Bump in the Road (Sep 26 update)

inn my earlier post I had mentioned about the issue identified on Friday when I visited the donor team in Chicago. 

Before getting into details, a brief primer on what the kidney does.

During normal activity, there is some muscle breakdown. Muscle breaks down protein called creatine which is present in blood/serum. Blood goes into kidney which filters the protein into urine. Under normal conditions creatinine levels in both blood and urine are in steady state.  Kidney patients have very high levels of creatine in blood because kidney is not able to filter (like a clogged drain pipe).  There is a test called Creatinine Clearance Test (CCT) that does the following: 

• 24 hour of collecting urine measure creatinine level in the collected sample over 24 hour period. They give you a gas can and you pee into a gas can for 24 hours (yeah disgusting). Rest assured, I worked from home that day and so co-workers you can relax....
• Measure creatinine in blood at the end of collection.  

In a normal person, the levels will be in the normal range. 

I was asked to do the CCT as my final test in Aug. I did it on Aug 30. The test results came back with 

1) ridiculously low levels of creatinine in my urine and 2) normal creatinine levels in my blood. The urine collection stopped 24 hours but the blood draw was done 6 hours later (and this bit of detail is important as you will find out). The nurse called back to find out what happened. I had run 16 miles on 80 degree day, got dehydrated. The doctors seemed to think that explained it and asked me to repeat the test. 

I repeated CCT on Sep 7. Urine and Blood showed normal levels.

When I reached Chicago, the nephrologist seemed unsure of the explanation for the tests done on Aug 30. According to him (and it seems to make sense) if creatinine levels in urine were low then they should have been high in the blood which it was not. So he came up with a plausible theory (after 25 min of spontaneous thinking aloud in front of me) that I had temporary kidney failure during the 24 hour because of my run explaining the low creatinine level in my urine. However, my kidney recovered between hour 24 and hour 30 explaining normal creatinine level in my blood at hour 30.  Of course, he said that he had never seen this kind of behavior recorded anywhere.  I am assuming that the irony of all this is not lost on you. Here I am, talking about kidney donation only to hear that the doctor thinks that I have temporary kidney failure every time I go for a long run on a sunny day.  The doctor then proceeded to think aloud what further tests we should do to validate this. 1) Repeat the entire 24 test 2) collect blood at hour 24, etc....

The entire donor team will meet Wed (Oct 2nd). They are expected to get back to me on next steps at that time