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Dr. Y.
Dr. Y., Urologist
Category: Urology
Satisfied Customers: 20360
Experience:  I am fellowship trained specializing in general urology and reconstructive urology.
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My PSA is 7.92 and my creatinine is 20.0 and I am also a diabetic.

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My PSA is 7.92 and my creatinine is 20.0 and I am also a diabetic. My cholesterol is 138. I am really concerned about the creatinine and psa relationship. I read that this could be a sign of liver disease. What do I ask my doctor? Any specific tests? I have had two biopsies both came back no cancer, 8 months apart.
Submitted: 4 years ago.
Category: Urology
Expert:  Dr. Y. replied 4 years ago.

Dr. Y : Thanks for your question. If I don't respond to you immediately, it is because I am either in the OR or traveling. I WILL get back to you ASAP.
Dr. Y : The only way to creatinine would be related to your PSA is if the PSA was due to an enlarged prostate which was causing blockage to your outflow of urine. This can cause a backup of urine into your kidneys and cause kidney damage. Your doctor needs to do an ultrasound of your kidneys to make sure that this is not the case. Since your PSA is elevated, it sounds like you probably have BPH and a medication such as finasteride is likely indicated to help shrink your prostate and cut your PSA in half. Hope this helps and let me know if you have questions.
Customer: replied 4 years ago.
Prostate has been checked and is not a problem with urination. To reduce PSA number does not solve problem of high PSA. I read that perhaps liver could be implicated if it fails to metabolize PSA properly. Is there a test to see if my liver could be the cause of my increasing PSA number? What other possibilities could be the cause for a high PSA once cancer and enlarged prostate have been eliminated as the likely cause?
Expert:  Dr. Y. replied 4 years ago.
Liver problems do not cause PSA readings to become high. If there is concern for liver problems, your doctor can check a liver function panel. Besides cancer and BPH, prostatitis is the only other cause of an elevated PSA. It would be worthwhile to see if your urologist can put you on a 30 day course of antibiotics like Cipro and then repeat the PSA to see if it lowers. Hope this helps.
Customer: replied 4 years ago.

Just had a complete blood workup and urinalysis done. From the urinalysis, it said that glucose was negative, Protein was 2 (MG%), Microalbumin was 0.6 (MG/DL), MALB/Creatinine Ratio was 30.0 (MG/GMCR), Leukocyte Screen was negative, Hemoglobin Screen was negative, Creatinine was 20.0 (MG/DL), Protein/Creatinine Ratio was 0.10 (MG/MGCR), no tests were done for white or red blood cells. From the blood workup it said my BUN was 12 (MG/DL), my Creatinine was 1.0 (MG/DL), my est. GFR (MAYO) was 100(ML/MIN), my ALK. PHOS. was 54 (U/L), my Bilirubin Total was 0.9 (MG/DL), my Asparatate Aminotransferase (AST, SGOT) was21(U/L), my Alanine Aminotransferase (ALT, SGPT) was 21 (U/L), my Gamma Glutamyl Transpeptidase (GGTP) was 19 (U/L), my total protein was 7.1 (G/DL), my Albumin was 4.9 (G/DL), my Globulin was 2.2 (G/DL), my Cholesterol was 138 (MG/DL), my HDL was 51 (MG/DL), my LDL was 66 (MG/DL), my CHOL/HDL ratio was 2.7, my LDL/HDL ratio was 1.31, and my triglycerides was 101 (MG/DL). My PSA was 7.6 (Past three years was 2.5, 5.0, and 7.2). I have had two biopsies 8 months apart and both came back no cancer cells detected. My prostate does not feel enlarged, showed up on ultrasound as slightly enlarged, and does not pose a problem when I urinate. I do not wake up in the middle of the night having to urinate. With the leukocytes negative, can I still have prostatitis?

Expert:  Dr. Y. replied 4 years ago.
Without leukocytes in the urine, it would be unlikely to have prostatitis. But the definitive way to detect prostatitis is to ask your doctor to see if they saw it on the biopsies that were performed.
Customer: replied 4 years ago.
That brings me back to the reason that I chose to seek an answer from Just Answer Urology. None of the three reasons for a high PSA that you outlined are present - so what could be causing the high PSA number?
Expert:  Dr. Y. replied 4 years ago.
Those are the only three reasons that would cause an elevated PSA. It sounds like your doctor may need to either repeat evaluation for an undetected cancer with another biopsy and CT scan and a bone scan, or they may need to repeat an ultrasound of your prostate to see if the size is larger than they actually think it is.
Customer: replied 4 years ago.
I have read that eating spicy foods or having sex before a PSA test can cause an elevated PSA. If this is true, then your only three reasons for an elevated are not the only three reasons. This would indicate to me that there may be other causes that you may not be aware of or that current science does not know. You mentioned a bone scan, would bone cancer cause a high PSA?
Expert:  Dr. Y. replied 4 years ago.
Spicy foods do not cause the PSA to become elevated. Having sex right before the PSA draw can cause a slight elevation, but not to the degree that yours is elevated. If you have had this persistently elevated PSA, I highly doubt you would have had sex as the cause of this. But if you think you had sex within 3 days of your PSA draws everyone, then you should abstain from sex for at least a week before having the PSA checked again.

Bone cancer does not cause a high PSA, but prostate cancer spread to the bone can. I don't think this is your problem either. The only other cause for PSA elevation can be the use of testosterone replacement therapy. Other than this, there are no other causes of PSA elevation.
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