Right Nephrolithiasis 5mm with Hydronephrosis & Transaminitis

A 35 year old male presented to OPD after getting a health check up done Chief Complaints Feeling lethargic, constant mild pain over right flank, sometime dysuria and urgency of urination too History He is known Alcoholic, and drinks occasionally, recently had good amount of Alcohol during HOLI Investigations ALT/SGPT highly raised - 145 S. Cr - 1.68 ( upper limit of lab is 1.12) S. Urea is normal LDL - C - 125 Non HDL is high Management I would like to know that whether this rise in S.Cr is due to hydronephrosis ?? So far I have prescribed him citalift syp., limcee tab, levoflox 750mg OD, Urispas 200 TDS, urimax 0.4 at bedtime, Reclaim AG OD

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Stone is 5mm only if it is obstructive at PUJ or UV junction than hydronephrosis would result otherwise it is small calculus unlikely to cause rise in sr creatinine Since pt is alcoholic and liver enzymes are raised i will see these findings in corelation to CLD likely kidney injury So subject to usg and ct abdomen and treat by diuretics So far urgency and frequency is concerned like due to alcohol and cystitis or prostatitis Tab cefixime+ofloxacin 1bd Tab calcury 1tds Tab gokhsharadi goggul 1tds Varuna-d-kwath 2tsf bd Tab torsamide 10mg 1 od Tab meftalspas 1x3 times Alkalisers Hepatocellular regeneratives Tab essentiale-L Tab hepamerz

Thanx dr Pushkar ji Bhomia
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Yes possible raised creatinine Usg kub GFR Bring down ldl 55 R/0 dehydration pyelonephritis Opinion of nephrologist

Alcohol in any concentration is a diuretic.So excess alcohol would lead to dehydration and if the kidney is at risk due to any cause, elevation of creatinine is likely. However is the patient with any comprbid risk factors? The dipsomaniac binge can easily explain the lft derangemt and a compromised livercan also compromise kidneys. When one kidney ia normal it does not matter what is the status of other kidney Specially se.crearinine will not rise.

Valuable opinion
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Agree with Dr Shivraj Agarwal

Thanks Dr Pushkar Bhomia
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Should go for P C N L

Sr.Creatitine Raised in Condition of Renal & post-renal abnormalities In your case , Abnormality present in Post-Renal , lead to Hyperhidrosis so Sr.creatitine level increased 5mm renal calculi & hyperhidrosis.... Management of Renal calculi needed

S.creatinine is slightly raised may be as u thinking. Urine C/S,RE ? Continue same medications & assay LFT time to time.

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