Elevated ACR Levels and Next Steps
I recently received the results from my urine analysis, which indicated that my Albumin-to-Creatinine Ratio (ACR) is at an alarming 2100 mg/g. The report also shows a creatinine level of 24.4 mg/dL and an albumin concentration of 512.5 µg/mL. As a 52-year-old man dealing with ulcerative colitis, I had been using oral mesalamine for treatment. However, I stopped taking it a couple of weeks ago after experiencing swelling in my ankles and feet, which subsided in just three days. Unfortunately, the foamy urine I've been having has not improved. In addition to mesalamine, I have been using qing dai to manage my condition. Until recently, my blood pressure had consistently been within the normal range, but I've noticed a change. A few months prior, it was recorded at 138/85, while my latest reading was 155/83. The urine test results I received were from a sample taken just two days ago, which followed a week and a half after ceasing mesalamine use. What should be my course of action now? I have asked for a referral to a nephrologist, but my primary care provider advised me to first complete the albumin/creatinine ratio test. She is also recommending an ultrasound of my kidneys to check for any potential blockages. Does this approach seem appropriate? I would greatly appreciate any guidance you can offer. Thank you!
Answers (1)
3/21/2025, 8:01:03 PM
OpenHealth AI
It’s understandable to be concerned about your elevated Albumin-to-Creatinine Ratio (ACR) and recent changes in your health, especially while managing ulcerative colitis. Your ACR level of 2100 mg/g is significantly elevated, indicating a potential issue with kidney function. Here's how we can approach this situation:
Main Points:
- Elevated ACR levels often suggest kidney damage or dysfunction.
- Monitoring and further testing are essential for a comprehensive understanding of your health.
- Your primary care provider’s recommendations for additional testing are appropriate.
Explanation:
The Albumin-to-Creatinine Ratio (ACR) is a marker used to assess kidney health. An elevated level like yours, especially considering your background with ulcerative colitis and recent symptoms, is concerning. This could indicate inflammation or damage to the kidneys, which can sometimes occur in people with inflammatory bowel diseases.
Given your history of ankle swelling, change in kidney function (evidenced by ACR levels and creatinine measurements), and fluctuations in blood pressure, it's wise to investigate these symptoms further. Your primary care provider's plan to repeat the ACR test and conduct an ultrasound is a standard approach to rule out any obstructions or other renal issues.
Next Steps:
-
Complete the Recommended Tests:
- Go ahead with the follow-up ACR test as advised. This can help monitor if there is a trend toward improvement or worsening of your kidney function.
- An ultrasound of your kidneys is also critical to check for blockages or structural issues.
-
Monitor Symptoms:
- Keep track of any changes in your symptoms, including the foamy urine, blood pressure readings, and any further swelling. Documenting changes can provide valuable information for your healthcare providers.
-
Reassess Medications:
- Communicate openly with your primary care doctor or a specialist about your medication, particularly regarding mesalamine and any supplements like qing dai. It’s essential to ensure they do not interact negatively with your kidney function.
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Follow Up:
- Once your referral to a nephrologist is completed, ensure to have a follow-up appointment scheduled to discuss the results of your tests and any necessary adjustments to your treatment plan.
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Lifestyle Adjustments:
- Consider maintaining a well-balanced diet that supports kidney health, limiting salt intake, and staying well-hydrated unless otherwise directed by your healthcare provider.
Supportive Note:
It's completely normal to feel anxious about these test results and changes in your health. Remember that you are doing the right thing by seeking further evaluation and monitoring. If you have any immediate concerns or if your symptoms worsen, don't hesitate to reach out for support promptly. Take each step at a time, and know that you're not alone in navigating this.
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