When Creatinine Levels Are Increasing Rapidly
Creatinine levels can be normal or slightly abnormal for a long time and then start increasing rapidly.
The main question to answer in such a scenario is whether the damage is reversible or not? In both the situations some very critical decisions regarding treatment have to be taken. In such a situation very detailed investigation including urine and blood tests, ultrasound scanning, kidney biopsy, etc may be needed.
Dialysis may also be needed at least temporarily. Hence it is important to see a nephrologist when creatinine levels start to rise rapidly.
So, there you have it. Four situations when one has to take proper care of ones kidney health based on blood creatinine test.
Also blood creatinine levels tell more about your kidney function than ultrasound scan which may be reported as bilateral renal parenchymal disease but gives very little information about kidney function.
Some numbers :;
- 15% of Indians have chronic kidney disease. Unfortunately, a vast majority are unaware of it. The easiest way to diagnose early is to be aware of the risk factors mentioned above and test regularly.;
- 2 lakh Indians develop kidney failure requiring dialysis every year. Again, most of them are recognised too late. The above measure of periodic testing will help in recognizing the people with severe kidney failure early. They can then prepare properly for dialysis.;
How Often You Require Creatinine Test
The test is done in the following conditions;
As A Routine Check-up
Many patients undergo complete blood tests as a part of their routine check-up. These blood tests also include creatinine test. Generally, routine check-ups are done once-a-year.
Symptoms Of Kidney Disease
On physical examination and based on your symptoms, if your doctor may doubt on the functioning of your kidneys, he may recommend creatinine tests along with certain other tests.
People With High Risk
Certain patients are at high risk of developing kidney diseases. These patients are advised to undergo complete kidney function tests. These patients include patients with type 1 and type 2 diabetes and suffering from a disease that may impact kidney functions.
Monitoring Kidney Patients
To monitor the function of kidneys and to analyze the progression of kidney disease, the doctor may advise a creatinine test at regular intervals. Continuous rise in creatinine levels poses a situation when to worry about creatinine levels.
You Dont Know Your Creatinine Levels At All
This is probably the situation that worries me the most. Of course the patient hasnt done the test and hence is unaware of her creatinine values.Most likely she is not aware that there is anything wrong. So, this is a situation in which the patient is not worried but the doctor is.
;Kidney failure is asymptomatic even upto its advanced stages. So, unless one is aware of ones blood creatinine report, kidney failure may not be diagnosed till it is very advanced.
Does that mean that every healthy person needs to get the blood test for creatinine regularly?
The answer to that is NO. But there are a few well known risk factors for kidney failure. People harbouring any of them should definitely test their creatinine levels periodically.
What are these risk factors that need regular creatinine testing?
The most important ones are :
1.;;;;Diabetes: even if it has been diagnosed recently
2.;;;;High blood pressure
5.;;;;Family history of kidney failure
So anyone with with the above risk factors should definitely check her creatinine levels regularly. How frequently? Generally once a year should be enough. People with multiple risk factors or with already elevated blood creatinine will need more frequent testing.;
It has happened so many times that I have suggested creatinine testing for someone with these risk factors and absolutely no symptoms and they turned out to have high creatinine levels.;
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What Happens If You Have Kidney Disease
Kidney disease can be treated. The sooner you know you have kidney disease, the sooner you can get treatment to help delay or prevent kidney failure. Treating kidney disease may also help prevent heart disease.
Treatment goals are to:
- If you smoke, take steps to quit.
- Take medicines the way your provider tells you to.
Blood Phosphorus And Potassium
Phosphorus, a mineral component found in the blood, works in tandem with your dogs calcium to maintain strong bones. Too much phosphorus creates an imbalance of the two minerals, so the kidneys must excrete just enough phosphorus to maintain a healthy phosphorus-to-calcium ratio. A normal phosphorus level is 2.8 to 6.2. When your dogs phosphorus value exceeds this range, his bones will start to weaken. Potassium is an important mineral and electrolyte responsible for maintaining your dogs heart function and overall well being. The ideal range is 3.6 to 5.5. In early stage kidney disease, potassium levels tend to be elevated, resulting in a condition called hyperkalemia. In the advanced stage, the potassium level falls dangerously low, resulting in hypokalemia.
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Additional Tests For Kidney Disease
If blood and urine tests indicate reduced kidney function, your doctor may recommend additional tests to help identify the cause of the problem.
Methods of renal imaging include ultrasound, computed tomography , and magnetic resonance imaging . These tools are most helpful in finding unusual growths or blockages to the flow of urine.
Your doctor may want to see a tiny piece of your kidney tissue under a microscope. To obtain this tissue sample, the doctor will perform a renal biopsya hospital procedure in which the doctor inserts a needle through your skin and into the kidney. The needle retrieves a strand of tissue about 1/2 to 3/4 of an inch long. For the procedure, you will lie on your stomach on a table and receive local anesthetic to numb the skin. The sample tissue will help the doctor identify the cause and severity of your kidney disease.
Why The Test Is Performed
Creatinine is a chemical waste product of creatine. Creatine is a chemical made by the body and is used to supply energy mainly to muscles.
This test is done to see how well your kidneys work. Creatinine is removed from the body entirely by the kidneys. If kidney function is not normal, the creatinine level in your blood will increase. This is because less creatinine is excreted through your urine.
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What Happens During A Creatinine Test
Creatinine can be tested in blood or urine.
For a creatinine blood test:
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a creatinine urine test:
Your health care provider will ask you to collect all urine during a 24-hour period. Your health care provider or a laboratory professional will give you a container to collect your urine and instructions on how to collect and store your samples. A 24-hour urine sample test generally includes the following steps:
- Empty your bladder in the morning and flush that urine away. Record the time.
- For the next 24 hours, save all your urine passed in the container provided.
- Store your urine container in the refrigerator or a cooler with ice.
- Return the sample container to your health provider’s office or the laboratory as instructed.
Can The Creatinine Clearance Test Be Wrong
The creatinine clearance test is generally a reliable test. Creatinine clearance is only an estimate of GFR, and in some cases can provide a result that is higher than what your GFR really is. In addition, there are a few reasons that the results could be wrong. These include:
- If you didnt collect all urine samples as directed.
- If the math formula used to figure out your creatinine clearance isnt done correctly.
Last reviewed by a Cleveland Clinic medical professional on 10/16/2020.
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Chronic Kidney Disease Treatment
Research shows that management of CKD is best done by nephrologists, specialists in treatment of kidney diseases. The first step in the treatment of CKD is to determine the cause. Some reversible causes of renal disease include impaired blood flow to both kidneys, blockage of urinary tract and the use of medications that can impair kidney function. It is important to treat hypertension since elevated blood pressure leads to further renal damage. A lot of patients with CKD have anemia. Some of them might require iron supplementation and Erythropoetin injection to increase production of the red blood cells. Patients with kidney disease might have elevated phosphorus levels and need to reduce phosphorus in their diet to lower the phosphorus blood level. Low potassium diet might be needed since CKD patients might develop high blood potassium level. Low salt diet might be needed to better control blood pressure. Dietary protein restriction is generally not advised as risk of low protein diet might outweigh benefits.
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What Is Creatinine And Creatinine Clearance
Creatinine is a waste product that your body constantly makes during normal muscle breakdown. Your kidneys filter creatinine from the blood into the urine and reabsorb almost none of it.
The amount of blood the kidneys can make creatinine-free each minute is called the creatinine clearance. Creatinine clearance in a healthy young person is about 95 milliliters per minute for women and 120 mL per minute for men. This means each minute, that person’s kidneys clear 95 to 120 mL of blood free of creatinine. The GFR can vary depending on age, sex, and size. Generally, the creatinine clearance is a good estimation of the glomerular filtration rate.
What Is The Creatinine Clearance Test
The creatinine clearance test is an older test used to check your kidney function. This test allows your healthcare provider to look at samples of your urine and blood to see how much of the waste product creatinine is filtered out by your kidneys. Abnormal levels of creatinine in your urine and blood could point to an issue like kidney disease.
Done in two parts, the creatinine clearance test involves collecting your urine over a 24-hour period of time and then having your blood drawn. These samples are then tested to see how much creatinine was filtered through your kidneys over the 24-hour window. The results of the test will be used in a mathematic formula that figures out your creatinine clearance. Creatinine clearance is one way to estimate your glomerular filtration rate , or how well the kidneys are filtering your blood. The GFR is the main number used by your provider to determine how well your kidneys are working.
The creatinine clearance test is not used very often any more. It has largely been replaced by the estimated GFR equations using creatinine levels in the blood which means a 24-hour urine collection is not needed.
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Why Creatinine Tests Are Done
Doctors use creatinine and creatinine clearance tests to check how well your kidneys work. This is called renal function. Testing the rate of creatinine clearance shows the kidneys’ ability to filter the blood. As renal function gets worse, creatinine clearance also goes down. Your doctor may also order a creatinine test if you have symptoms of kidney disease, including:
Changes in how much you pee
Swollen feet and ankles
What Level Of Creatinine Indicates Kidney Failure And When To Worry About Creatinine Levels
The normal creatine level is different in males and females. In the female, the normal level of creatinine is 0.6 to 1.1 mg/dl while in male, the level of 0.8 to 1.3 mg/dl is considered normal. The creatinine levels are also affected by race. In non-Hispanic blacks, males have 1.25mg/dl while the female has 1.01 mg/dl as average creatinine level and in non-Hispanic whites, the average level of serum creatinine is 1.16 mg/dl in male and 0.97 mg/dl in the female. The level of creatinine above 2.0 mg/dl in infants and above 5.0 mg/dl in adults indicates severe kidney problems. Now that you are clear with when to worry about creatinine levels.
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Chronic Kidney Disease: Detection And Evaluation
TODD GEHR, MD, Virginia Commonwealth University School of Medicine, Richmond, Virginia
Am Fam Physician.;2011;Nov;15;84:1138-1148.
Chronic kidney disease affects an estimated 27 million adults in the United States, and is associated with significantly increased risk of cardiovascular disease and stroke. Patients should be assessed annually to determine whether they are at increased risk of developing chronic kidney disease based on clinical and sociodemographic factors. Diabetes mellitus, hypertension, and older age are the primary risk factors that warrant screening. Other risk factors include cardiovascular disease, family history of chronic kidney disease, and ethnic and racial minority status. Serum creatinine levels can be used to estimate the glomerular filtration rate, and spot urine testing can detect proteinuria. After the diagnosis of chronic kidney disease is made, staging based on estimated glomerular filtration rate determines prognosis, evaluation, and management. Further evaluation should focus on the specific type of kidney disease and on identifying complications related to the disease stage. Patients should be assessed for risk factors leading to the further loss of kidney function and cardiovascular disease. Patients with estimated glomerular filtration rates less than 30 mL per minute per 1.73 m2, significant proteinuria, or rapid loss of kidney function should be referred to a nephrologist for further evaluation and management.
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.
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When Is The Creatinine Clearance Test Done
The creatinine clearance test is done when your healthcare provider thinks that the eGFR result given with your blood creatinine level may not be accurate. Examples includes when people have very little or a lot of muscle on their bodies. However, there are ways to check this, such as with the eGFR result using cystatin C, another blood test. As a result, creatinine clearance is rarely used in modern practice.
Increased Consumption Of Protein
What a person eats can have a significant impact on creatinine levels. For example, proteins and cooked meat contain creatinine, so eating more than the recommended amount of meat or other proteins for your activity levels, or adding extra protein to the diet through supplements can cause high creatinine levels.
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Reasons For High Creatinine Levels
Weve said that high creatinine levels in your blood is a common indication of kidney damage. However, there are exceptions. Your nephrologists organize these based on three possible causes: pre-renal, renal, and post-renal. This means before the kidneys, in the kidneys, and after the kidneys.Creatinine may temporarily increase due to certain conditions. These need to be considered when creatinine test results are being analyzed. Otherwise, it may lead to an inaccurate estimate of kidney function.Here are some factors that may cause high creatinine levels:
Test Results And Stages Of Ckd
Your;test results can be used to determine how damaged your kidneys are, known as the stage of CKD.
This can help your doctor decide the best treatment for you and how often you should have tests to monitor your condition.
Your eGFR results is given as a stage from 1 of 5:
- stage 1 ;a normal;eGFR above 90ml/min, but other tests have detected signs of kidney damage
- stage;2 ; ;a slightly reduced;eGFR of 60 to 89ml/min,;with other signs of kidney damage
- stage;3a ;an eGFR;of 45 to 59ml/min
- stage 3b; ;an eGFR;of 30 to 44ml/min
- stage;4; ;an eGFR of 15 to 29ml/min
- stage;5 ;an eGFR below 15ml/min, meaning the;kidneys have lost almost all of their function
Your ACR result is given as a stage from 1 to 3:
- A1 ;an ACR of less than 3mg/mmol
- A2 ;an ACR of 3 to 30mg/mmol
- A3;;an ACR of more than 30mg/mmol
For both eGFR and ACR,;a;higher;stage indicates more severe kidney disease.
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Understanding Your Lab Values
People who develop chronic kidney disease may have some or all of the following tests and measurements. If you have kidney disease ask your doctor which tests you will have and how often they will be done. Speak to your doctor about your results. If your numbers are not in the normal range, ask how to improve them.
Serum Creatinine: Creatinine is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function slows down, the creatinine level rises. Your doctor should use the results of your serum creatinine test to calculate your GFR.
Glomerular Filtration Rate : Your GFR tells how much kidney function you have. It may be estimated from your blood level of creatinine. If your GFR falls below 30 you will need to see a kidney disease specialist . A GFR below 15 indicates that you need to start a treatment for kidney failure. Your kidney disease specialist will speak to you about treatments for kidney failure, such as dialysis or kidney transplant.
Blood Urea Nitrogen : Urea nitrogen is a normal waste product in your blood that comes from the breakdown of protein from the foods you eat and from your body metabolism. It is normally removed from your blood by your kidneys, but when kidney function slows down, the BUN level rises. BUN can also rise if you eat more protein, and it can fall if you eat less protein.
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