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Asacol and kidneys

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Posted 4/23/2014 12:03 PM (GMT 0)
Hi everybody! I'm new to this forum and I was diagnosed with pancolitis 8 months ago and put on prednisone and asacol. They worked wonders and all symptoms stopped after one week. I'm now on maintenance dose: Asacol 800mg 3 times a day.

My question regards my blood test results, I've been proactive and have taken 3 blood tests so far and the only thing I'm a little concerned about are the creatinine results, which have been

77 umol in Sep. 2013
80 umol in Jan. 2014
85 umol in Apr. 2014

I know that these results are well within range of the normal values but since it's only gone up so far it worries me a little.

Am I worrying over nothing? Do you have any suggestions about further blood test?
Posted 4/23/2014 1:45 PM (GMT 0)
Is your GI concerned? I had a similar situation this past winter where my serum creatinine levels were rising and although they were still well within the normal range, my GI was very concerned and had me go to the nephrologist. In my case, I was getting monthly blood tests because I had just started 6mp, so whereas over the years my serum creatinine levels were always 1.1-1.3 (I don't know what the umol numbers you have are), we started to see it go up to 1.4 then up to 1.6. To complicate matters, I had also been taking a creatine supplement for a couple of months which is known to raise that number (although safe).
So, the nephrologist had me stop taking mesalamine (Lialda in my case) and the creatine - he ruled our 6mp as the culprit. My next blood test showed my levels go back down, so to see what was causing the problem, I started taking creatine again and my levels went back up, then went off it and they went back down. Then I started taking the Lialda again and everything has been fine since.

But the point of my story is that my rising serum creatinine levels were of great concern to my GI and also to the nephrologist even though it was still well within the normal range. Your levels shouldn't really change much ever and a rise in the number can indicate something is stressing your kidneys, so the movement in the level is a big red flag.

Get it checked out.
Posted 4/23/2014 2:06 PM (GMT 0)
Worth consulting, not yet worth worry. I read in less than 3% of patients on Asacol that the kidneys will have decreased creatinine clearance, which is seen as higher levels in blood tests.
Posted 4/23/2014 3:37 PM (GMT 0)
Oh, umol is micro mol for short. Creatinine results are given in micro mol in Finland, where I'm from. So after converting my results to US units it would look like:

0.87 mg/dl in Sep. 2013
0.90 mg/dl in Jan. 2014
0.96 mg/dl in Apr. 2014

So, as you can see, my numbers are (still) very good. My GI was not concerned and has not mentioned this small rise in creatinine levels at all. Is it possible for creatinine levels to rise/fluctuate depending on what you've eating, state of hydration and so on? Cause, I've certainly put on a couple of kilograms after my initial flare.

But I will talk with my GI about my concerns but I'm pretty sure that he won't be too alarmed about my results. And I am trying not to be too alarmed myself to be honest since I'm trying to finish my thesis in mathematics and I don't have time to worry too much about something that may be completely normal.
Posted 4/23/2014 3:52 PM (GMT 0)
I wouldn't worry too much, but I wouldn't ignore it either. An individuals serum creatinine levels should stay fairly constant over time. A significant lifestyle change can affect the levels including diet and exercise and including weight gain/loss. But generally, your individual baseline level stays in a tight range and a move out of your normal range is of concern and should be looked into.
Posted 4/23/2014 7:32 PM (GMT 0)
Thanks for the inputs. I'll get back to you after talking to my GI!
Posted 4/24/2014 6:51 PM (GMT 0)
Have you had all other testing done related to kidney enzymes?

Are you consuming high protein?

q
Posted 4/25/2014 6:45 AM (GMT 0)
Nope, I have had other tests for liver enzymes and blood, but only serum creatinine for the kidneys. I eat quite a lot of protein but I wouldn't say any more than I used to.
Posted 4/25/2014 6:52 AM (GMT 0)
Oh, and I also had two urine test taken at the same time as the last two blood tests. Both were normal.
Posted 4/25/2014 3:31 PM (GMT 0)
https://www.kidney.org/kidneydisease/threesimpletests.cfm (you'll have to copy and paste, the link won't work for some reason).

Do you have copies of all your tests? including the urine? if not, I suggest you do. As well...do research, and request other tests.

q
Posted 4/26/2014 6:34 AM (GMT 0)
Yeah, I have copies of all my test. I'm about to move to another city after finishing my thesis, which should be some time in May. I'll see my doctor on Tuesday and ask about the creatinine and possible other test.

Thanks for your input!
Posted 4/26/2014 4:18 PM (GMT 0)
Keep us posted...hopefully, your move will go smoothly with no issues.

q
Posted 4/29/2014 5:53 AM (GMT 0)
So, I talked to my GI today and he told me that creatinine levels can fluctuate a little and since the rise in value was so little (0.09 mg/dl) I shouldn't be concerned. I'm also getting a new GI when I'm moving to another city, appr. 330km from Turku where I now live, so he told me to be proactive and keep getting blood and urine test there.

So, I think I'll wait a couple of months and take a new blood test to check my creatinine. Since, it has been "fairly" stable so far my GI doesn't think it will rise dramatically in a couple of months.
Posted 4/29/2014 6:04 PM (GMT 0)
Yes, things can go up and down, and it's good to have a plan for further testing.

I would suggest to have other kidney enzyme blood testing as well, in conjunction with the Creatinine, should it be up as it was previously.

thanks for the update!

q
Posted 4/30/2014 12:39 AM (GMT 0)
I have not noticed since going on ASACOL HD over 6 months ago, great liver and kidney numbers, in fact best labs in years and just completed 3 pages of bloodwork.

Creatinine is effected by protein intake and working out, but if yours keeps climbing then maybe the drug is not for you.
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