Resolved question:
Recently diagnosed with chronic interstitial nephritis after bout of dehydration. Bun/cr 22/1.2. No hematuria or proteinuria. US kidneys normal. Pmhx: htn, gerd, Meds: norvasc, Aciphex, suboxone. Had been on hctz but dc'ed. Alcohol abuse(heavy), marijuana abuse, opiate abuse in past. 27 y/o white male, long term prognosis. I have stopped the alcohol and marijuana and will be weaning off suboxone.
Submitted:
4 Days
Category:
Nephrologist
Hello. Thank you for posting your query at DoctorSpring.com
Chronic interstitial nephritis( CIN) is a disease which has a prolonged course before detection and is progressive over several yeras to complete kidney damage.
But, Your report do not suggest that you have CIN. Your renal function are normal by all means as per the reports submitted
you need to clarify few things
1. Did you develop kidney failure during the episode of dehydration?
2. what was the creatinine that time?
3. Did you receive any special medication that time or are you on any special drug therapy since a long time?
4. did you undergo kidney biopsy ( a procedure of taking out a small piece out of kidney and checking it under microscope)
as such you dont have any kidney disease
As far as the drug addictions are concerned, its good that you have quit them or other wise they would have had severe repercussions on your health and can also cause damage to the kidneys.
Feel free to discuss further,
Regards
Dr. Sree Bhushan Raju
MD, DM (AIIMS), DNB, FISN, FICP, FIACM
My creatinine at the time of dehydration was 2.7. It dropped slowly over the next 4 days and my doctor thought that it should have dropped quicker. I hadn't had recent blood work to get a baseline. I had been on Aciphex for about 5 years. Tribenzor for about 8 months for HTN...
Hello. Thank you for the follow up.
Firstly I sincerely apologize for the late reply. I am very sorry for the delay.
That very reason why your creatinine shot up to around 2 mg/dl is that your kidneys are unhealthy. That is already demonstrated by presence of hypertension in your body. You have the tendency to get kidney damage means there is a vulnerability for you to get kidneys injured very easily however trivial may the insult. The insult can be as simple as dehydration though it may be reversible in the initial stages. Your kidney function is normal at present but there can be a gradual detriration with a slow and trivial insults to the kidneys. You need to be very careful in avoiding such an injuries/insults to the kidneys. High BP, Over weight, smoking, unnecessary drugs like antacids, pain killers, certain antibiotics , dehydration, infections, sudden cardiac problems, long standing skin dieases like psoriasis, joint disorders etc are the injuries to your kidneys. excess intake of animal protein also increases the vulnerability.
Feel free to discuss further,
Regards.
Dr. Sree Bhushan Raju
MD, DM (AIIMS), DNB, FISN, FICP, FIACM
So the fact that my creatinine dropped slowly doesn't mean I have CIN. It might just be CKD related to HTn
Hello. Thank you for the follow up.
Yes. You can get it proved once you undergo a kidney biopsy. If you are not aware and realise one day that the kidneys are small after few years, you will be labelled as the one having CIN. You be prepared and avoid any further injuries to the kidneys. Even frequent such injuries despite being reversible also can decrease the overall kidney function in the long run.
Feel free to discuss further,
Regards