All other blood work looks great. Trying to make sense out of this. Wondering if it could be related to radiation injury. Only urinary symptoms are increased urgency occasionally but no retention. No hypertension or diabetes or any other comobidities. Husband has tele health appointment to discuss but I would like to hear if anyone else has experienced this.
Anyone experience increased Creatinin... - Advanced Prostate...
Anyone experience increased Creatinine and low GFR with Advanced PCa?
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Shellhale
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I have had that for years. Mine is now called stage 3 kidney disease. Fluctuates up & down all the time. Did that for 4,5 years on ADT and the last 2.5+ years off ADT.
Not sure if there is a relationship but I commenced ADT and radiation for Gleason 9 prostate cancer in 2014 and immediately my eGFR dropped from 60 to 44 and has gone down since (now 35). Creatinine went from 120 to 140 and has gone up ever since (now 153). Urologists and Radiologist deny any relationship. Kidney specialist is not overly concerned. Still on ADT. All has been steady for a few years. Apart from lack of energy there are no other issues.
Glad to hear no other issues and stable. I pulled out one of the off label drugs he was currently taking Celecoxib prescribed by integrative Dr as a COX-2 inhibitor to help with PCa. Told PA about this yesterday and she agreed this may be the culprit. It is known to cause AKI since it is a NSAID. So hopefully discontinuing this helps.
Maybe he was just eating too much meat? Repeat the test. I am surprised that they didn't ask you to repeat the test? What was the result? All these results are actually calculated.
We are thinking it may be from the Celecoxib since it is a NSAID which is known to cause AKI. So discontinued it. I am also thinking too much protein. We are repeating the test next week. But I brought it up to MO last month that I noticed a trend with GFR declining. He said it can go up and down.
Creatinine and eGFR are indications of kidney function, which can be affected by chemo, etc.
I finished chemo two months ago, (Enfortumab Verdotin), and only now are my kidney numbers heading towards normal.
Hope that helps. 😊
Yes. Thanks for your reply. He did 1 round of chemo but had to discontinue wasn't able to tolerate. Glad your Kidney functions are heading back to normal.
I've tended to have lower since being on hormone therapy (6+ years), but supplementing with creatine monohydrate seems to correct it.
Interesting. I have him on that also since it has anti-cancer properties and helps with cognition. He is on nubeqa and was wondering if that plays a role in kidney function also. Are you on ADT? Or ARI?
I've been on Lupron for 6.5 years, but have never been on an ARPI like Zytiga or Xtandi.
There's the problem! Supplementing with creatine will increase creatinine levels on a blood test, as creatine gets broken down to creatinine before being excreted. eGFR is calculated by algorithm, and the higher creatinine is factored in so it makes the glomuleral filtration rate look lower/worse.
Have him drop creatine supplementation for a couple of months, and increase his water intake during that time to flush it out of his system. Then repeat the test to see his real numbers.
I'll have to look back over the last six years. When it's reached higher end of normal and I've run out, I've stopped. Not sure it dropped that quickly. Also, my other protein readings increased into normal as well during usage.
But you've given me something to check back on.
I wondered about that. I will have him drop it. Thanks for the input.
Could you please explain in more detail how could creatine monohydrate correct the kidney function test results? I believe it would make the results worse than your real kidney function.
ChatGPT said
You're correct in thinking that creatine monohydrate could affect kidney function test results, but it's important to clarify how this happens.
Creatine itself is a naturally occurring substance in the body, mostly stored in muscles, and used for energy production during high-intensity activities. When you supplement with creatine monohydrate, it increases the amount of creatine in the body, and this can influence certain markers in kidney function tests, especially serum creatinine.
Here’s how it works:
1. Creatine and Serum Creatinine: Creatinine is a waste product generated when creatine breaks down in the muscles. The kidneys are responsible for filtering creatinine from the blood, and a blood test for serum creatinine levels is commonly used to assess kidney function. If you supplement with creatine, your muscle creatine stores increase, leading to a higher breakdown of creatine into creatinine. This results in a temporary increase in serum creatinine levels.
2. Impact on Kidney Function Test: Kidney function is often assessed using the glomerular filtration rate (GFR), which can be estimated based on serum creatinine levels, age, gender, and race. Because creatine supplementation raises serum creatinine levels, it might lead to a misleadingly lower GFR (suggesting poorer kidney function) when in fact your kidneys are functioning normally. This is why creatine can cause an overestimation of kidney dysfunction in some individuals.
3. Temporary and Non-Indicative of Kidney Damage: The increase in serum creatinine from creatine supplementation isn’t due to kidney damage but rather the increased muscle mass and creatine breakdown. In healthy individuals, creatine supplementation doesn’t cause kidney damage, but it can skew kidney function tests temporarily.
If you're concerned about kidney health and you're taking creatine, it's best to inform your healthcare provider so they can interpret the results correctly or possibly adjust the test parameters for muscle mass or other factors. If you already have preexisting kidney issues, creatine should be used with caution, and a healthcare professional should be consulted.
So, in short: creatine doesn’t "correct" kidney function test results; rather, it can cause an artificially elevated serum creatinine level, potentially masking the true kidney function if it's not taken into account.
ChatGPT said
Are you taking creatine monohydrate as a supplement?
That could all be spot on. I simply reported what happened when I took it.
If your memory is like mine than I understand.
When my estimated glomerular filtration rate was first time low my GP asked me: "did you eat meat?"
Meat is full of creatine.
I experienced this firsthand. Before my PCa days I went for a routine physical, and the bloodwork showed elevated creatinine. My GP called me back in on an urgent basis, told me about the higher numbers and wanted to refer me to a nephrologist! I told him about the creatine monohydrate supplementation I was doing at the time, and asked if we could repeat the test 4 weeks from me going cold turkey that day. He agreed, and that follow up test after 4 weeks of no supplementation showed my creatinine back in the normal range.
Note also that individuals who do intense exercise (particularly resistance training/weights) or who are generally muscular will often show creatinine at the high end of the range. This is due to creatinine being released as a result of muscle tissue breakdown & turnover.
Husband has been taking creatinine supplements 3 to 4x a week, with a fat scoop appx 8 grams. How much were you supplementing with at that time? He is retesting next week.
5g/day with a smoothie at breakfast.
Note he'll need at least a month "washout period" to clear out the higher creatine levels stored in his liver and muscle tissue. You probably won't see much of a change by next week.
Good to know. Then we will know for sure if it is the celecoxib. It will at least rule that out.
I was supplementing 2g of creatine per day. I had elevated blood pressure with higher dose. Blood pressure elevation with creatine use is probably the main reason that I am avoiding creatine now plus my medical oncologist was against it because of the fear of DHT elevation as a result of creatine use. Maybe if you are really deficient like conducting vegan lifestyle is a good reason to supplement it like 2g per day.
I suffered from this about halfway through Pluvicto treatment causing them to reduce my dose of Pluvicto. MO said it was the result of too many diuretics in my BP regimen. Another doctor said to cut back on protein. Seems minimally okay now but must watch it.
So diuretics caused your BP to be too low, from volume loss?
BP was okay but only when taking meds, two of which had diuretic properties and I guess overworking kidneys.
Do you happen to remember which meds they were? Husband gets low BP alot . I know cialis doesn't help. But since he started on HT seems to have more interactions with other drugs.
His kidney function issues are a common result of radioligand treatments such as Pluvicto or Lu-177. There are other causes. One doctor will tell him he needs more protein to help the bone marrow produce hemoglobin depleted by treatments, and the next doctor will tell him he needs to cut down on protein to protect his kidneys, so he doesn't wind up on dialysis later. He needs to see a good nephrologist to try to prevent his kidney disease from getting worse.
He hasn't done any radioligand treatments. Although it was suggested at one point. I heard it only works for 30% of patients. Is this true?
Lasix (furosemide) is the main one.
Information regarding increased Creatinine and low GFR with Advanced Prostate cancer.
A I - ChatGPT said:
Increased creatinine and low glomerular filtration rate (GFR) in a patient with advanced prostate cancer typically indicate kidney dysfunction, which can arise due to several factors, including:
Possible Causes of Kidney Dysfunction in Advanced Prostate Cancer
Urinary Tract Obstruction (Post-Renal AKI)
Prostate cancer metastases can cause ureteric obstruction, leading to hydronephrosis (swelling of the kidneys) and acute kidney injury (AKI).
This can be identified through renal ultrasound or CT scan.
Treatment options include ureteral stents or nephrostomy tubes to relieve obstruction.
Tumor Infiltration of the Kidneys (Rare but Possible)
Direct invasion of cancer into renal structures can impair kidney function.
Paraneoplastic Syndrome or Cancer-related Cachexia
Advanced cancers may cause muscle breakdown, increasing creatinine levels despite normal kidney function.
Nephrotoxic Effects of Cancer Treatment
Androgen Deprivation Therapy (ADT), chemotherapy, or immunotherapy can have kidney-related side effects.
Some medications, such as bisphosphonates (for bone metastases), can also affect renal function.
Hypercalcemia of Malignancy
Bone metastases can cause hypercalcemia, leading to kidney damage and a decline in GFR.
Chronic Kidney Disease (CKD) from Other Causes
Hypertension, diabetes, or pre-existing kidney disease can worsen due to the cancer burden.
Key Diagnostic Steps
Serum creatinine, BUN, and electrolytes to assess kidney function.
Estimated GFR (eGFR) to categorize kidney disease severity.
Urinalysis to check for proteinuria or hematuria.
Renal ultrasound or CT scan to evaluate for obstruction.
Calcium and phosphorus levels to assess for hypercalcemia-related nephropathy.
Management Strategies
If obstructive uropathy → Ureteral stent or nephrostomy placement.
Monitor and adjust medications → Avoid nephrotoxic drugs.
Correct hypercalcemia → Hydration, bisphosphonates, or denosumab.
Optimize hydration and electrolytes to prevent worsening kidney function.
Palliative care considerations if the disease is in its end-stage.
Would you like details on a specific aspect, such as treatment options, prognosis, or palliative care considerations?
Good Luck, Good Health and Good Humor.
j-o-h-n
Yep my Creatine is off too and has been for months during triplet therapy. I drink a lot of water so I'm not dehydrated. They hypothesize Androgen Deprivation Therapy (ADT), and docetaxel chemotherapy, have kidney-related side effects. But my other bloodwork and PSA look good.
I don’t have that issue. When I started ADT my gfr was high 80s. I started taking curcumin for ADT side effects and gfr went to 117 and has stayed there. Hope this helps.
How much Curcumin do you take? I am starting to cook more with it besides the supplement he takes..
I have been taking 2800mg for several years. I also take 400mg of magnesium and drink lots of water. I take 95% curcumin, not Tumeric. I advise you consult with your doctor before adding supplements. Curcumin thins the blood and lowers bp so this must be monitored. God bless.
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