Hi Doctor - Curious as to what your thoughts are on this subject. Here's my factual situation. Life insurance exam done on[u] 11/9/18: Blood - BUN 14 mg/dl; creatinine .9 mg/dl. Urine (spot test) - Protein 11 mg; creatinine 164.9 mg/dl; protein/creatinine (URI) .07; negative for Leukocyte & Hemoglobin.
Had a Chest ct scan w/contrast done on 11/14/18 after an x-ray showed a nodule on my lung. Omnipaque 300 used at 80 ml dose.
Lab results on 11/15/18 - done on an unrelated ER visit. Blood - Bun 17 mg/dl; creatinine 1.25 mg/dl
Went to nephrologist last week and he is doing a complete renal panel blood/urine. Obviously, quite anxious about results. He seems to think CIN likely.
My review of the literature indicates I had little or no risk - 53, non-diabetic, no high blood pressure, GFR per life insurance was estimated at 118; low dose of contract, no other risk factors.
I've read numerous articles/studies but conclusions are diverse to say the least.
Do you believe CIN to be real?
Thanks for any imput. Will update you on my test results which I hope to have soon.
Had a Chest ct scan w/contrast done on 11/14/18 after an x-ray showed a nodule on my lung. Omnipaque 300 used at 80 ml dose.
Lab results on 11/15/18 - done on an unrelated ER visit. Blood - Bun 17 mg/dl; creatinine 1.25 mg/dl
Went to nephrologist last week and he is doing a complete renal panel blood/urine. Obviously, quite anxious about results. He seems to think CIN likely.
My review of the literature indicates I had little or no risk - 53, non-diabetic, no high blood pressure, GFR per life insurance was estimated at 118; low dose of contract, no other risk factors.
I've read numerous articles/studies but conclusions are diverse to say the least.
Do you believe CIN to be real?
Thanks for any imput. Will update you on my test results which I hope to have soon.
Accepted Answer
Hi Doctor - so I got my labs back. Serum creatinine down to 1.0; Bun at 18 ( lab ref range 5-26). Urine protein random spot 9.1 and creatinine 174 so PCR .05. Microalbumin <1.2. ACR ratio said unable to calculate because urine and/or albumin falls outside reportable range. Seems to me CIN was temporary? Really thankful for your input.
I believe CIN to be real but very often it will resolve, especially when one begins with normal levels of GFR such as in your case. Has the creatinine been rechecked since the initial rise?
Dr. Jordan Weinstein
Dr. Jordan Weinstein
Thanks for your quick response. I'm still waiting on my lab results from last week. Wonder if CIN is more common than studies suggest especially in an out-patient situation like mine with a very unique fact pattern. I would think it unlikely that very many patients would have an established creatinine / BUN baseline done so close in time to the CT scan w/contrast followed by subsequent lab work done so soon after the CT scan - especially with my lack of all risk factors. Perhaps that's more common with hospitalized patients but I expect I would have never known of the cause of my problem (if it in fact turns out to be non-correcting). Will update you regarding my labs. Thanks again.
I expect the creatinine will normalize. Transient increases following contrast are not uncommon.
Dr. Jordan Weinstein
Dr. Jordan Weinstein
Accepted Answer
Hi Doctor - so I got my labs back. Serum creatinine down to 1.0; Bun at 18 ( lab ref range 5-26). Urine protein random spot 9.1 and creatinine 174 so PCR .05. Microalbumin <1.2. ACR ratio said unable to calculate because urine and/or albumin falls outside reportable range. Seems to me CIN was temporary? Really thankful for your input.
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