UKidney's Ask the Experts

  1. Chris
  2. General Nephrology Questions
  3. Wednesday, 04 April 2018
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Hi.
I was diagnosed with renal cell carcinoma 4 years ago. I had a right radical nephrectomy. My cancer scans are clear. As a result of my surgery I am monitored regularly. I have high blood pressure. I am taking Amlodopine 5mg, Bisoprolol 1.25mg, Losartan 100mg, Lansoprazole 30mg.
I was taking Ramopril 10mg but I had to come off this due to the cough. This was approx 7 weeks ago. My bloods were taken then and my creatinine was 1.24. A new blood test was taken a week ago to make sure the Losartan was not compromising my remaining kidney. My creatinine level is now 1.33. I feel rather disconcerted with the seemingly rapid increase in creatinine levels within 6 or do weeks.
Can you advise me on whether it is because of the change of drug, should I be unduly concerned and can I reverse this level?
Many thanks.
Responses (4)
Hello,

I would not be concerned.

Creatinine levels can fluctuate +/- 10% from lab to lab, even on the same day. Adding losartan in to the mix might also explain some of the variation.

I would only become concerned if it continually rose from here. It would also be important to know whether or not you have any protein in your urine. But chances are very high that you have nothing to worry about. Feel free to post any follow-up questions or comments.

Dr. Jordan Weinstein
Chris Accepted Answer
Thank you for your extremely prompt response. In terms of protein in my urine, I had a 'dip test' of my urine when I had my first blood test c.7 weeks ago. This was clear.
Given my current egfr level of 53, have I reached a point were I should be taking a more managed approach to what I eat and drink? I try to drink around 4/5 pints of water a day and I have cut my salt intake right down. My age is 51 and I am a white male.
Many thanks.
That's good news. The absence of proteinuria would provide further reassurance.

I personally do not think you need special precautions. I would maintain a healthy life-style (exercise as tolerated, avoid smoking at all costs, maintain good cholesterol and body weight). The one medical factor that should be monitored is your blood pressure. Salt reduction, the use of losartan/amlodipine/bisoprolol, healthy lifestyle factors listed above will all help. The target blood pressure you should achieve is something to discuss with your physician as there would be some pros and cons to go over. Finally, your creatinine levels should be monitored, as they have, to ensure stability.

All the best,

Dr. Jordan Weinstein
Chris Accepted Answer
Many thanks for your responses. You have been very helpful. Best wishes.
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