Hello Karen, I am Dr. Arun and will be helping you today. With your history of rheumatoid arthritis the likely cause would be immune mediated nephropathy or Immunotactoid glomerulonephritis for the low creatinine clearance. Medications (if you are taking analgesics) too may be contributory or primary cause for it. The other common causes are high blood pressure, Immunoglobulin A (IgA) nephropathy etc. Usually the further protocol for the investigations are (if not done);1) ultrasound of the kidneys2) CT scan of kidneys3) kidney biopsy.Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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Thank you for your fast response. So, it's actually possible to have one of those conditions and the only abnormality be creatinine clearance? I've had an Mra, also normal, but no US, CT, etc.