41y/o Diagnosed with acute renal failure

[captedwardteach]

Greetings, all...

Well, here goes my issue. Approximately two years ago, I had a 3am trip to the emergency room with chest pains. Blood pressure was extremely high: 165/110 but after several hours of observation and a cardiac catheter (sp?) which showed "I have the arteries of a 15-year old" I was released to return home and referred to a kidney doc for follow-up, based upon elevated creatinine levels found during the myriad of tests performed during whatever episode occurred that put me in the ER at 3am.

To this day no doctor has been able to tell me exactly what happened.

However, my trip to the renal doc was less than I expected. I'm 6'4", 240 pounds, non-smoker, etc...I work out approx. 5 days per week, an hour of cardio, blah, blah, blah, blah...basically, at 41, I'm in better shape than when I was 21.

However, the renal doc also agreed that the elevated creatinine levels were a cause for concern, as was my cholesterol levels (according to him, I have an abnormally low "good" cholesterol number, and even though my "bad" cholesterol is in the "normal" range, the ratio is off so I have "high cholesterol"). Also at that time (two days after the ER trip) my blood pressure was still elevated at 140/90. During the consultation, I explained to him that my wife and I had just started "two-a-days" where we would do our cardio training in the morning and weight training in the afternoon. As part of this, we had just started the loading phase of Creatine as a supplement to aid in the recovery process of our muscles.

Now, I'm a computer programmer by trade and not a physician, but to me Creatine and creatinine sound awfully similar, and considering the two perform the same function of removing waste material from muscle tissue, I asked him if that could lead to an elevated reading of creatinine. He didn't know, but promised to research it for me.

Fast forward two years: My blood pressure has returned to normal and I have not taken blood pressure meds for a year. My cholesterol remains "odd" with the abnormally low "good" number and average "bad" number, and my wife and I still work out regularly.

The problem is I have just been declined medial insurance because I still have a diagnosis of "Hypertension, High Cholesterol and Acute Renal Failure" thanks to this doctor.

How can I show this doctor and the blood-suckers at the insurance company that I'm in good health and no longer suffering from (and probably never did suffer from) the above-mentioned diagnosis?

I look forward to your responses.

[Dr. Chan Lowe]

Hi Captedwardteach,

This is a difficult situation. Creatine breaks down into creatinine so theoretically an increased amount of creatine would translate into an increased amount of creatinine. However, the kidneys should be able to filter off the excess creatinine with no problem such that the creatinine level in the blood would remain normal despite the increased creatine. Unfortunately, I cannot say this with 100% certainty, though.

If all your symptoms are now resolved and have not returned you may want to see a doctor again and have all the lab work repeated so that the doctor can now declare that you do not have hypertension, high cholesterol and acute renal failure. Perhaps having your physician write a letter to the insurance company explaining that these were brief issues that are questionable in regards to their origin but have now resolved completely will help.

I am actually fairly suspicious that you may have had a post-infectious cause of the acute renal failure. There are several viruses and bacteria (most notably group A streptococcus) that can cause an acute renal failure following these infections. The acute renal failure then leads to elevated creatinine and hypertension. As the renal failure resolves, the blood pressure and creatinine return to normal. In some cases this can lead to permanent renal failure but if the BP and creatinine have returned to normal it would indicate that this is not going to happen since the kidneys have recovered properly.

Regarding the hypercholesterol issue. I would not consider a low HDL, the good cholesterol, with a normal overall cholesterol level as hypercholesterolism. A low HDL can be an issue but based on the definition of hypercholesterolism it does not satisfy the criteria for this diagnosis. I would recommend talking with your primary care doctor about all these issues.

Best wishes. I hope this all works out for you.