I believe this is partly to blame for my stage 3 chronic kidney disease. The rest may be due to my age (61). My doctor limits my daily acetaminophen use to no more than 1300mg/day (4 Vicodin tabs) and I take the lowest dose of long-acting morpine (15mg) every day so that I don't have to take higher doses of Vicodin. Any and all NSAIDs are forbidden.

    There are many published articles from peer-reviewed journals regarding acetaminophen use, toxicity and CKD. You can see them by inserting this search string into Google:

    acetaminophen "chronic kidney disease" site:http://www.ncbi.nlm.nih.gov/pubmed (79 hits)
    or you can click this link:
    https://www.google.com/search?biw=1....4.4.0....0...1c.1.64.serp..4.0.0.eFb3AUEgri4

    If you don't mind me asking, what is your age, most recent serum creatinine or calculated eGFR?
     
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  9. rd123

    rd123

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    Hi Barb,

    I do not think it is just a theory, as it was from a pub. study. When I looked last year, I found several articles relating to it, ie: the creatine/muscle breakdown in CFS, one said if you had it, it was considered a "gold standard" biomarker that you indeed had ME/CS. If I get the energy to look more I will. I know I have lost considerable muscle mass, and continue too. I have been having an issue keeping weight on, even though I have been trying to gain.

    Sorry that the last of my post did that, I just copied and pasted, but I guess it took out the extra spacing. I too have issues reading, esp. when it is bunched like that. I am not new, I just do not post much, or read too much, as it does get pretty taxing. I read an article on HuffPost recently about one of Dr. Montoya's patients having some recovery after Valcyte/an immune modulator & an anti-inflammatory. I am most curious what anti-inflammatory was used, as I have issues with that as well, but have not wanted to take a long term steroid. I need to do more looking on that I guess.

    Hi CFS 19,

    I do not know what my current levels are, or what exactly was tested for, as I will not get results until next visit. I have had this DX since 2008 by 2 infectious disease DR.'s one was Dr. Brewer, who was 100% certain due to having every criterion. But, I have had it for a lot longer, I had issues/pretty sick in spring 2004, and never fully came out of it, felt like a floundering fish most of the time, still not sure how I got through some of it. And then got hit really, really hard in 2007.. I think it goes back to HS and mono for me though, as the possible origin. I also worked at the local hospital when I was in late teens/early 20's, as well as HHC, so I just really don't know. I had high titers of HHV6 & 7, as well as CMV and something else I can not remember.

    I am male, now 47, I have taken Vicodin(hydro) since June '08 with dosing going from 2x a day 5/500, to 3 times after. Now I take 3Xday 5/325 so 975mg, plus an extra 1,000 mg of aceto. when I take the hydro which goes w/ 3xday of .5 mg Xanax for pain, and 10 mg of Ambien each night. I do not take any NSAIDS either. I try not to go over that 1,975 of aceto. daily.

    I keep hoping that something will come along when they finally figure this out, it is just hard to know what is correct, and what is not, and what to do for sure. Thanks for the help for sure.
     
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  10. IreneF

    IreneF Senior Member

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    Acetaminophen/tylenol/paracetamol/APAP is hard on the kidneys. I think it would be safer to take straight hydro- or oxycodone but I don't think it's currently available.

    I never had kidney function (creatinine clearance) issues until I stated taking antiviral and anti-inflammatory drugs. I see Dr. Montoya; he prescribes Valcyte, colchicine, and Plaquenil.

    You def want to keep your kidneys healthy. If your kidneys fail you will need dialysis or a transplant.
     
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  11. RYO

    RYO Senior Member

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    A kidney ultrasound and a urinalysis with microscopy is a good place to start when investigating decline in GFR or rise in serum Cr. Kidney ultrasound will provide valuable information such as size of kidneys, rule out hydronephrosis, find cysts and look for kidney stones. Nephrotoxic medications such as NSAIDs are very common reason for kidney failure. The kidneys also are more vulnerable in a patient experiencing hypotension or low blood pressure.

    Your physician should closely monitor your kidney function when using antivirals, anti-inflammatory medication, as well as herbs and supplements. Keep yourself well hydrated.
     
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