Physiology or Pathology? Elevated Serum Creatinine in a Female-to-Male Transgender Patient

A 36-year-old female-to-male (FTM) transgender patient was referred to our nephrology clinic for evaluation of an elevation in serum creatinine (Scr) level. He had a history of transient ischemic attack secondary to patent foramen ovale, as well as attention deficit disorder. A review of records shows that the patient's Scr level was 0.94 mg/dL before initiation of testosterone treatment (2 years before presentation). He denied acute changes in...