15 days at the VA – day 14

by rcentor on December 30, 2009

Very interesting teaching point occurred yesterday.  We have a patient with long standing diabetes mellitus and known CKD Stage III.  We admit him for increasing dyspnea – probably secondary to his COPD.  I notice that his creatinine had run around 2.5, but now was around 1.3.  These values had multiple repeats 6 months ago and currently.

So the puzzle for today – why did his creatinine improve so dramatically?

{ 4 comments… read them below or add one }

Jared December 30, 2009 at 6:29 pm

Did someone review his medications and replace a loop diuretic in the past 6 monhts?

david December 30, 2009 at 8:58 pm

I bet you are going to say it was because he lost muscle mass but that can't be it.  He was probably taken off and ACE/ARB or diuretic.

Snipergirl January 2, 2010 at 9:18 pm

He was massively fluid overloaded from an exacerbation of CCF

Snipergirl January 2, 2010 at 9:19 pm

OR- was he put on prednisolone which for some reason treated his stage III CKD, resulting in a sudden improvement of renal function???

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