Creatinine levels and all that follow (YANMD) (Lithium filter)
March 9, 2018 12:57 PM   Subscribe

My blood draw has showed slightly elevated creatine levels. I'm a little freaked out.

After years of lithium use, my creatine is a little high (I left the numbers at work and can't tell you exactly but it was small.) What should I expect now? I see my doc in two weeks (barring a cancellation sooner) and he says he can set me up with a kidney specialist. How gradual is this damage? For example, I need to drive 300 miles next week and don't see switching meds before that. What other drugs have you used successfully after going off Lithium? Good links would be appreciated as the ones I've found so far are dire. I'm under enough stress right now. I will message the mods with a throwaway account, I have to go to work now.
posted by anonymous to Health & Fitness (9 answers total)
You're looking for creatinine.

If you were in immediate danger, your doctor would be sending you to the ER -- doctors don't mess around with that. And you would be feeling beyond terrible.

In the meantime, call your doctor and ask what you can take instead of lithium. Stress makes things worse, so as hard as it is, just take a moment and breathe.
posted by mochapickle at 1:09 PM on March 9, 2018

Don't panic, this is not an emergency. IANAD, but renal failure is typically a very gradual process (as in years) and you can't know if you're even at the beginning of that process just because you have one slightly elevated biomarker. This is something that needs to be discussed with your doctor, but it's not something that's worth being worried about at this stage. Nothing terrible is going to happen in the next few weeks, and you will in all likelihood have plenty of time to navigate whatever transitions are in order.

It's not even a guarantee that you will need to change medications at all; perhaps a dosage adjustment is all that's in order, or perhaps something can be done to support your kidneys and keep them healthy and functioning as normal. Maybe watchful waiting is the best course at this stage.

Nobody here can give you helpful advice about what medication to try next. Depression treatment is notoriously idiosyncratic, and we don't know your medical history. That's what your doctor is for.

Don't worry. Wait and see what your doctor has to say, and plan your next move from there.
posted by Anticipation Of A New Lover's Arrival, The at 2:08 PM on March 9, 2018 [2 favorites]

Just speaking generally, one test isn't even definitive evidence that your levels are elevated. The kidney dr will probably re-test you. It could be a statistical blip.
posted by praemunire at 2:24 PM on March 9, 2018 [1 favorite]

And if you do have some kidney impairment, there's generally not any aggressive treatment associated with that in the early stages. They may tell you to avoid smoking, NSAIDs, and too much alcohol. They may encourage you to eat a balanced diet and not overdo the protein, that sort of thing. Treat any high blood pressure. They may have you in periodically for bloodwork and maybe the occasional urine collection.

It's all subjective and kidney health and resilience is different for everyone. You can have a little impairment and live a perfectly normal life.
posted by mochapickle at 2:28 PM on March 9, 2018 [1 favorite]

I’ve never taken lithium, but i have a number of medical issues that cause me to have more concern about kidney function than an average person.

I would not be concerned about a single data point, especially only “slightly elevated”. It is important to monitor these things, which you are, but this may be just a natural fluctuation within the range of normal for your body. For example, last summer at my annual post-cancer check-up, everything cancer-related was fine but the specialist noted that my kidney function was down and i should follow-up with my regular doctor, but also that i may have been a bit dehydrated the day i took the tests. Sure enough, at my recent annual physical with my GP, my kidney function was normal (and everything else was good).

Even if you do have the start of a problem, you should be a bit reassured that you are one of the people who gets check-ups to detect possible problems and correct for them. You’re not someone who goes twenty years without seeing a doctor and dies of preventable disease. As long as your follow your doctors’ recommendations for further testing and treatment you’ll likely be fine.
posted by D.C. at 2:46 PM on March 9, 2018 [2 favorites]

Mod note: Fixed spelling in title.
posted by Eyebrows McGee (staff) at 4:17 PM on March 9, 2018

I have Stage IV chronic kidney disease and recently had fluke lab results that showed my creatinine at 3 instead of my usual 2.1-ish. (We knew it was a fluke because the next two sets of labs have been back in my normal range.) They are going to want to do more tests before they decide anything. I had to wait two weeks to see my kidney doctor when my random extra-high creat happened, so I understand you're anxious about this, but whatever is going on (which could be a total fluke) doesn't appear to be acute or they wouldn't be making you wait to be seen.

I don't recommend Dr. Google for kidney disease stuff, but if you really want to find out more before you see someone the National Kidney Foundation is usually reliable without fanning the panic. Here's their info on lithium and your kidneys if you haven't found it already.
posted by camyram at 5:44 PM on March 9, 2018 [1 favorite]

Mod note: From the OP:
throwaway address at:
posted by Eyebrows McGee (staff) at 8:16 PM on March 9, 2018

Was there any chance you were dehydrated? Creatinine and BUN tend to be better indicators of acute kidney function. Your eGFR is what's going to be a better indicator of chronic damage, though none of these three numbers exist in a vacuum. It's always scary to hear your labs are coming back abnormal, but do what you can to take care of yourself and not dwell too much on it; as others have pointed out one abnormal value does not necessarily mean an inexorable slide to CKD has begun.
posted by jacy at 8:36 PM on March 9, 2018

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