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Dr. Gupta
Dr. Gupta, Pediatrician
Category: Pediatrics
Satisfied Customers: 7845
Experience:  MD, practicing Pediatrician with 19 years of experience. Member American Academy of Pediatrics.
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Hi my son 3.5years .he had UTI infection 2.5 years ago when

Customer Question

Hi my son 3.5years .he had UTI infection 2.5 years ago when he was 1 year. he had reflux grade 3-4.he had only one infection(uti) and also fountd the left kidney function was 27% and the right one was 73%.after a year from the UTI infection ,i repeated the nuclear medicine test and the result was showing the same result as left kidney function 27% and the right 73% similar when he had the infection. physician said kidneys will stay like this and he will be ok.currently my son's health is well ,but last week i did blood test and urine test.urine test was showing ok,but blood test was showing the creatinine level a lit bit high(45). i am concern a bout his kidneys ,my Qs is this happened relate to his past? but his right one was taking the load and was 73%,or my be his right kidney's function going in decreasing but he has no broken new infection.i jus wanna know right now his level creatinine is normal or a bnormal ,becaus Gp said a bit high than normal,because normal level is 35.also i need to know if this result of creatinine a abnormal ,in this case relate to his kidneys
Submitted: 2 years ago.
Category: Pediatrics
Expert:  Dr. Gupta replied 2 years ago.

PediatricMD :

Hello & welcome to Just Answer!

If you have any questions after reading my answer, be sure to let me know.

PediatricMD :

I assume that you are referring to the blood urea levels when you are talking about the figure of 45

PediatricMD :

Normal levels of creatinine in the blood are approximately 0.6 to 1.2 milligrams (mg) per deciliter (dL)

PediatricMD :

Are you there ?

JACUSTOMER-fb4r8j82- :

hi

JACUSTOMER-fb4r8j82- :

i need to know his level normal or no

PediatricMD :

I believe that the level that you have stated is not of creatinine but of Blood urea

PediatricMD :

Normal levels of creatinine in the blood are approximately 0.6 to 1.2 milligrams (mg) per deciliter (dL)

PediatricMD :

Do you have the blood creatinine levels value too ?

JACUSTOMER-fb4r8j82- :

Gp told me the creatinine level is 45 and the normal should be 35,also tolad the urea in blood is ok

PediatricMD :

Ok

PediatricMD :

I believe that this is an error, since the blood urea levels are generally within 15-35 or up to 40

JACUSTOMER-fb4r8j82- :

what do mean by OK please?

PediatricMD :

and the serum creatinine is 0.6 to 1.2 approximately

PediatricMD :

The blood levels are certainly higher than normal for his age

PediatricMD :

and indicate possibly some degree of kidney dysfunction

PediatricMD :

So yes your GP is correct in being concerned about the levels,

PediatricMD :

these need to be followed up and if they are not rising, then this is not something that needs to be actively intervened

PediatricMD :

I hope that helps?

PediatricMD :

What else do you want to know?

JACUSTOMER-fb4r8j82- :

so what that mean ?i cant understand is the level normal or abnormal and also whats a bout his kidnes the right and left

PediatricMD :

The level is abnormal

PediatricMD :

it indicates kidney damage

PediatricMD :

The damage has occurred in the left kidney, which is causing the blood levels to rise

JACUSTOMER-fb4r8j82- :

which kidney is damage

PediatricMD :

This will not lead to any problems, unless the child suffers further repeated infections

PediatricMD :

Is there anything else that you would like to know ?

PediatricMD :

Are you still there?

JACUSTOMER-fb4r8j82- :

but ha had no boken new infection ,only he had one 2.5 years a go after fellowing up every thing showing ok,but i did test last week to do double check and Gp told me the level slightly up,i need to knoe is his kidnes function will go worst ?

PediatricMD :

No,

PediatricMD :

it will not go worse if there are no further infections,

PediatricMD :

but given that the levels are abnormally high, he will need to follow up every 3-6 monthly and repeat tests would be needed

PediatricMD :

to confirm the same

PediatricMD :

Is there anything else I can assist you with ?

JACUSTOMER-fb4r8j82- :

please i am very worry .but why the creatinine level showing slightly up,is because his left kidny function was showing 27% and the right one was showing 73%,but that 2.5 years.and the specialist was checking him every 6months and he told me he is ok.but the test last week was showing slightly high tlevel creatinine

PediatricMD :

I understand your concern, being a parent myself, and having seen many similar children and counseled their parents

PediatricMD :

As far as the child is concerned, there will be no long term ill-effects if he does not have recurrent UTI

PediatricMD :

the damage has already been done during the earlier episode(s) of UTI

JACUSTOMER-fb4r8j82- :

what do you mean if the test is showing the same in next 3 months?

PediatricMD :

what I mean is that the tests need to be repeated after 3-6 months, and it is very likely that the results will be similar to what they are now.

PediatricMD :

and if this is the case, there is no reason to be worried

PediatricMD :

as the child grows, if there are no further infections,

PediatricMD :

many of these kids will get back to normal test results, and there will be no impact on their long term health

JACUSTOMER-fb4r8j82- :

but usauly if the blood showing slight high ,means there will be infctions,but there was no infection

JACUSTOMER-fb4r8j82- :

please can i get ur phon number i need to call u now

JACUSTOMER-fb4r8j82- :

please doctor i need to call u now instead writing

PediatricMD :

Unfortunately, the website JustAnswer prohibits us from sharing personal information

PediatricMD :

I understand your concern though ...

PediatricMD :

The elevate blood levels do not indicate an infection

PediatricMD :

at the present point of time

PediatricMD :

they indicate that at some point in the past, there was an infection (s) that lead to kidney damage (left side)

PediatricMD :

which is causing the elevated blood leves

PediatricMD :

Once the child grows, the kidneys may 'heal'

PediatricMD :

and the levels will go down

PediatricMD :

This does NOT mean any acute infection or medical issues at the present point of time

PediatricMD :

Is that clear?

JACUSTOMER-fb4r8j82- :

ok ,i need to know ,what will be happen to his both kidneys when he grow up,is the right one with 73% will stay same function and the left one with 27% will stay the same function?pleases ,i need to know

PediatricMD :

Ok,

PediatricMD :

Let me explain that in slightly more detail

PediatricMD :

the test that you have done - the scan ....

PediatricMD :

has a total of 100 %

PediatricMD :

which means that if left kidney is at 27 % then the rt kidney would automatically become 73 %

PediatricMD :

So the total has to be 100 %

JACUSTOMER-fb4r8j82- :

correct the GFR was 100 in nuclear scan

PediatricMD :

As your son grows

PediatricMD :

:) you seem to be settling a bit now

PediatricMD :

Ok

PediatricMD :

As your son grows,

PediatricMD :

his left kidney will 'heal' and the blood levels are likely to go down to normal

PediatricMD :

and your son will not likely suffer any problems related to the same

PediatricMD :

assuming that he does not get further 'insults' to the kidney

PediatricMD :

specifically repeated UTIs

PediatricMD :

Is the clear?

PediatricMD :

is this clear?

JACUSTOMER-fb4r8j82- :

but i am concern now ,if the right kidney decreasing in function now or in the future,because the blood showing slightly up,may be the right giong unwell

PediatricMD :

No,

PediatricMD :

There appears to be no problem with the right kideny

PediatricMD :

the normal report is actually 50 % function for EACH kidney

PediatricMD :

So if say you got tested,

PediatricMD :

your result would be 50 % function left kidney, and 50 % function rt kidney

PediatricMD :

which would be normal

PediatricMD :

Is that clear?

JACUSTOMER-fb4r8j82- :

oh yeas this clear to me now?do i need to repeat the nuclear test to check his kidneys function?

PediatricMD :

Yes,

PediatricMD :

but that would be decided with the consulting doctor's advice

PediatricMD :

generally the protocol is to do the scan 6 monthly to 1 yearly

PediatricMD :

Even if there is no change, this is a good thing....

PediatricMD :

Is there anything else ?

JACUSTOMER-fb4r8j82- :

sorry i need to aske a nother Qs,my son is not eating well and not drinking water,only like to drink so dring a lot and eat chips alote and some time has bad constipation.is this relate to his kinyes

PediatricMD :

:)

PediatricMD :

No problem

PediatricMD :

he needs to drink a lot of water to avoid constipation

PediatricMD :

BUT this is NOT related to the kidneys

PediatricMD :

There will be NO symptoms related to the kidney disease at the present point of time

JACUSTOMER-fb4r8j82- :

ok.last qs.in a future if there is no broken new infection,his both kidnys will stay like this and my son be a well,also the left will came back to normal function?

PediatricMD :

Alright

PediatricMD :

The kidney function may remain exactly the same or may get better over a period of time

PediatricMD :

one cannot be sure since it varies

PediatricMD :

in each individual

PediatricMD :

but this will NOT impact his health in any discernible way

JACUSTOMER-fb4r8j82- :

ah ,thanx,but why t he creatinine showing a bit high?is because when he done the test ,my son nearly fasting ,he didnt drink and he didnt eat .

PediatricMD :

Yes, that can certainly impact the blood test result

PediatricMD :

it needs to be repeated, but i believe there is no medical urgency to repeat it soon, it can be done after 3-6 months ...

PediatricMD :

If YOU are unable to sleep because of this :) then you may want to get it repeated earlier

PediatricMD :

but I would advise waiting at the present point of time ....

PediatricMD :

I am sorry but I need to go now, I would encourage you to leave a positive feedback if you are satisfied, and leave any message/ questions which I can answer later once I log back in ......

PediatricMD :

A tip would be great too :)

JACUSTOMER-fb4r8j82- :

today he had blood test a gain,and also he had only half bottle of chock let drink before the test.the test was done in 3pm

PediatricMD :

Ok

PediatricMD :

That sounds good

PediatricMD :

keep him hydrated before the test, and see how it goes ....

PediatricMD :

give him some water, juice electrolyte containing drinks , any fluid that he likes

PediatricMD :

before the next test

PediatricMD :

Got to go now,

JACUSTOMER-fb4r8j82- :

thank you very much for you help.i need to be in touch with you in future ,how can i do that?

PediatricMD :

You can continue on this thread

PediatricMD :

or ask a new question specifically asking for Dr Gupta- Pediatrician

PediatricMD :

or write to the moderators at this website and they would forward your request

PediatricMD :

Do leave a feedback,

PediatricMD :

by

PediatricMD :

bye

JACUSTOMER-fb4r8j82- :

please i need ur private number ,and i will pay u each consultation,i just need u for fellow up with my son

JACUSTOMER-fb4r8j82- : do you mean when the rt kidney taking the lt kidney load and the even the result showing 100%,still the creatinine is showing up inthe blood?is that what u mean?
JACUSTOMER-fb4r8j82- :

i just i need to know that creatinine level in blood is high,is because the left kidney 's damage with 27% in the past affect that level ,and even the rt kidney is working over load and 73% with the ratio 100%.still a abnormal level of creatinine in the blood will show.

JACUSTOMER-fb4r8j82- :

please if cant get back to me for the answers,please send me an email with answers on this email XXX@XXXXXX.XXX

JACUSTOMER-fb4r8j82- :

please i waiting ur reply

Dr. Gupta, Pediatrician
Category: Pediatrics
Satisfied Customers: 7845
Experience: MD, practicing Pediatrician with 19 years of experience. Member American Academy of Pediatrics.
Dr. Gupta and other Pediatrics Specialists are ready to help you
Expert:  Dr. Yogindra Vasavada replied 2 years ago.
Hello,
normal creatinine level is mentioned in either mg per 100 cc blood or micro mol per liter of blood. The figure you mention is the latter unit of blood test.
Normal range is (age 2 wk to 5 yr) 0.4 mg/dL [35.4mcmol/L] and the range of normal is 0.2 to 0.5mg/dL [17.7 to 44.2 mcmol/L]
So your son's result of 45 is upper normal range.
The differential of two sides as seen on nuclear scan indicates difference in sizes and hence the filtering capacities. This would be important only when he gets problem with one or the other kidney if at all - since the better functioning kidney (right) is more critical.
A past severe infection could have scarred one kidney more resulting in the difference but such difference can also be genetic and since birth.
Please get his urine to plasma ratio of creatinine, urea tested next time as also urine osmolarity, KFI (kidney failure index, calculated as urine sodium divided by the ratio of urine creatinine to serum creatinine).
These are better indicators of renal health.
Customer: replied 2 years ago.
oh thanx ,every thing you said was correct with my son.i will follow your advice
Customer: replied 2 years ago.
oh thanx ,every thing you said was correct with my son.i will follow your advice.so do you mean his creatinine level was relating to his left kidney because the function was only 27%,but if yes ,what a bout his rt kidney its working well and over load 73%,in this case should be no abnormal of creatinine is showing on the blood?please if you can ,i need more explinations
Expert:  Dr. Yogindra Vasavada replied 2 years ago.

Hello,

Blood level is result of both kidneys working together, and there can not be reflection of one kidney under performing on the blood levels.

If the total function falls below 40 %, there would be rise in creatinine. You must be aware that persons can donate one full kidney to those having total bilateral kidney failure and function fully well without suffering and when one kidney totally stops functioning or has cancer, the patient can survive on one healthy kidney when that diseased kidney is removed.

He can be considered to have problem, if his Cr level rises much above 45 for prolonged time and other tests (like KFI) are also abnormal.

Customer: replied 2 years ago.
if blood level rely on bothkidneys,why then the creatinine rais in the blood,my son got 45.should be no rais,because the his total function=100%,because his rt kidney work with73%and left 27%,so the total=100%.in this case there should be no rais level in blood.please if u dont mind i need reply
Expert:  Dr. Yogindra Vasavada replied 2 years ago.
Creatinine is a product of protein breakdown. If his diet somehow has excess of protein over the required amount for growth etc, his system will have more creatinine to remove. Please try restricting meat and other high protein products (like health drinks, pulses and legumes, cheese etc) for couple of months. In fact he should be fine being a vegetarian.
Customer: replied 2 years ago.
do u mean to be
vegeterain for ever or just for coupl months.also ,i
need say som thing ,





when my son did blood test,he was almost fasting and dehydrate and had nothing when he did the test.may be a reason why that level was high.any i reated the test agian to day and waiting for result.please i need common

Expert:  Dr. Yogindra Vasavada replied 2 years ago.
Being hungry few hours does not change creatinine level because food intake does not materially change level in few hours (as does for glucose level in diabetes). Being on low protein diet will take 2-3 weeks to show effect. He may try this a couple of months with occasional meat dish allowed to see effect on level. Changes in creatinine level take days and not hours so result should be re-checked less frequently. Apart from nuclear scan, simple ultrasound also shows kidney structure better and is harmless to be repeated frequently
(You have rated previous expert's service positive but you may again rate my replies positively so that I may be reimbursed)

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