Diagnosis

Creatinine

introduction

Most people only hear about creatinine after a visit to the doctor, and that is when something is wrong with the functioning of the kidneys. Creatinine is a chemical breakdown product that is excreted by the kidneys. The creatinine level is therefore an important indicator of kidney function.

What is Creatinine?

As already indicated, creatinine is a substance that is usually excreted by the kidneys. Creatinine is a breakdown product of creatine. About 1-2 percent of creatine is converted into creatinine each day and excreted from the body. In numbers, this is a relatively constant amount of 1.0-1.5g creatinine per 24 hours.

Creatinine itself has no function for the organism. When kidney function deteriorates, blood creatinine levels increase as less creatinine is excreted by the kidneys. Although creatinine plays a subordinate role in the body, it is viewed in laboratory medicine as an important indicator of impaired kidney function. Above all, the so-called creatinine clearance, with which the GFR (glomerular filtration rate) can be calculated, and urine and plasma values play an important role.

Creatinine levels

Typically, blood creatinine is measured, either in blood plasma or in serum. Depending on age, muscle mass, gender and previous illnesses, the creatinine level can vary greatly.The unit for the creatinine value is given in milligrams per deciliter mg / dl or in micromoles per liter µmol / l.

The normal values of the creatinine value for men and women are in different ranges:

Men: 0.5-1.1 mg / dl (44-97 µmol / l)
Women: 0.5-0.9 mg / dl (44-80 µmol / l)

The creatinine value is determined when the functionality of the kidneys is to be checked. People with suspected kidney damage or other kidney diseases are particularly affected. The value is also a means of therapy control for existing diseases such as diabetes, hypertension (high blood pressure) or when taking medication that can damage the kidney.

One problem with the informative value of the creatinine value, however, is that it can only be measured when the kidney function has already decreased by 50 percent, so if more serious illnesses are suspected, further parameters should be used for diagnosis.

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How are creatinine levels determined?

In order to determine the creatinine level in the urine, the 24-hour urine collection method is selected for diagnosis. This method is used when the so-called creatinine clearance is to be determined or certain substances are to be detected in the urine.

With the 24-hour urine collection, as the name suggests, all the excreted urine is collected over a period of 24 hours. It is important that the patient empties his bowels and bladder before time x.

From then on he collects the urine for 24 hours in a special container and then returns it to the laboratory for analysis. Normal values for this type of analysis are 1.0-1.3 g / day for women and 1.5-2.5 g / day for men.

Elevated creatinine levels

The creatinine levels can be increased for various reasons. The creatinine value is only of limited relevance for medical assessment. This is due to the fact that changes in the creatinine level only become visible when the filter function of the kidney has already decreased by half. The value is therefore primarily used as a control for people with known kidney damage.

The creatinine value can deviate from the already wide-ranging normal values. Since creatinine is a breakdown product of creatine, which is mainly used in muscles, athletic people with a lot of muscle mass automatically have a higher creatinine value than untrained people.

If the value of creatinine in the blood is increased, this allows conclusions to be drawn about a functional disorder of the kidneys, because normally the creatinine is almost completely excreted by it. Possible diseases of the kidney are, for example, kidney failure, kidney infections such as pelvic inflammation, etc.

Other possible causes of high creatinine levels can be pregnancy, underweight, increased muscle mass, high blood loss or muscle inflammation or other diseases such as diabetes or heart failure.

The intake of creatine to improve performance in sports and the intake of certain medications can also have an influence on the creatinine level.

Consequences of increased creatinine levels

An increased creatinine level alone does not say much about possible diseases or the cause of the increase. If the creatinine level is increased, further examinations are initiated first. This includes, for example, an ultrasound of the kidney, taking tissue samples, analyzing the patient's medical history and the current living conditions.

Since the creatinine level is an indirect indicator of the functioning of the kidneys, additional symptoms specific to the underlying disease can occur as a consequence of excessively high creatinine levels. These include, for example, kidney diseases:

fatigue
lack of concentration
frequent urination
Painful urination
a headache
fever

with heart failure:

low load capacity
nocturnal urination
general exhaustion

In diabetes, kidney damage is a common secondary disease, which is why the value should be checked regularly there. If the kidney is already damaged, other organs can also be at risk.

Due to the low informative value of looking at the creatinine level alone, it is not possible to make a precise statement about the possible consequences of increased levels. Basically, in the case of significantly increased values, a thorough investigation of the cause should be carried out in order to be able to identify or treat diseases in good time.

If, in addition to the increased creatinine level, there is also a greatly reduced GFR, life-threatening conditions can occur. Due to the increasing poisoning of the urine, those affected suffer from symptoms such as:

Vomit
diarrhea
severe abdominal pain

Pulmonary edema, brain damage or pericardial inflammation are rare but possible consequences of elevated creatinine levels.

How can you lower creatinine levels?

The lowering of the creatinine level is primarily aimed at treating the underlying disease. There is no one universal method to bring the creatinine level back into the normal range. Rather, the underlying disease needs to be treated.

In the case of a dysfunction of the kidneys, this means, for example, first of all changing the diet to a less protein-rich diet in order to improve the filtering capacity of the kidneys. In general, there are a few measures that can help reduce the creatinine level, including:

Adequate hydration, (at least 1.5-2l) to avoid staying dehydrated and to produce enough urine to flush out toxins.
Change of lifestyle. These include, for example, changing your diet or restricting physical activity to gentle sports such as yoga, Pilates or walking.
Get enough sleep to keep your metabolism in good rhythm.
Conscious use of medication. This means drugs that have a negative effect on the creatinine level (e.g. ASA, ibuprofen, and other anti-inflammatory drugs) should be omitted. However, if it is indicated by a doctor, the use of ACE inhibitors or ciclospoprin A can treat the kidney disease and therefore make sense.
Herbal teas, especially nettle tea, can help eliminate toxins more easily and flush the kidney.

In general, when lowering the creatinine values, it is important to know which cause led to the increase in the values, so that, conversely, the cause can be targeted, whereby the creatinine values automatically normalize again. To be on the safe side, you should discuss any therapy with your doctor beforehand in order to avoid risks.