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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35793
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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Recently saw nephrologist on trace proteinuria on urine

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Recently saw nephrologist to follow up on trace proteinuria on urine dipstick test x 3 mos. Neph didn't observe proteinuria but did 24 hour urine and renal function tests. All results came back WNL except one.. My 24 hr creatinine clearance came back very low - 1 ml/min. what would cause that?

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 kidneys
2) CT scan of kidneys
3) 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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Customer: replied 4 years ago.

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.

Hello Karen,

Yes, only creatinine clearance can be affected initially. Serum creatinine and blood urea (blood urea nitrogen / BUN) are affected very late as kidney has very high reserve. It is not serious; though, your nephrologist may advice further investigative work and keep you in follow up (getting creatinine clearance and protein estimation in 24 hours urine every 3-4 month).

It is privilege assisting you.

Dr. Arun
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