Variation in Serum Creatinine

Question
Hi,

My wife had a renal transplant about 2.5 months ago. Her creatinine was varying between 1.1 to 1.3 but after adjustments of immuno-suppressants, it was stable at 1.18-1.2. Now recently her white blood cells count has decreased and the creatinine level has gone up to 1.36. As per recent investigations, her c0 and c1 levels have also decreased a lot. Please advice as to what may be the cause for it and how can it be treated.

Thank you.


Answer
Hi James,



Thanks for your question on "Allexperts".



Low levels of immunosuppressants can trigger a rejection, resulting in an elevated serum creatinine. On the other hand, too high immunosuppression or very severe infection can result in low white cell count.



If blood levels of cyclosporine/tacrolimus are not helpful in diagnosing the condition, a biopsy of the transplanted kidney may be required.



Please discuss the situation with your wife's transplant nephrologist.



Sincerely,



Dr. Shah