Metformin And Chronic Kidney Disease
Systematic review evaluates benefits and harms of metformin use in people with diabetes and CKD.
Blake Cameron, MD, discusses his teams research on clinical outcomes of metformin use in people with chronic kidney disease and explains what health care professionals need to know about changes to the U.S. Food and Drug Administrations guidance on metformin. These changes make some people who have both diabetes and CKD eligible to take metformin, and research suggests that the medication may have benefits for this population.
Q: Why did the U.S. Food and Drug Administration add a boxed warning about metformin use in people with CKD when it approved the medication in 1994?
A: The story on metformin is really a story of guilt by association. Metformin belongs to a class of drugs called biguanides. From the 1950s to the 1970s, the leading drug in the biguanide class was phenformin. Globally, metformin was rarely used because phenformin was much more effective in lowering blood sugar. However, phenformin had a big problem: it was killing people. In 1977, phenformin was pulled from the U.S. market because it caused a fatal condition called lactic acidosis.
Q: How has the FDA changed the boxed warning about metformin use in people with CKD?
The FDAs new boxed warning indicates that metformin can be initiated in patients who have an eGFR greater than 45 mL/min, and treatment can be continued in existing patients as long as the eGFR remains above 30 mL/min.
Creatinine In Kidney Disease: When To Worry About
- Could running marathons be hard on your kidneys, or at least biomarkers that track kidney injury> this paper in AJKD seems to suggest so. Join us to discuss this intriguing data and whether it should impact on runners, on May 23 and 24th
- fights against free radicals which is the very root cause of a variety of diseases and ageing
- Creatine is safe. There is a myth out there that says creatine is bad for your kidneys. This is because testing kidney health involves testing body levels of creatine. When people loading creatine came in to get a test, technicians would see the high levels of creatinine and incorrectly think the kidneys were failing
- Blood creatinine test: Creatinine is a waste product produced by your muscles. It is entirely filtered from the blood by the kidneys and excreted in the urine. It is entirely filtered from the.
- A, B6 and C, phosphorus, iron, manganese, potassium, and calcium. When taken in excess, it can cause metals to.
Improves Strength And Endurance
A meta-analysis reveals the results of different studies, showing that taking creatine improves the weight-lifting abilities of young men who do resistance training. Creatine increases levels of phosphocreatine, which in turn increases the production of ATP energy. ATP energy is the main source of fuel for high-intensity workouts, which leads to an increase in strength and power.
One study that looked at athletes over a period of four weeks found that people had an average of 17% improvement in cycling sprints, an 18-pound increase in one rep of bench presses, and a 20% greater work load when using a lower amount of weight when taking creatine supplements. Clearly, creatine improves several aspects of both strength and endurance. The average increase is thought to be around 5%.
Recommended Reading: Whats A Kidney
Don’t Miss: Is Ibuprofen Metabolized In The Kidneys Or Liver
What Is A Good Creatinine Level
In most cases, the normal range for serum creatinine for someone with healthy kidneys is 0.9 to 1.3 mg per deciliter for adult males and 0.6 to 1.1 mg per deciliter for adult females.
However, there are a lot of variables when it comes to levels of creatinine. Normal is a somewhat subjective term. Muscle breakdown creates creatinine, so your muscle mass and activity level can influence the amount in your blood. To accurately measure blood creatinine levels, a doctor will first assess these various factors to establish a baseline, according to Taylor Graber, MD, an anesthesiologist and founder of ASAP IVs. Creatinine level assessment starts with getting a demographic baseline to assess what normal levels should be, Dr. Graber says. This depends on age, race, gender, and body size. Once these values are normalized, changes from this range can signify abnormalities of the kidney.
Healthcare providers like to keep an eye on creatinine levels for various reasons. If you had or currently have kidney disease, kidney damage, diabetes, or another illness that affects your kidneys, or are taking a medication that could affect your kidneys, your healthcare provider might order regular creatinine measurement to monitor your renal function. The most common test methods are via blood and urine.
Also Check: Osteocleanse
Creatine And Fear Mongering
While a great rule of thumb, If its too good to be true, it usually is sometimes gets misused by people trying to take down whatever appears to be great just to appear controversial.
Personally, I feel there are many valid reasons to say that creatine isnt perfect. Creatine non-response, or how some people simply do not get the claimed benefits of creatine due to how their body is, is a great example.
Varying response rates explain why some people gain easily over five or more pounds of muscle while using creatine while others are lucky to gain one pound over a year. Reliability in beneficial effects yet unreliability in magnitude isnt the best feeling to us nonresponders.
However, rather than this valid example creatine was linked to kidney damage seemingly because it had to have something wrong with it and kidney concerns are an easy go-to among worrywarts.
But claims stated without evidence can be dismissed without evidence, which makes it a bit of a predicament when a good chunk of this fear mongering came out of a misinterpretation of actual evidence.
You May Like: Ginger Good For Kidneys
What Do Abnormal Creatinine Levels Mean
So, you went to the doctor, did the tests, and the results are in: You have high creatinine levels. Now what? Step onedont panic. Elevated creatinine doesnt necessarily mean your kidneys are in a downward spiral. Anything outside the normal range may cause a healthcare provider to investigate further, but doesnt always spell danger. Numerous factors can influence your test results. Here are just a few:
- Increased exercise: Have you been on a fitness kick? In the gym every day? This spike in muscle breakdown will increase the production of creatinine.
- Increased protein consumption: Cooked meats contain creatinine, so if youre feasting on steak and roast chicken every night, you could see higher levels.
- Urinary tract blockage: If you cant urinate, your body cant eliminate creatinine, so kidney stones and other urinary disruptions will allow it to remain in your bloodstream.
- Certain medications: Sometimes, drugs can be the culprit. The antibiotic trimethoprim and Cimetidine, a stomach ulcer and heartburn medication, can inhibit creatinine secretion. Sometimes, non-steroidal anti-inflammatory drugs , such as ibuprofen, can also be a cause.
- High blood pressure:Studies have also shown that hypertension, heart failure, and other heart conditions can cause increased creatinine levels.
Likewise, low creatinine isnt always dangerous. It could be the result of low muscle mass , pregnancy, a low-protein diet, or certain liver conditions.
If I Need Pain Medicines What Can I Do To Keep My Kidneys Healthy
Kidney disease caused by pain relievers is often preventable. Here are some things you can do to help keep your kidneys healthy.
How you take these medicines makes a difference:
- Make sure you read the warning label before using any overthecounter analgesics.
- Do not use overthecounter pain relievers more than 10 days for pain or more than three days for fever. If you have pain or fever for a longer time, you should see your doctor.
- Avoid using pain medicines that contain a combination of ingredients, like aspirin, acetaminophen and caffeine mixed together in one pill.
- If you are taking pain medicines, increase the amount of fluid you drink to six to eight glasses a day.
- If you are taking pain medicines, avoid drinking alcohol.
Talking with your doctor about pain medicines can also make a difference:
- If you have kidney disease, ask your doctor before taking a pain medicine, particularly NSAIDs and higher dose aspirin.
- If you have high blood pressure or heart disease, make sure you only take NSAIDs under your doctors supervision. This is especially important if you take diuretic medications or are over 65 years of age.
- Make sure your doctor knows about all medicines you are taking, even over-the-counter medicines.
Also Check: Can Pop Cause Kidney Stones
Boosts Performance During High
A study has shown that supplementing with creatine during high-intensity interval training can help improve performance. Creatine increases the bodys production of phosphocreatine, which is an essential element in the production of energy. Phosphocreatine is also essential in improving athletic performance in exercises of different intensities at different times, such as high-intensity interval training.
In fact, researchers believe that creatine is among the most effective supplements when used for high-intensity exercise. Over 70% of studies have shown a strong positive correlation between creatine supplementation and improved performance in high-intensity exercise, while the other 30% still showed a small positive effect, meaning no negative effects have ever been discovered.
You May Like: Grapes For Kidney Stones
Common Uses For Creatine Supplements
The most common use of creatine is for boosting exercise and athletic performance. For this purpose, creatine supplementation can:
Increase muscle mass and strength
Help post-exercise recovery
Improve short-burst activity performance
Improve exercise tolerance
Creatine supplementation also helps treat some types of creatine deficiency disorders. These are disorders in which creatine is not made or transported properly in the body.
Other possible, but not proven, uses of creatine supplementation include:
Maintaining strength as we age
Protecting nerve tissues, such as those in the brain and spinal cord
Improving cognitive performance
Treating muscle diseases called myopathies
You May Like: Is Watermelon Good For Your Kidneys
Physiology And Natural Course Of Endogenous Testosterone During Lifespan
Since testosterone synthesis is partially suppressed by multiple causes linked to a failing kidney, it is possible that the normal progressive reduction in renal function with age contributes, at least in part, to this natural decline. No studies, to our knowledge, have, however, addressed this issue. The community-based PREVEND cohort suggested that risk factors such as age, BMI and plasma glucose contributed to exacerbating the male progression to ESRD to a greater extent than for comparable women . It may not be coincidence that also ageing, diabetes and increased BMI are also associated with lower testosterone levels .
Dont Miss: Cost Of Estradiol Without Insurance
How Our Body Breaks Down Creatine
1. The skeletal muscles, brain, and other muscles in our body store the creatine you take as supplements.
2. The muscles break down the ingested creatine into phosphocreatine and use it to replenish the ATP.
3. The process creates a byproduct called creatinine.
Now, the kidneys excrete creatinine as it is. And this is where all the misconception begins!
Our bodies produce creatinine in response to various events.
For instance, your creatinine levels may rise if you have more muscle mass. Or, you may have high creatinine levels if you consume more animal protein.
Most importantly, your kidneys also produce more creatinine if they are damaged or impaired.
So, high creatinine levels are a marker of kidney disease.
Doctors use blood and urine tests to determine creatinine levels for diagnosing liver or kidney diseases.
Taking these supplements in excess of what your muscles can store may increase your creatinine levels. Your body breaks down more phosphocreatine and produces more creatinine.
But increased levels of creatinine doesnt always mean kidney problems. You can have high creatinine levels for different reasons and still have healthy kidneys.
So even if creatine supplements may raise your creatinine levels, it doesnt damage the kidneys.
Read Also: Does Blue Cross Cover Testosterone
Also Check: Is Ibuprofen Metabolized In The Kidneys
Potential As Treatment For Depression
Although further research is still needed, initial reports from a study suggests that creatine can help treat depression. In this study, 52 women between the ages of 19 and 65 who had been diagnosed with major depressive disorder were randomly assigned to take either creatine or a placebo in addition to the antidepressant Lexapro.
The results of this study showed that in comparison to taking a placebo, those who took creatine in addition to their antidepressant had an improved mood as measured by the Hamilton Depression Rating Scale. These improvements were still evident after four and eight weeks following the study.
Creatine And Kidney Biomarkers
The biomarker issue, which is more relevant, pertains to creatinine as a metabolite. Note the extra -ine at the end of that word, its important.
Creatine, when metabolized in the body, will turn into creatinine.
Creatinine is whats eliminated from the body. As creatine is a vital molecule that always exists in the body then its metabolite, creatinine, will always be present in your blood as well.
Creatinine, in particular, is fairly sensitive to kidney issuesinsofar that when the kidneys are damaged then a lot more creatinine is reabsorbed into the body than rightfully eliminated. When they kidneys are damaged, blood creatinine levels tend to be increased.
This is why you have creatinine measured when you visit the doctorsits a biomarker for kidney health. Biomarkers are cheap, efficient, and seemingly reliable ways to determine problems that dont require more expensive and invasive investigation.
Each biomarker differs and has its own upsides and downsides. Creatinine is pretty reliable under most conditions for indicating kidney damage, with only one exception.
If you consume more creatine than normally expected, more of its metabolite will be produced. This causes a small elevation of blood creatinine levels that, without context, looks indicative of kidney damage at first glance.
Alas, it is a false positive.
However, rest assured, that scientifically speaking all the above are non issues.
Recommended Reading: Kidney Infection Cause Diarrhea
How To Lower Creatinine Levels
How your healthcare provider treats your abnormal creatinine levels depends entirely on the underlying cause. Changes in lifestyle and diet can be a simple and effective treatment for minor cases. But chronic kidney disease, kidney damage, or kidney failure require more robust procedures. Medications to control symptoms, dialysis, or in the most extreme cases, a kidney transplant may be necessary. Here are a few potential methods for lowering creatinine levels:
Healthconditions That Require Kidney Screenings
If you have one of thesehealth conditions, or if you or your family has a history of kidney problems,its important to have your kidneys checked once a year:
- High cholesterol.
But even if you dont haveany risk factors, a yearly check-up with blood pressure check, lab and urinetests is the only way to get a clear picture of your kidney function, says Dr.Heyka.
Don’t Miss: Matcha Kidney Stones
Who Has Low Or High Blood Creatinine Levels
- Muscular young or middle-aged adults may have more creatinine in their blood than the norm for the general population.
- Elderly persons may have less creatinine in their blood than the norm. Infants have normal levels of about 0.2 or more, depending on their muscle development.
- In people with malnutrition, severe weight loss, and long standing illnesses, the muscle mass tends to diminish over time and, therefore, their creatinine level may be lower than expected for their age.
Blood And Urinary Analyses
Blood samples were obtained from an antecubital vein, following a 12-h overnight fasting. Participants followed their normal diet consumption during the 24-h urine collection. Urine samples were stored at approximately 4°C. Both blood and urinary measurements were performed in the morning. Creatinine was determined using Jaffes kinetic method. Urinary and serum sodium and potassium were assessed by using a flame photometer . Urea was assessed by an UV-kinetic method. Albuminuria was determined by nephelometry and proteinuria was measured through the benzethonium chloride method.
All of the samples were analyzed in duplicate and the CV were 2.0, 2.2, 1.1, 2.1, 2.3, 5.3, 24.5, and 16.4% for serum creatinine, serum sodium, serum potassium, serum urea, proteinuria, albuminuria, urinary sodium, and urinary potassium, respectively.
Read Also: Is Cranberry Juice Good For Your Liver
Normal Kidney Function And The Gfr
All the blood in your body flows through your kidneys hundreds of times each day. The kidneys push the liquid part of blood through tiny filters called nephrons and then reabsorb most of the fluid back into the blood. Fluid and waste products that the kidneys don’t reabsorb are sent out of your body in your urine.
The rate of blood flow through your kidneys is the GFR. Your doctor canât measure the GFR itself, so that’s where creatinine and creatinine clearance come in.
The Role Of Testosterone In Chronic Kidney Disease And
From the perspective of clinical and public health practice, by negative I mean that in some cases testosterone replacement therapy could actually aggravateSuspecting issues with your kidneys might not be the first thing you do when you hear about low libido, testosterone can affect the kidneys in several counterintuitive ways that most men on HRT may not be aware of, Testosterone effects on kidneys, and excess fluids from the body, If youre male and living with kidney disease or you dont know your level of kidney function, That where majority of damage occurs.Testosterone is classified as an androgenic steroid hormone that is secreted primarily by the testicles in males, One is generally positive and the other generally negative, intramuscular 400 mg nandrolone decanoate and oral 40 mgTestosterone effects on kidneys Sign in to follow this , Stress can be a contributing factor as can any chronic illness.
Dont Miss: Nugenix Estro Regulator Reviews
Also Check: Is Ginger Good For Kidney