Symptoms, Signs, Stages & Diet

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Sources:

National Institute of Diabetes and Digestive and Kidney Diseases. Your Kidneys and How They Work.
<https://www.niddk.nih.gov/health-information/health-topics/Anatomy/kidneys-how-they-work/Pages/anatomy.aspx>

NIH: The Kidneys and How They Work
<http://kidney.niddk.nih.gov/Kudiseases/pubs/yourkidneys/#kidneys>

National Kidney Foundation. 10 Signs You May Have Kidney Disease.
<https://www.kidney.org/news/ekidney/august14/10_Signs_You_May_Have_Kidney_Disease>

National Institute of Diabetes and Digestive and Kidney Disease. Kidney Failure: Choosing a Treatment That’s Right for You.
<https://www.niddk.nih.gov/health-information/health-topics/kidney-disease/kidney-failure-choosing-a-treatment-thats-right-for-you/Pages/facts.aspx>

The Renal Association. CKD Stages.
<http://www.renal.org/information-resources/the-uk-eckd-guide/ckd-stages>

NIH. Eat Right to Feel Right on Hemodialysis.
<http://kidney.niddk.nih.gov/Kudiseases/pubs/eatright/>

NIH: Acute Kidney Failure
<http://www.nlm.nih.gov/medlineplus/ency/article/000501.htm>

NIH: Kidney Disease of Diabetes
<http://kidney.niddk.nih.gov/Kudiseases/pubs/eatright/>

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Creatinine tests – Mayo Clinic

Overview

A creatinine test is a measure of how well your kidneys are performing their job of filtering waste from your blood.

Creatinine is a chemical compound left over from energy-producing processes in your muscles. Healthy kidneys filter creatinine out of the blood. Creatinine exits your body as a waste product in urine.

A measurement of creatinine in your blood or urine provides clues to help your doctor determine how well the kidneys are working.

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Why it’s done

Your doctor or other health care provider may order a creatinine test for the following reasons:

• To make a diagnosis if you have signs or symptoms of kidney disease
• To screen for kidney disease if you have diabetes, high blood pressure or other conditions that increase the risk of kidney disease
• To monitor kidney disease treatment or progression
• To monitor for side effects of drugs that may include kidney damage or altered kidney function
• To monitor the function of a transplanted kidney

How you prepare

A standard blood test is used to measure creatinine levels in your blood (serum creatinine). Your doctor may ask you not to eat (fast) overnight before the test.

For a creatinine urine test, you may need to collect urine over 24 hours in containers provided by the clinic.

For either test, you may need to avoid eating meat for a certain period before the test. If you take a creatine supplement, you’ll likely need to stop use.

What you can expect

For a serum creatinine test, a member of your health care team takes a blood sample by inserting a needle into a vein in your arm.

For a urine test, you’ll need to provide a single sample in the clinic or collect samples at home over 24 hours and return them to the clinic.

Results

Results from creatinine in blood or urine are measured and interpreted in many ways, including the following:

Serum creatinine level

Creatinine usually enters your bloodstream and is filtered from the bloodstream at a generally constant rate. The amount of creatinine in your blood should be relatively stable. An increased level of creatinine may be a sign of poor kidney function.

Serum creatinine is reported as milligrams of creatinine to a deciliter of blood (mg/dL) or micromoles of creatinine to a liter of blood (micromoles/L). The typical range for serum creatinine is:

• For adult men, 0.74 to 1.35 mg/dL (65.4 to 119.3 micromoles/L)
• For adult women, 0.59 to 1.04 mg/dL (52.2 to 91.9 micromoles/L)

Glomerular filtration rate (GFR)

The measure of serum creatinine may also be used to estimate how quickly the kidneys filter blood (glomerular filtration rate). Because of variability in serum creatinine from one person to another, the GFR may provide a more accurate reading on kidney function.

The formula for calculating GFR takes into account the serum creatinine count and other factors, such as age and sex. A GFR score below 60 suggests kidney disease. The range of scores below 60 may be used to monitor treatment and disease progression.

Creatinine clearance

Creatinine clearance is a measure of how well the kidneys filter creatinine out of the bloodstream for excretion in urine.

Creatinine clearance is usually determined from a measurement of creatinine in a 24-hour urine sample and from a serum sample taken during the same time period. However, shorter time periods for urine samples may be used. Accurate timing and collection of the urine sample is important.

Creatinine clearance is reported as milliliters of creatinine per minute per body surface area (mL/min/BSA). The typical range for men, 19 to 75 years old, is 77 to 160 mL/min/BSA.

The typical range, by age, for creatinine clearance in women is as follows:

• 18 to 29 years: 78 to 161 mL/min/BSA
• 30 to 39 years: 72 to 154 mL/min/BSA
• 40 to 49 years: 67 to 146 mL/min/BSA
• 50 to 59 years: 62 to 139 mL/min/BSA
• 60 to 72 years: 56- to 131 mL/min/BSA

Standard measures have not been determined for older adults.

Results lower than the typical range for your age group may be a sign of poor kidney function or conditions that affect blood flow to your kidneys.

Albumin/creatinine ratio

Another interpretation of urine creatinine count is called the albumin/creatinine ratio. Albumin is a protein in blood. Healthy kidneys generally don’t filter it out of the blood, so there should be little to no albumin found in the urine.

Albumin/creatinine ratio describes how much albumin is in a urine sample relative to how much creatinine there is. The results are reported as the number of milligrams (mg) of albumin for every gram (g) of creatinine. Results indicating a healthy kidney are:

• For adult men, less than 17 mg/g
• For adult women, less than 25 mg/g

A higher than typical result may be a sign of kidney disease. In particular, the result may indicate a complication of diabetes called diabetic nephropathy, or diabetic kidney disease.

Your doctor or other health care provider will discuss the results of a creatinine test with you and help you understand what the information means for a diagnosis or treatment plan.

Feb. 25, 2021

Test, Range & Symptoms of High Creatinine

Overview

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 (GFR), 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 (eGFR) equations using creatinine levels in the blood — which means a 24-hour urine collection is not needed.

What is creatinine?

Creatinine is actually a waste product of creatine. Creatine is a chemical that your body uses to supply your muscles with energy. As you muscles use energy the tissue that makes up your muscles breaks down. This natural breakdown of muscle tissue causes creatinine to be released into your bloodstream. This is when creatine becomes creatinine.

Normally, creatinine is filtered out of your blood by your kidneys. If you think of each organ in your body as having a job, the kidneys are the filters. They’re responsible for cleaning your blood. The material that’s removed from your blood leaves your body in your urine. If your kidneys aren’t working properly, than you may have higher levels of creatinine in your blood than you should.

Why do I need to have the creatinine clearance test?

Anyone can be at risk for a kidney disease at some point in their life. However, some people have a higher risk of developing a kidney problem than others. These risks can include:

• Age (you could be at a higher risk after age 60).
• Diabetes.
• High blood pressure (hypertension).
• Family history of kidney disorders.
• Heritage (there’s a higher risk for people of an African-American, Asian, Native American or Pacific Islander background).

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.

Are there any symptoms associated with a high creatinine level?

Kidney disease tends to be silent and, for many people, there are no symptoms in the early stages. However, as the disease progresses, you may experience a few symptoms. These can include:

• Swelling.
• Fatigue (feeling tired).
• Changes in how often you urinate.
• Loss of appetite.
• Nausea.
• Itching.

Why is the creatinine clearance test done?

The creatinine clearance test is to confirm the level of kidney function reported with the eGFR level. Your healthcare provider will want to know how well your kidneys are working. The results of this test can lead to a diagnosis of kidney disease.

Test Details

Is the creatinine clearance test done at home?

Part of the creatinine clearance test is done at home and the other part in a lab. You will collect your urine over a 24-hour period of time at home. During this time, you can still participate in your normal daily activities. You just need to stick to a schedule for collecting your urine samples and make sure not to miss any collections (do not flush any urine).

The second part of the test involves having your blood drawn. This will need to be done at a lab, healthcare facility or your provider’s office. Your provider will give you directions on where to go to for the blood test when you pick up your test materials. Often, you will drop off your urine collection when you go to get your blood drawn.

What do I need to do to prepare for the creatinine clearance test?

Before the creatinine clearance test, your healthcare provider will give you specific instructions. During the creatinine clearance test you will need to collect your urine for 24 hours and then your blood will be drawn.

Your provider will provide the container you will need to collect your urine sample and will tell you how to store it over the 24-hour period when you’re collecting it. It’s important to follow the instructions your provider gives you. Make sure you collect urine throughout the test. If you skip a few times or don’t follow the instructions, you may need to repeat the test.

You may also be asked to stop taking some medications. This will be done with your provider’s direct supervision. Some medications could affect the test’s accuracy, and so you might need to temporarily stop taking them. These medications could include:

• Antibiotics (Bactrim).
• Stomach acid pills (such as famotidine).

Make sure to let your provider know about any medication you are taking and make sure there is a complete list of all medications you are taking in your medical record. Never stop any medication without first talking to your healthcare provider.

Do I need to fast (not eat) before the creatinine clearance test?

In general, you can eat normally before and during the creatinine clearance test. However, you may be asked not to eat overnight. Your provider may also ask you not to eat meat before the test. This could change the results because there’s higher levels of creatine in meat, which would cause your body to have higher levels of creatinine during the test.

What happens during the creatinine clearance test?

You will do the creatinine clearance test over 24 hours. During this time, you will collect your urine each time you urinate. This will give your healthcare provider a good idea of your creatinine levels throughout the entire day.

Make sure to follow the directions from your healthcare provider closely. These instructions will include details about how to store your urine sample and where you will take it when the test is over.

After 24 hours of collecting your urine, you will need to have your blood drawn. This second part of the test looks at the amount of creatinine in your bloodstream. This is called serum creatinine. Your results from both of these tests will be plugged into a mathematic formula that determines your creatinine clearance. This rate tells your provider just how well your kidneys are filtering waste products out of your bloodstream.

What happens if I forget to collect one urine sample during collection?

It’s very important to collect urine samples throughout the entire day for the creatinine clearance test to be accurate. If you skip one urine collection, it could affect the test results. Call your healthcare provider’s office if you miss a collection to see if you should continue the test or stop and start over the next day.

Will I feel any pain during the creatinine clearance test?

The creatinine clearance test is generally painless. The first part of the test involves normal urination over a 24-hour period of time. You might experience some discomfort from the needle when you have your blood drawn. This is a necessary part of the test and happens quickly. Some people describe having their blood drawn as a stinging feeling. It’s possible to feel some throbbing or have a slight bruise after having your blood drawn. However, all of this discomfort goes away quickly.

Results and Follow-Up

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 didn’t collect all urine samples as directed.
• If the math formula used to figure out your creatinine clearance isn’t done correctly.

Blood test, normal range, and how to lower levels

You’re on mile two of your afternoon run, or powering through a third set on the bench, or biking uphill on your daily commute. You’re breathing fast, and your muscles are on fire. Sweat drips off your chin. Heat flushes your cheeks. And when you’re done, nothing feels better than a warm shower, a cold glass of water, and a seat on the couch.

Like most people, you’re acutely aware of how physical activity makes your body feel—the breathing, sweat, and heat. You might even thrive on it. But there’s a whole lot more going on under the surface. When your muscles break down during exercise, they slowly build back up, increasing muscle mass, but this process also releases waste products into your blood, primarily creatinine. 

While it might be the last thing you think about while you’re timing your miles or hitting a one-rep max, your blood creatinine levels can be a key indicator of your renal health and kidney function. 

What is creatinine?

Everyone has certain serum creatinine levels in their bloodstream. Creatinine is a natural byproduct of muscle use, caused by the breakdown of a chemical called creatine. Creatinine itself doesn’t have a specific physiological function—it’s just a waste product. It simply stays in the blood until reaching the kidneys, where it’s filtered and eliminated through urination.  

So, how does your body generate creatinine? It starts with creatine, which is synthesized in the kidneys, pancreas, and liver, then transported via blood flow and stored in your skeletal muscles. During exertion, your muscles convert creatine to energy, which assists in muscle contraction. After serving its purpose, creatine becomes creatinine and re-enters the bloodstream en route to the kidneys. 

Even though creatinine doesn’t actively benefit (or harm) your body, the amount of creatinine in your blood can be measured to evaluate your kidney health. For this reason, physicians will often use a creatinine test—along with other lab tests, like a blood urea nitrogen (BUN) test—to monitor for chronic kidney disease (CKD) or renal failure.

What is a good creatinine level?

In most cases, the normal range for serum creatinine (found in the blood) 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. 

Blood tests

Creatinine that comes from your blood is called serum creatinine, and it can be measured by administering a routine blood test. “When kidney function becomes impaired, less creatinine is able to be cleared, which results in a higher level of creatinine in the blood,” Dr. Graber explains. “While this test does not directly tell you how well the kidney is functioning, it can be followed over time for changes.” Healthcare providers can use this creatinine blood test (along with factors like age, sex, race, etc.) to calculate your glomerular filtration rate (GFR), which is vital in diagnosing kidney failure or chronic kidney disease. 

​Urine tests

The other most common way to test creatinine levels is through a 24-hour urine collection. Why 24 hours? Exercise, diet, and hydration can all affect creatinine, so your levels could fluctuate throughout the day. Therefore, your healthcare provider will need multiple urine samples to evaluate your creatinine clearance effectively. As you might imagine, this test involves collecting all of your urine over 24 hours, then delivering it to your healthcare provider. Based on the results, your healthcare provider can determine how well your kidneys are filtering creatinine into the urinary tract. 

Healthcare providers will order both tests to get a comprehensive look at your kidney function by comparing your estimated GFR (eGFR) with the amount of urine creatinine present. If your doctor suspects kidney disease or damage, he or she may also order a blood urea nitrogen (BUN) test to confirm their diagnosis. This test measures the amount of urea nitrogen—another type of waste filtered by the kidneys—in a blood sample.

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 one—don’t panic. Elevated creatinine doesn’t necessarily mean your kidneys are in a downward spiral. Anything outside the normal range (0. 9 to 1.3 mg per deciliter for adult males and 0.6 to 1.1 mg per deciliter for adult females) may cause a healthcare provider to investigate further, but doesn’t 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 you’re feasting on steak and roast chicken every night, you could see higher levels. 
• Urinary tract blockage: If you can’t urinate, your body can’t 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 (find trimethoprim coupons | trimethoprim details) and Cimetidine (find Cimetidine coupons | Cimetidine details), a stomach ulcer and heartburn medication, can inhibit creatinine secretion. Sometimes, non-steroidal anti-inflammatory drugs (NSAIDs), 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 isn’t always dangerous. It could be the result of low muscle mass (or a muscle disease like muscular dystrophy), pregnancy, a low-protein diet, or certain liver conditions. 

Can creatinine levels change quickly?

Creatinine levels can change rapidly, even throughout the day, which is why healthcare providers monitor them for an extended period of time. One blood test that returns high creatinine in blood could be a fluke. However, several tests in a row that show elevated levels could indicate chronic kidney disease. A sudden spike in creatinine levels could be a warning sign for acute kidney damage or other conditions, depending on symptoms. 

What is the connection between cancer and creatinine levels?

Abnormal creatinine levels could also indicate kidney or prostate cancer. Although, high or low creatinine on its own doesn’t necessarily mean you have cancer.

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:

What to do

• Stay hydrated
• Reduce protein intake
• Reduce vigorous activity (but don’t cut out exercise altogether!)
• Get more fiber in your diet (specifically from fruits and vegetables)

What to avoid

Natural remedies

Medications

There are no medications that specifically reduce the amount of creatinine in your blood. If a doctor determines kidney disease is causing abnormal creatinine levels, he or she might prescribe medication to alleviate symptoms. Prescription drugs include:

• Angiotensin-converting enzyme (ACE) inhibitors like Lotensin (benazepril) and Capoten (captopril) to lower high blood pressure.
• Angiotensin II Receptor Blockers (ARBs) like Edarbi (azilsartan) and Teveten (eprosartan) also treat high blood pressure and can reduce the amount of protein in your urine.
• Erythropoiesis-stimulating agents (ESAs) to help increase your red blood cell count.
• Phosphate or potassium binders to help eliminate extra phosphate and potassium that your kidneys can’t filter.

RELATED: Lotensin details | Captopril details

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In the end, the best medical advice for optimizing kidney function is living a consistently healthy lifestyle. Dr. Graber says: “Minimizing unhealthy foods high in processed ingredients, increasing fruit and vegetable intake, regular exercise (150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week), staying hydrated, and maintaining body weight in a healthy range (body mass index of 20 to 25) are things to focus on over time to make sure you are giving the body the tools it needs to be successful.”

What to Expect with a Kidney Disease Diagnosis

Since you can have kidney disease without any symptoms, your doctor may first detect the condition through routine blood and urine tests.

The National Kidney Foundation recommends 3 simple tests to screen for kidney disease:

1. Blood pressure measurement
2. Spot check for protein or albumin in the urine (proteinuria) 
3. Calculation of glomerular filtration rate (GFR) based on a serum creatinine measurement

Measuring urea nitrogen in the blood provides additional information.

Blood Pressure Measurement

High blood pressure can lead to kidney disease. It can also be a sign that your kidneys are already impaired. The only way to know whether your blood pressure is high is to have a health professional measure it with a blood pressure cuff.

The result is expressed as two numbers. The top number, which is called the systolic pressure, represents the pressure when your heart is beating. The bottom number, which is called the diastolic pressure, shows the pressure when your heart is resting between beats. Your blood pressure is considered normal if it stays below 120/80 (expressed as “120 over 80”).

The National Heart, Lung, and Blood Institute (NHLBI) recommends that people with kidney disease use whatever therapy is necessary, including lifestyle changes and medicines, to keep their blood pressure below 130/80.

Microalbuminuria and Proteinuria

Healthy kidneys take wastes out of the blood but leave protein. Impaired kidneys may fail to separate a blood protein called albumin from the wastes. At first, only small amounts of albumin may leak into the urine, a condition known as microalbuminuria, a sign of deteriorating kidney function.

As kidney function worsens, the amount of albumin and other proteins in the urine increases, and the condition is called proteinuria. Your doctor may test for protein using a dipstick in a small sample of your urine taken in the doctor’s office. The color of the dipstick indicates the presence or absence of proteinuria.

A more sensitive test for protein or albumin in the urine involves laboratory measurement and calculation of the protein-to-creatinine or albumin-to-creatinine ratio. This test should be used to detect kidney disease in people at high risk, especially those with diabetes.

If your first laboratory test shows high levels of protein, another test should be done 1 to 2 weeks later. If the second test also shows high levels of protein, you have persistent proteinuria and should have additional tests to evaluate your kidney function.

Glomerular Filtration Rate (GFR) Based on Creatinine Measurement

GFR is a calculation of how efficiently the kidneys are filtering wastes from the blood. A traditional GFR calculation requires an injection into the bloodstream of a substance that is later measured in a 24-hour urine collection. Recently, scientists found they could calculate GFR without an injection or urine collection. The new calculation requires only a measurement of the creatinine in a blood sample.

Creatinine is a waste product in the blood created by the normal breakdown of muscle cells during activity. Healthy kidneys take creatinine out of the blood and put it into the urine to leave the body. When kidneys are not working well, creatinine builds up in the blood.

In the lab, your blood will be tested to see how many milligrams of creatinine are in one deciliter of blood (mg/dL). Creatinine levels in the blood can vary, and each laboratory has its own normal range, usually 0.6 to 1. 2 mg/dL. If your creatinine level is only slightly above this range, you probably will not feel sick, but the elevation is a sign that your kidneys are not working at full strength.

One formula for estimating kidney function equates a creatinine level of 1.7 mg/dL for most men and 1.4 mg/dL for most women to 50 percent of normal kidney function. But because creatinine values are so variable and can be affected by diet, a GFR calculation is more accurate for determining whether a person has reduced kidney function.

The new GFR calculation uses the patient’s creatinine measurement along with weight, age, and values assigned for sex and race. Some medical laboratories may make the GFR calculation when a creatinine value is measured and include it on their lab report.

Blood Urea Nitrogen (BUN)

Blood carries protein to cells throughout the body. After the cells use the protein, the remaining waste product is returned to the blood as urea, a compound that contains nitrogen. Healthy kidneys take urea out of the blood and put it in the urine. If your kidneys are not working well, the urea will stay in the blood.

A deciliter of normal blood contains 7 to 20 milligrams of urea. If your BUN is more than 20 mg/dL, your kidneys may not be working at full strength. Other possible causes of an elevated BUN include dehydration and heart failure.

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:

Renal Imaging

Methods of renal imaging (taking pictures of the kidneys) include ultrasound, computed tomography (CT scan), and magnetic resonance imaging (MRI). These tools are most helpful in finding unusual growths or blockages to the flow of urine.

Renal Biopsy

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 biopsy — a hospital procedure in which the doctor inserts a needle through your skin into the back of 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 problems at the cellular level.

The above information is from the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health of the U.S. Department of Health and Human Services. Publications produced by the Clearinghouse are carefully reviewed by both NIDDK scientists and outside experts.

Creatinine Stages and Risks at Each Stage

Creatinine is a metabolic waste product produced by the metabolic activity of the body muscles. Creatinine is the determining factor to detect whether the kidneys are a function or not. The kidney functions to eliminate most of the creatinine out of the body via urine. When the kidneys are working well they efficiently excrete creatinine but high creatinine levels in the blood show chronic kidney disease (CKD).

CKD is a kidney disease that gradually shows its symptoms and is classified into 5 stages according to the severity of kidney failure (the ability to eliminate waste from the body). The kidney function is measured by Glomerular Filtration Rate (GFR). A mathematical formula involving the age, gender, race, and serum creatinine levels is used to calculate GFR. Blood tests are thus ordered to detect the stages of CKD.

Five Stages Of CKD And GFR For Each Stage

• Stage 1 with normal or high GFR (GFR > 90 mL/min)
• Stage 2 Mild CKD (GFR = 60-89 mL/min)
• Stage 3A Moderate CKD (GFR = 45-59 mL/min)
• Stage 3B Moderate CKD (GFR = 30-44 mL/min)
• Stage 4 Severe CKD (GFR = 15-29 mL/min)
• Stage 5 End Stage CKD (GFR

Creatinine Normal Range

The normal levels of creatinine in the blood are 0. 6 to 1.2 milligrams (mg) per deciliter (dL) in adult males and 0.5 to 1.1 mg/dL in adult females. You can find the level of creatinine in the blood high at times.

High Creatinine Levels

A very high creatinine level may require kidney transplantation or dialysis treatment.

Different symptoms of kidney dysfunction associated with high serum creatinine levels include fatigue, feeling dehydrated, edema, nausea, vomiting, confusion, dry skin, and neuropathy.

Low Creatinine Levels

Having low levels of blood creatinine levels is uncommon but it can occur due to conditions causing muscle loss. There is nothing much to worry about lower levels of blood creatinine.

Kidney health is an important factor that should be taken into consideration while performing master health checkup or opting for complete body checkup package. Serum creatinine levels play an important role in the detection of the stages of CKD. So get in touch with our Indus Health Plus experts and learn more about the health checkup packages that include creatinine tests.

Kidney health is an important factor that should be taken into consideration while performing master health checkup or opting for complete body checkup package. Serum creatinine levels play an important role in the detection of the stages of CKD. So get in touch with our Indus Health Plus experts and learn more about the health checkup packages that include creatinine tests.

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High Creatinine Symptoms | Causes of High Creatinine Level

The chemical waste created by the metabolic activities of body muscles is known as creatine. Creatine is a significant chemical molecule that helps in the production of energy for the muscles. It is the main source of creatinine in our body. About 2% of the body’s creatine is converted into creatinine every day and is transported to the kidneys for disposal. The kidneys function to eliminate most of the creatinine via urine.

Normal levels of creatinine in the blood are 0.6 to 1.2 milligrams (mg) per deciliter (dL) in adult males and 0.5 to 1.1 mg/dL in adult females. You can find the level of creatinine in the blood high at times.

Let’s look at the causes and symptoms cause high creatinine in blood below:

Causes of High Creatinine Level

Kidneys are the most important organs for eliminating waste from our body. They filter all chemical by-products carried by the blood and excrete it from our body through urine. If the normal kidney function is interrupted or impaired by any disease or condition, then you may find a rise in the level of creatinine. Here’s the list of what causes the creatinine levels to go up.

• Various supplements, medications, and foods can temporarily raise the levels of creatinine in the blood
• Consuming large amounts of proteins and red meat
• Doing strenuous or heavy exercises
• Kidney impairment and infections

Certain diseases also affect the kidneys resulting in high creatinine levels:

• Gout
• Diabetes
• Abnormal muscle breakdown due to rhabdomyolysis or muscular dystrophy.
• High blood pressure
• Urinary tract infections
• Autoimmune disorders, such as lupus
• Goodpasture syndrome
• Blood loss caused by shock

High Creatinine Symptoms

The disturbing symptoms of high creatinine in blood include:

• Swelling or edema
• Shortness of breath
• Nausea and vomiting
• Changes in urination
• Dehydration
• Muscle cramps and chest pains
• Fatigue
• High blood pressure
• Confusion

Looking at the alarming causes and symptoms of high creatinine levels in blood it becomes obligatory for us to go for a master health checkup package at least twice annually. The temporary elevation of creatinine can be due to the intake of various medications, large amounts of proteins or red meat, large amounts of physical activities or dehydration but the condition can be more serious if there is kidney impairment involved as the underlying cause of high creatinine levels. Thus check with your Indus Health Plus health care provider and get your kidney diagnosed periodically if you have high blood creatinine levels. You may also opt for a full body checkup package to lead a healthier life.

Kidneys are the most important organs for eliminating waste from our body. They filter all chemical by-products carried by the blood and excrete it from our body through urine. If the normal kidney function is interrupted or impaired by any disease or condition, then you may find a rise in the level of creatinine. Here’s the list of what causes the creatinine levels to go up.

Are you looking to modify your lifestyle and habits to improve the quality of your life? Answer simple questions related to your Immunity, Fitness, Nutrition, Health and Habits check your health assessment. View More

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Guidelines for Patients with Chronic Kidney Disease

This patient guide is based on the 2017 Estonian treatment guide “Prevention and Management of Patients with Chronic Kidney Disease” and the topics discussed therein together with recommendations. The recommendations of the patient guide were compiled from the analysis of the scientific literature based on the principles of evidence-based medicine. In this patient guide, you will find the recommendations that are most important from the patient’s point of view.The patient manual was compiled in cooperation with nephrologists and takes into account the capabilities of the Estonian health care system. The clarity of the text of the patient guide and the importance of the topics described was appreciated by the patients, and feedback from them helped to complement this guide.

The Patient Guide is intended for people with chronic kidney disease and their loved ones. The patient guide explains the nature of the disease and its possible causes, diagnosis, treatments and possible complications.The guide also tries to answer questions about nutrition and daily lifestyle.

Chronic kidney disease is a slow-onset disease and does not cause especially many complaints in the patient in the initial stages. Chronic kidney disease includes a variety of kidney diseases in which kidney function declines over several years or decades. If you are diagnosed with chronic kidney disease, it may happen that changes in your lifestyle and diet need to be made to keep your kidney function at the proper level.There is so much you can do yourself to help the treatment.

Usually a person has two kidneys, which are shaped like beans and adjoin the posterior abdominal wall under the ribs. Both kidneys are the size of a clenched male fist.

Healthy kidneys:

• are engaged in the removal of metabolic end products and excess fluid from the body
• helps keep blood pressure under control
• help produce red blood cells
• helps keep bones healthy

HEALTHY KIDNEYS

Imagine that your kidneys are a coffee filter. When making coffee, the filter retains the coffee powder, but at the same time allows the liquid to move through it.

The kidneys do something similar – they retain and leave the necessary substances in the body, but at the same time they filter out unnecessary substances from the body. The metabolic waste products that are filtered out by the kidneys are released into the body during the breakdown processes associated with food, drink, medication, and normal muscle function.

Each kidney contains about a million small filters called glomeruli. Primary urine is formed in the glomeruli, which flows through small tubules, where part of the fluid is absorbed back.The functional unit of the kidney is the nephron – a specific structure consisting of a glomerulus and a tubular system. Nephrons remove residual substances and excess fluid from the blood in the form of urine into the renal pelvis, then urine is transferred into the ureters, and then into the bladder.

In the case of chronic kidney disease, renal function deteriorates – the kidneys are no longer able to sufficiently filter residues and purify the blood. The ability of the kidneys to filter is assessed on the basis of a special indicator – the glomerular filtration rate (GFR).

Chronic kidney disease is a slow-onset disease and does not cause especially many complaints in the patient in the initial stages. Chronic kidney disease includes a variety of kidney diseases in which kidney function declines over several years or decades. With early diagnosis and treatment, it is possible to slow or even halt the progression of kidney disease.

In the course of international studies of renal function in many people, it was found that almost one in ten had a violation of the kidney function to one degree or another.

What Causes Chronic Kidney Disease?

The three most common causes of chronic kidney disease are diabetes, high blood pressure and glomerulonephritis.

• Diabetes – In the case of this disease, various organs are damaged, including the kidneys and heart, as well as blood vessels, nerves and eyes. With long-term diabetic kidney damage, many patients have high blood pressure and should be treated accordingly.
• High blood pressure (hypertension, primary arterial hypertension) – during hypertension, blood pressure cannot be controlled and it begins to exceed the normal range (more than 140/90 mm Hg). If this condition persists, it can cause chronic kidney disease, brain stroke, or myocardial infarction.
• Glomerulonephritis is a disease resulting from a malfunction of the immune system, during which the filtration function of the kidneys disrupts immune inflammation.The disease can affect only the kidneys, but can spread to the entire body (vasculitis, lupus nephritis). Glomerulonephritis is often accompanied by high blood pressure.

Many other conditions can cause chronic kidney disease, for example:

• hereditary diseases – such as polycystic kidney disease, due to which, over the years, a large number of cysts appear in the kidneys, which damage the functioning renal tissue and therefore develop renal failure. Other hereditary kidney diseases are much less common (Alport syndrome, Fabry disease, etc.)
• Problems caused by obstructions in the kidneys and urinary tract – such as congenital malformation of the ureter, kidney stones, tumors or enlargement of the prostate gland in men
• Recurrent urinary tract infections or pyelonephritis.

Can everyone get chronic kidney disease?

Chronic kidney disease can develop at any age.People who have one or more of the following risk factors are at greatest risk of getting sick:

• diabetes
• high blood pressure
• family members previously had kidney disease
• over 50 years old
• Long-term use of drugs that can damage the kidneys
• overweight or obese

What are the symptoms of chronic kidney disease?

If chronic kidney disease progresses, the level of metabolic end products in the blood rises. This, in turn, causes poor health. Various health problems can occur, such as high blood pressure, anemia (anemia), bone disease, premature calcification of the cardiovascular system, and changes in the color, composition and volume of urine (see Complications of Chronic Kidney Disease ).

With the progression of the disease, the main symptoms may be:

• weakness, feeling of exhaustion
• shortness of breath
• sleep problems
• no appetite
• dry skin, itchy skin
• muscle cramps, especially at night
• swelling in the legs
• swelling around the eyes, especially in the morning

Stages of Chronic Kidney Disease Severity

There are five severity stages of chronic kidney disease (see table).table 1). The stage of the severity of kidney damage depends on the glomerular filtration rate (GFR), by which renal function is assessed. Further treatment depends on the severity stage of chronic kidney disease.

Table 1. Stages of severity of kidney disease

To diagnose kidney disease, there are two simple tests that your family doctor may prescribe for you.

Blood test: glomerular filtration rate (GFR) and serum creatinine level. Creatinine is one of those end products of protein metabolism, the level of which in the blood depends on age, sex, muscle mass, diet, physical activity, on what foods were taken before the sample (for example, a lot of meat products were eaten), and some medications.Creatinine is excreted from the body through the kidneys, and if the kidneys slow down, then the level of creatinine in the blood plasma increases. Determining the level of creatinine alone is not enough to diagnose chronic kidney disease, since its value begins to exceed the upper limit of the norm only when GFR has decreased by half. GFR is calculated using a four-parameter formula that takes into account the creatinine reading, age, gender, and race of the patient. GFR measures the level of the kidney’s filtration capacity.In the case of chronic kidney disease, a GFR score of indicates the stage of kidney disease severity (see Table 1).

Urinalysis : The albumin content in the urine is determined, in addition, the relationship between the albumin and creatinine values ​​in the urine is determined. Albumin is a protein in the urine that is usually found in minimal amounts in the urine. Even a small increase in urinary albumin levels in some people can be an early sign of onset kidney disease, especially in those with diabetes and high blood pressure.In the case of normal renal function, albumin in the urine should be no more than 3 mg / mmol (or 30 mg / g). If the release of albumin increases even more, then this already speaks of kidney disease. If the excretion of albumin exceeds 300 mg / g, then other proteins are excreted in the urine and this condition is called proteinuria.

If, after receiving the results of the urine analysis, the doctor suspects that there is a kidney disease, then an additional urine analysis for albumin is performed. If albuminuria or proteinuria is re-detected within three months, then this indicates chronic kidney disease.

Additional examinations

Y Ultrasound examination of the kidneys: for the diagnosis of chronic kidney disease is the first choice examination.Ultrasound examination allows you to evaluate the shape of the kidneys, their size, location, as well as determine possible changes in kidney tissue and / or other abnormalities that may interfere with the normal functioning of the kidneys. An ultrasound examination of the kidneys does not require special training and does not pose any risks to the patient.

If necessary and if a urological disease is suspected, an ultrasound examination of the urinary tract (as well as an analysis of residual urine) can be prescribed, for men an ultrasound examination of the prostate gland can also be prescribed and referred to a urologist for consultation.If necessary and if a gynecological disease is suspected, the woman is referred for consultation to a gynecologist.

What you need to know about a contrast test if you have chronic kidney disease?

Diagnostic examinations such as magnetic resonance imaging, computed tomography and angiography are used to diagnose and treat various diseases and injuries. In many cases, intravenous and intra-arterial contrast agents (containing iodine or gadolinium) are used to show the organs or blood vessels being examined.

What is especially important to do before conducting an examination with a contact with plant matter?

If you have been assigned an examination with a contrast agent, then you need to determine your GFR .

Together with your doctor, you can discuss and evaluate the benefits or harms to your health. If the examination is nevertheless necessary, observe the following preparation rules:

• Drink plenty of fluids (water, tea, etc.) the day before the examination and the day after the examination.). If you are being treated in a hospital, the required amount of fluid will be injected through a vein through a vein. When in hospital, after a contrast test (within 48-96 hours), a blood creatinine test is usually prescribed to assess renal function. Your family doctor will be able to assess your renal function in an outpatient contrast examination.
• Talk with your healthcare provider about what medications should not be taken before the contrast test.Some drugs (antibiotics, drugs for high blood pressure, etc.), together with contrast agents, begin to act as poison. The day before and the day after the examination, in no case should you take metformin, a medicine for diabetes.
• Between two examinations with a contrast medium, at the first opportunity, leave enough time so that the contrast medium that was used during the first examination has time to leave the body. It is important to exclude repeated examinations with a large volume of contrast medium.

How does contrast agent work on the kidneys?

Sometimes the contrast medium can damage the kidneys. The greatest risk is kidney damage in people with chronic kidney disease. There are two rare but very serious conditions that can arise from the administration of contrast media: nephropathy and nephrogenic systemic fibrosis.

What is contrast medium nephropathy?

Contrast nephropathy is rare and may occur in about 6% of patients.The risk of getting sick is especially high in diabetics, as well as in people with chronic kidney disease.

In the case of contrast-mediated nephropathy, there is a sharp decrease in renal function within 48-72 hours after the examination. In most cases, this condition goes away and the person recovers, but in rare cases, serious problems can occur both in the kidneys and in the cardiovascular system.

What is nephrogenic systemic fibrosis?

Systemic nephrogenic fibrosis is a very rare but serious condition that affects the skin and other organs.Nephrogenic systemic fibrosis is present in some patients with advanced chronic kidney disease (4%) who underwent magnetic resonance imaging with contrast medium including gadolinium. The disease can develop over a period of 24 hours to 3 months, starting on the day of exposure with a contrast agent that includes gadolinium.

This disease is very rare and in people with mild renal impairment or normal renal function, the occurrence of nephrogenic systemic fibrosis has not been observed.

Treatment options for chronic kidney disease depend on the stage of kidney disease, comorbidities and other health problems.

Treatment may include:

• Treatment of high blood pressure
• Diabetes care
• In case of excess weight – weight reduction.
• Lifestyle changes: eating a healthy diet, reducing the amount of salt consumed, getting enough physical activity, quitting smoking, limiting alcohol consumption (see How can you help the treatment yourself? ).
• Dialysis treatment and kidney transplant in case of chronic kidney disease in the latter stages of development (stage 5).
• Psychological counseling and support.

Treatment of high blood pressure for chronic kidney disease

What is blood pressure?

Blood pressure is the pressure that is created by the blood flowing in the blood vessels against the walls of the blood vessels.The unit of measurement for blood pressure is millimeter mercury (abbreviated as mmHg) and blood pressure is defined by two numbers – systolic and diastolic blood pressure – for example, 130/80 mmHg. Art. Systolic pressure, or upper pressure value, means the level of blood pressure at the moment when the heart ejects blood from the chamber, i.e. when the heart is compressed.

Diastolic pressure, or lower pressure value, means the level of blood pressure at the moment when the heart is in a moment of relaxation.

High blood pressure (hypertension) is a common disease and often the person himself does not know that his blood pressure is higher than normal. With the progression of the disease, the main symptoms may be:

• headache
• rapid heart rate
• fatigue
• imbalance

Untreated high blood pressure can cause kidney damage, heart disease, stroke, or eye disease.High blood pressure can damage the renal arteries and reduce kidney function. Kidneys with damaged arteries can no longer remove waste products or excess fluid from the body. Due to the excess fluid, the pressure begins to rise even more.

It is important to keep blood pressure within the normal range. Regardless of age, blood pressure should not exceed 140/90 mm Hg.

If you have chronic kidney disease and additional risk factors are present (eg albuminuria, diabetes, cardiovascular diseases), then the blood pressure should be kept at 130/80 mm Hg.st ..

The best way to measure your blood pressure and keep it under control is to measure your blood pressure yourself at home (and at the pharmacy) with a blood pressure monitor.

Discuss your treatment plan with your healthcare provider. If necessary, the doctor will refer you to a cardiologist or ophthalmologist for a follow-up examination. In addition to taking pills and controlling blood pressure, a healthy lifestyle plays an important role in treatment. How can you help the treatment yourself? ).

Diabetes care for chronic kidney disease

What is diabetes?

Diabetes is a chronic disease in which blood sugar levels rise above normal levels. There are also metabolic disorders of carbohydrates, fats and proteins. Normally, in a healthy person, the pancreas secretes enough insulin to balance blood sugar levels.In the case of diabetes, the secretion of insulin from the pancreas is impaired and too little or no insulin is released. Therefore, blood sugar levels begin to rise. This condition begins to disrupt muscles and many other organs, including the kidneys, heart, blood vessels, nerves, and eyes.

Type I diabetes

It usually begins in childhood and occurs when the body cannot produce the required amount of insulin.Insulin therapy is always used to keep blood sugar under control.

Type II diabetes

May form slowly and initially without symptoms. The reasons for the development of type II diabetes are predominantly heredity (the presence of the disease in close relatives), overweight, metabolic syndrome (high blood pressure, obesity in the lumbar region, high blood pressure), as well as pregnancy diabetes.If a person has type II diabetes, their body still produces insulin, but their levels are very low or cannot be used in the correct way.

In the case of type II diabetes, it is sometimes possible to keep blood sugar levels under control through proper nutrition / diet or physical activity, but usually treatment with pills and / or insulin is still necessary.

Keeping blood sugar levels under control is essential to prevent kidney damage and / or slow the progression of disease.According to the results of many surveys, the best glycated hemoglobin (HbA1c) value in people with diabetes was 53 mmol / mol or less than 7%.

The blood level in the blood can be measured independently using a glucometer. This way you can measure your own blood sugar and keep track of keeping it at the correct level. Ask your family doctor / nurse, endocrinologist or diabetes nurse for advice and more information.

The best time to measure blood sugar is before a meal (on an empty stomach) or 1.5-2 hours after a meal.Below are the recommended blood sugar values.

What you need to know about medications if you have chronic kidney disease?

Medicines for hypertension

In the case of chronic renal disease, angiotensin-converting enzyme (ACE) inhibitors are used to treat hypertension – enalapril, ramipril, fosinopril, captopril, etc., or angiotensin II receptor blockers (ARBs) – for example, valsartan, telmisartan, losartan, olmesartan, candesartan. Studies have shown that these drugs delay the progression of chronic kidney disease.

At the same time, these drugs increase the risk of hyprekalemia (serum potassium rises to a dangerous level), the risk increases with the simultaneous use of both groups of drugs. The risk of hyperkalemia is increased due to decreased renal function (GFR) scores.

All people with chronic kidney disease are advised to have regular GFR checks with their family doctor or other health care provider, the frequency of which depends on kidney function and associated risks.

Diabetes drugs

The primary drug of choice in the treatment of type II diabetes is metformin. Metformin is used to control blood sugar levels and lower cholesterol levels, and in addition, it reduces the risk of cardiovascular disease.In the case of chronic kidney disease due to impaired kidney function, there is a risk of medication-related acidosis.

If your GFR is from 30 to 45 ml / min / 1.73 m2 (stage G3B), then the dose of metformin taken should be reduced, if your GFR is less than 30 ml / min / 1.73 m2 (stage G4 – G5), then taking the medication you need to reduce and use other drugs for this. Discuss your treatment plan with your healthcare provider.

Other common medicines used to treat various diseases

Statins

Statins are used to prevent cardiovascular disease.Statins reduce blood cholesterol levels. The use of statins in patients with chronic kidney disease has shown good results in the prevention of serious cardiovascular disease.

Aspirin

Aspirin is often used in the primary prevention of cardiovascular disease. Aspirin has blood thinning properties and therefore increases the risk of bleeding with the consumption of aspirin. If you have any disease of the cardiovascular system, then when taking aspirin, you should evaluate, together with your doctor, the ratio of the possible benefits to the risk of bleeding, while taking into account your health status and concomitant diseases.

Non-steroidal anti-inflammatory drugs

If you regularly use non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, diclofenac, or celecoxib, it is advisable to have your kidney function tested at least once a year. Avoid NSAIDs if your GFR is too low (up to 30 ml / min / 1.73 m2). Do not take NSAIDs with aspirin. If your cardiologist has prescribed aspirin for you, talk to your doctor about what medications for joint disease and pain can be safely taken with it.

Digoxin

Digoxin is a commonly used medicine to treat heart failure and certain types of irregular heart activity. In the case of chronic kidney disease, digoxin should be taken with caution and renal function should be considered. With a decrease in renal function, the concentration of digoxin in the blood may increase and as a result, accumulation of digoxin in the body may occur.

Antibiotics

Aminoglycosides are a specific type of antibiotic that is used to treat a variety of bacterial diseases (eg, pneumonia, acute bronchitis, and other inflammatory diseases).The use of aminoglycosides is a common cause of toxic kidney damage from medication (nephrotoxic drugs). Sometimes it is still necessary to take aminoglycosides. Aminoglycosides are prescribed by a doctor who, using a blood test, also monitors the concentration of the drug in the blood.

Vitamin D

Always check with your family doctor or health care provider prior to taking vitamin D.In case of vitamin D deficiency and chronic kidney disease, vitamin D intake is advisable, based on a certain level of vitamin D (25-OH).

To avoid an overdose of vitamin D, it is necessary to monitor the level of vitamin D in the blood, the frequency of control examinations is prescribed by the family doctor.

Source: Haiglate Liit

When taking vitamin D, side effects may occur, which may depend on the severity of chronic kidney disease (excessive amount of calcium in the blood, rapid progression of chronic kidney disease, etc.).).

Complications of chronic kidney disease

The incidence of complications of chronic kidney disease depends directly on the severity of renal impairment, which can be detected by determining the level of GFR and numerical indicators of albuminuria / proteinuria.As GFR decreases, complications are more common and more severe.

Major complications:

• Malnutrition, which may be due to insufficient calories and / or protein in food.
• Metabolic acidosis is an acid-base imbalance caused by impaired renal function. The kidneys do not filter enough blood and, as a result, the production of acid (hydrogen ions) decreases.
• Potassium levels in the blood begin to rise above normal (hyperkalemia) if potassium excretion decreases due to impaired renal function. This may be due to the consumption of foods high in potassium and taking medications that interfere with the excretion of potassium (for example, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, diuretics, etc.).
• Disorders of the balance of minerals (lack of calcium and vitamin D and excess phosphorus) and diseases of the skeletal system (renal osteodystrophy).The risk of developing skeletal disease is greatest when chronic kidney disease reaches severity stages 3a-5. Blood levels of phosphorus, vitamin D, and calcium are assessed by a blood test.

Diseases of the skeletal system are frequent complications of chronic kidney disease, because due to kidney damage, excess phosphates are not released from the body through the blood and thus hyperfunction of the parathyroid gland occurs (the level of the parathyroid hormone – parathyroid hormone increases), which, in turn, is the cause of the leaching of calcium from the bones.

Such imbalances in the balance of calcium and phosphorus lead, in the absence of treatment, to a violation of ossification, bone pain and fractures. In case of imbalance of calcium and phosphorus, the formation of bone tissue (calcifications) begins to cover the internal organs and blood vessels, which is the reason for the disruption of the functioning of these organs.

• Anemia can result from impaired erythropoiesis (erythropoiesis is the formation of red blood cells or erythrocytes) and low levels of iron in the blood.
• Diseases of the cardiovascular system that contribute to dyslipidemia (an increase in the content of cholesterol in the blood and changes in its structure).

Chronic kidney disease is often associated with heart disease. Low physical activity, poor diet and excess weight can increase blood cholesterol levels, which in turn can damage arterial blood vessels in all organs and increase the risk of cardiovascular disease.

Anemia in case of chronic kidney disease

If the kidneys are diseased or damaged, they do not produce enough erythropoietin (EPO). Erythropoietin, produced by the kidneys, is required for the formation of red blood cells (erythrocytes) in the bone marrow. Red blood cells are involved in the transport of oxygen in the body. If the kidneys do not produce enough erythropoietin, and because of this, the number of red blood cells decreases, then anemia or anemia begins to develop.Anemia occurs in most people with chronic kidney disease.

Another common cause of anemia is inadequate iron, B vitamins and folate.

Anemia symptoms:

• pallor
• feeling tired
• lack of energy in daily activities
• no appetite
• Sleep Disorders
• Decreased concentration
• dizziness and headaches
• heart palpitations
• shortness of breath and shortness of breath

Anemia most common in patients:

• with moderate to severely impaired renal function (chronic kidney disease stage 3 or 4)
• with end-stage renal failure (severity stage 5)

Not all people with chronic kidney disease develop symptoms of anemia.If you have chronic kidney disease, the hemoglobin (Hb) level in your blood should be measured at least once a year to check for possible anemia. Hemoglobin is part of the red blood cells that carry oxygen throughout the body. If the hemoglobin level is too low, we are dealing with anemia – it is important to find out the cause of the anemia in order to plan the correct treatment regimen.

Treatment for anemia depends on the types of causes that cause it. Treating anemia is very important as it helps prevent heart disease and other health problems.If you already have a heart condition, treating your anemia can help reduce the risk of heart disease progressing.

Anemia treatment options:

• Specific treatment with erythropoietin stimulating drugs (ESA). Your doctor will discuss the benefits and risks of ESA with you before starting treatment and will monitor how ESA works during treatment. ESA treatment is not always justified, sometimes iron supplementation is sufficient.
• Iron preparations. Iron supplements are safe for most people.If you are allergic to certain medications, tell your doctor. In some rare cases, side effects of iron supplementation can include low blood pressure, nausea, vomiting, diarrhea, and excess iron in the body. Some reactions can be dangerous and damage your health.
• Your doctor will test your blood to monitor its iron content and will decide a safer and more appropriate method for taking iron supplements. Iron can be taken either as food, tablets or injections.
• Vitamin B ₁₂ or folic acid. These drugs help balance the treatment of anemia. For chronic kidney disease and anemia, your doctor may recommend vitamin 90 100 B ₁₂ and folic acid or add foods containing them to your diet to help ensure consistent and safe treatment.
• Blood transfusion. If the hemoglobin level in your blood drops too low, you may be given a blood (red blood cell) transfusion.Red blood cells are injected into your body through a vein and this will increase their blood levels, which in turn will increase the supply of oxygen to the body.

In the case of chronic kidney disease, there is no specific diet indicated for the disease. Your doctor will advise you on dietary recommendations based on how kidney function changes during illness. Your doctor will assess, based on the results of blood tests, whether you are getting enough nutrients and calories from your food. As chronic kidney disease progresses, certain substances (such as potassium) may accumulate in the body.In the case of chronic kidney disease, it is important to eat well, to monitor the amount of food and its variety. All this will help the kidneys to better cope with their function. Monitoring your diet with your healthcare provider and changing it appropriately will help protect your kidneys and prevent the progression of chronic kidney disease. In the case of mild kidney damage, the so-called nutritional pyramid can be taken as the basis of the diet, but in the case of severe kidney damage, the diet must be agreed with the doctor.

Determine your healthy weight range and try to keep your weight within it. The healthy weight interval can be easily calculated using the body mass index (BMI) formula (a person’s weight in kilograms divided by the person’s height squared in meters). It is better to discuss additionally with your doctor how valid the obtained values ​​are for you.

Body mass index:

• to 19 – insufficient body weight
• 19-24.9 – Normal Weight
• 25-29.9 – overweight
• more than 30 – obesity

If you are losing too much weight, your doctor may recommend special nutritional supplements.If the body weight is too heavy, it puts a lot of stress on the kidneys. In this case, you need to discuss with your doctor exactly how you can gradually reduce weight, without it being dangerous to your health. If your body weight is increasing too quickly, be sure to inform your doctor. A sudden increase in body weight that is accompanied by swelling, breathing problems, and an increase in blood pressure may be a sign that too much fluid is accumulating in your body.

Sodium

Sodium is a mineral that helps regulate the exchange of fluid between blood and tissues in the body, the function of the nervous system, and maintain an acid-base balance.Excess sodium affects the volume of fluid in the body and this can cause an increase in blood pressure as well as swelling in the legs. In the case of chronic kidney disease, dietary sodium should be limited.

Sodium is found in high amounts in salt as well as in foods that have added salt. Most of the salt is found in ready-made sauces (such as soy sauce), in seasonings (garlic or onion salt), in prepared foods (canned soups, canned food, dry soups, broths), in processed foods (for example, ham, bacon, sausages, smoked fish), salty snacks, potato chips, salted nuts and biscuits, and most instant foods.

Some recommendations for reducing salt intake:

• Buy and prepare fresh food at home.
• Choose foods with less salt. Do not use more than one pinch of salt when cooking food.
• Avoid adding salt with meals.
• When adding seasoning, use fresh or dried herbs and spices, lemon juice, aromatic vinegar.
• Do not use salt substitutes unless recommended by your doctor.Most salt substitutes are high in potassium.
• Avoid fast food and ready-to-eat foods as they contain a lot of hidden salt.
• Read labels carefully to select foods with less salt.

Proteins

Protein is essential for normal muscle and tissue function, wound healing and infection. Proteins can be of animal or vegetable origin.Both types of protein are needed for daily activities. Sources of animal protein include, for example, eggs, fish, chicken, red meat, dairy products and cheese. Sources of plant proteins are vegetables and grains, legumes and nuts.

In the case of chronic kidney disease, consuming too much or too little protein can worsen your health. A balanced intake of protein will help you to reduce both the burden on the kidneys and the content of metabolic end products in the blood, and thus slow the progression of the disease.At the same time, protein foods cannot be completely excluded from the diet, as a protein-free diet can cause weakness, fatigue and malnutrition. Your doctor will help you determine how much protein your food should contain based on your kidney function. If your diet has a limited protein content due to chronic kidney disease, the source of calories may be significantly reduced. In this case, you must receive the missing calories from other sources that do not contain protein.For example, you can increase your carbohydrate intake or add vegetable fats to your diet.

Some recommendations for wise protein intake:

• You should know how much protein you can consume in one day.
• Investigate which foods contain protein and choose the most suitable for you.
• Try to eat a small amount of protein at a time.

Potassium

Potassium is an essential mineral that helps muscles, nerves and heart function properly.Too high or too low amounts of potassium in the blood can be dangerous to the body. Usually, the excess potassium is removed from the body through the kidneys. As chronic kidney disease progresses, blood potassium levels begin to rise because the kidneys are no longer able to remove excess potassium from the body (see Complications of Chronic Kidney Disease ). The potassium level in the blood is checked regularly with a blood test. If your blood potassium is too low, your doctor may prescribe potassium substitutes.In the event that the potassium content is too high, medications are prescribed that can balance the potassium levels in the blood. The potassium content in the body can be successfully regulated through dietary changes.

If you must limit your intake of foods containing potassium, then:

• Research which foods contain the most and least potassium and make healthy choices.
• Read labels carefully to select products that do not contain potassium chloride.

Phosphorus and calcium

Phosphorus is a mineral that plays an important role in the functioning of cells, in the regulation of muscle work, the activity of the brain and nervous system, in the formation of teeth and bones. Phosphorus is obtained primarily from animal products. Healthy kidneys excrete excess phosphate from the body, but in the case of chronic kidney disease in advanced stages, the kidneys may not be able to cope with this task.

Calcium is a mineral that is important for the formation of whole, healthy bones and teeth, for blood clotting, and for the functioning of the heart and nerves. Several foods that are good sources of calcium often contain too much phosphorus.

If the phosphorus content in the blood is too high, then the calcium content decreases and calcium is washed out of the bones. Calcium begins to build up in blood vessels, joints, muscles, and the heart – where it shouldn’t normally be (see below). “Complications of chronic kidney disease” ).

In order to prevent calcium leaching from bones and reduce the level of phosphate in the blood, you need to limit the consumption of foods that are high in phosphorus (for example, dairy products, beans, peas, nuts, seeds, cereals, Coca-Cola).

Your doctor may prescribe medications called phosphorus binders. The medicine should be taken with meals according to the frequency prescribed by the doctor.The drug binds phosphorus in such a way that it cannot enter the bloodstream.

• Phosphorus has been added to some packaged foods. To avoid consuming excess phosphorus, be sure to read the label.

Liquid consumption

For mild to moderate chronic kidney disease, fluid intake is usually not restricted. Talk to your doctor or nurse about how much fluid you should be drinking.If you feel that fluid begins to accumulate in your body and your legs swell, be sure to inform your doctor. If kidney disease progresses more and more, it may be necessary to limit the amount of water consumed daily.

If your doctor has prescribed you a limited fluid intake, then:

• Specify the maximum amount of liquid you can consume per day. Start each day by filling the jug with the permitted amount of water.If you also drink coffee or tea during the day, pour the appropriate amount of liquid from the jug. If the jug is empty, it means that you have already used the assigned liquid limit.
• It must be remembered that many solid foods also contain liquid; it is also necessary to take into account the liquid in soups to calculate the consumed liquid.
• Try to choose healthy drinks. Control the sugar, phosphorus and calcium content of your drinks.
• If you sometimes eat canned food, then also take into account the liquid from canned food in the calculation of the daily limit or drain excess liquid from the can before eating.

If you are a vegetarian

If you are a vegetarian, be sure to inform your doctor about this. A vegetarian diet may contain foods that are too high in potassium and phosphorus, and at the same time, contain less protein. With everyday food, you need to get a balanced and correctly combined amount of plant proteins and the required amount of calories. At the same time, the level of potassium and phosphorus in the blood must be kept under control.If the food is not high in calories, then the body begins to consume proteins for energy production.

Alcohol consumption and smoking

Smoking can have serious long-term effects on kidney function. Smoking damages blood vessels. People with chronic kidney disease are more likely to have heart disease than healthy people. In this case, smoking plays the role of an auxiliary risk factor. If you have chronic kidney disease, work with your doctor to find the best way to quit smoking.

In the case of chronic kidney disease, alcohol consumption is not completely contraindicated. However, alcohol can only be taken in very moderation. Excessive alcohol consumption can damage the liver, heart and brain and cause serious health problems.

Women are not recommended to consume more than 1-2 units of alcohol, and men – more than 2-3 units per day. Make at least three days in a row alcohol-free for one week.One unit of alcohol is equivalent to 10 grams of absolute alcohol. One unit is, for example, a strong alcoholic beverage (4 cl), a glass of wine (12 cl) or 250 ml of 4% beer.

Physical activity

Physical activity and sports are not contraindicated for chronic kidney disease. On the contrary, getting enough physical activity helps to better cope with the disease.

Moderate physical activity is important because:

• gives you energy
• Improves muscle strength and elasticity
• helps you to relax
• helps keep blood pressure under control
• reduces the content of cholesterol and triglycerides in the blood
• improves sleep, makes it deeper
• helps maintain a healthy weight
• helps prevent the onset of heart disease and diabetes
• Increases self-confidence and general well-being

You can only exercise for a short period of time each day, but the effect of the exercise lasts all day.Be sure to talk to your doctor before starting regular exercise. Your doctor can help you choose the right sports based on your health condition and early training experience. If necessary, the attending physician will refer you for a consultation with a restorative medicine physician.

Aerobic training works well – walking, Nordic walking, hiking, swimming, water gymnastics, cycling (both indoor and outdoor), skiing, aerobics, or other activity that requires a large muscle group.If a more relaxed workout is preferred, then yoga is well suited for this.

If you have not previously played sports regularly, then start with light workouts that last 10-15 minutes a day. By gradually increasing the load, you can increase the duration of your workout to 30-60 minutes and you can train on most days of the week. Start your workout with a warm-up and end with a stretch, these exercises will help you prevent injury. Try to integrate your workout schedule into your day plan – workouts can be done, for example, in the morning or in the evening.After the main meal, you need to wait about one hour with training. It is also not recommended to train just before bedtime (approximately one hour).

The easiest way to control how well your workout is for you:

• During exercise, you should be able to speak to your companion without shortness of breath.
• Within about one hour after training, the pulse should be restored, the state of health should be normal.If these points are not met, then the next time you need to train in a more relaxed mode
• Muscles should not hurt so much that it would be an obstacle to the next workout
• The intensity of the workout should be at the comfort level

Still, there are some signs that you should abandon or interrupt your workouts:

• you feel very tired
• shortness of breath occurs during exercise
• Feel chest pain, heart rate increases suddenly or becomes irregular.
• Feel stomach pain
• cramps occur in the leg muscles
• dizziness or drowsiness occurs

Remember that regular physical activity does not give “permission” for uncontrolled consumption of foods that should be limited. Diet and exercise must work together. If you feel that in addition to increased physical activity, your appetite has increased, discuss this with your doctor or dietitian. They will help you change your diet so that the amount of calories consumed is sufficient.

If you have been diagnosed with chronic kidney disease, then at first it can cause negative feelings.Information about the diagnosis can initially cause shock, it can be difficult to believe in it – anxiety may arise in connection with a specific situation (for example, examination, procedure) or in general (loss of control over one’s life, decreased quality of life).

A person can get angry, blame others and deny the situation – these are the primary normal emotions, but after some time, the person must begin to recognize the disease and get used to it. After that, it is already possible to cope with the necessary life changes emanating from chronic kidney disease.If negative feelings remain strong over time and are the cause of daily problems, you should definitely tell your doctor about them. At the doctor’s appointment it is easier to talk about what is the cause of physical discomfort: fatigue, feeling unwell, dizziness, etc. It is always more difficult to talk about your feelings and they try to avoid it. Caring for the psychological state is also important, the recognition of our feelings and the opportunity to speak about them allows us to free ourselves from them, and the doctor will be able to find an opportunity to help you.

Stress mainly appears due to changes that need to be introduced into your life: changing the diet, depending on the state of renal function, getting used to the disease, remembering to take medications. You can get a lot of new information at the same time, and understanding it can be difficult. The best way to deal with stress is to admit that there is a problem, it needs to be dealt with, and it will take time. General ill health and fatigue (both physical and emotional) can be quite common at some point.You may feel tired and easily vulnerable to the point of tears. Several symptoms may be present – for example, irritability, loss of personality, loss of interest in what is happening around, trouble sleeping. Emotional exhaustion is the cause of general fatigue. This condition can occur and progress slowly and almost imperceptibly. If the feeling of sadness already becomes desperate or hopeless, due to fatigue, there is no longer any motivation to do anything, and this condition lasts longer than 2 weeks, then you need to inform your doctor about this.

Despite the fact that you cannot change the diagnosis, on your part you can do a lot to better cope with the disease:

• Pay attention to your emotions, don’t deny them. Even if you think these emotions are not related to illness, talk about them, as holding on to emotions increases stress. Share them with people you trust – loved ones, friends, your doctor, nurse. No one can read your mind, but people can always come to your aid.
• Find and read information about chronic kidney disease and its treatment, and be proactive in making decisions about your treatment plan. Don’t be afraid to ask questions. Before visiting your doctor, write down any questions you may have. Many patients recognize that being aware of their illness and treatment helps them feel involved in the treatment process. If it seems to you that you cannot remember everything that the doctor said, take a loved one with you to the appointment or write down the important information received.
• Try to actively change your lifestyle and follow your doctor’s recommendations.
• Take care of yourself. Treat yourself to your favorite activities: listen to soothing music, read your favorite literature or magazines, go to the theater, and take walks in nature. It’s perfectly okay to let people know that you feel you don’t want or have enough time to participate in social activities.
• If you feel you don’t want to talk about and discuss your concerns, keep a journal.Sometimes writing down your thoughts helps you better cope with your feelings and this at some point can make it easier to talk about them as well.
• Seek professional help if necessary. In case of persistent social problems and mood swings, ask your doctor which specialist you should see.
• Accept help when you need it. If people offer help, then they really want to help you. This gives them confidence that they are involved in your life and that you need them.Your loved ones and friends can be the main stronghold of your support.
• Local chronic kidney disease patient groups or support groups are good places to connect with other patients. There you can also get practical advice, training courses and emotional support.

Free time and holidays

Do not give up your favorite activities and hobbies. They can help you relax, keep in touch with friends, and keep you distracted.You can decide how much you want to talk about your illness. Rest is important as it is the time you can spend with your loved ones away from your daily responsibilities. If you are planning a trip, inform your doctor about it. Check if the necessary tests have been done for you, if all the necessary medications are stocked, and find out which medical institutions you can contact if necessary.

Operation

Job opportunity is an important source of good self-esteem and life satisfaction for all people.A diagnosis of chronic kidney disease does not mean that your ability to work is lost until the moment when the disease begins to directly affect activities related to work and daily duties (for example, restrictions during replacement treatment for kidney, which become necessary in the last stages of the severity of chronic kidney disease). Of course, you should discuss with your doctor the hours and types of work (eg lifting weights) that are acceptable in the event of your illness.Your healthcare provider will be able to refer you to a rehabilitation doctor who will teach you the correct movement or work technique. Your employer should be informed if you need to change your work schedule.

Medical insurance

Estonia has a health insurance system based on solidarity insurance principles. The principle of solidarity means that all persons with health insurance receive the same health care, regardless of their monetary contribution, personal health risks or age.People who are permanent residents of Estonia or who are in Estonia on the basis of a temporary residence permit or residence permit have the right to health insurance if social tax is paid for them. In addition to these categories, children under the age of 19, schoolchildren, students, conscripts, pregnant women, the unemployed, on parental leave, dependent spouses, pensioners, guardians of disabled persons, persons with partial or absent work capacity and persons who have entered into a voluntary insurance contract.The costs of medical treatment of the insured person are covered by the Health Insurance Fund. You can check the health insurance status on the state portal www.eesti.ee under the heading “Information on health insurance and family doctor”.

Cash compensation 90 120 90 104

The Health Insurance Fund pays many monetary benefits to insured persons, such as compensation for incapacity for work, supplementary compensation for medicines and compensation for dental treatment and artificial insemination.You can read detailed information on monetary compensation on the website http://haigekassa.ee/ru/cheloveku/denezhnye-kompensacii

Medicines, medical aids and aids 90 120 90 104

Subsidized medicines

Despite the fact that medicines are now very expensive, the Health Insurance Fund helps to compensate for part of their cost. Preferential discount on medicines, i.e. full and partial payment for drugs is one of the ways to provide the population with affordable drugs.This helps to avoid a situation where a person cannot start the necessary treatment because of the too high price for it. With each prescription purchase, the purchaser must pay a mandatory self-financing share that depends on the preferential rate on that prescription. Its value is about 1-3 euros. The rest of the prescription price is subject to a reduced rate based on the percentage of prescription written out. Thus, the buyer, in addition to the obligatory share of financing, pays the remaining part of the price after deducting the benefit.If a ceiling price is set for a given medicine and the price of the purchased medicine exceeds the maximum price, then in addition to the share of compulsory financing and the share remaining after deducting the benefit, the buyer must pay a part of the price that exceeds the maximum price. The last share refers to the part of the prescription cost that cannot be avoided when choosing an expensive drug package. The buyer of the prescription, with a rational choice of a medicine with the same active ingredient, but with a cost not exceeding the maximum price, can save significant amounts.

Medical aids

The Health Insurance Fund compensates the insured for the necessary medical aids that are used at home and with which illnesses and injuries can be treated or the use of which prevents the deepening of the illness. The need for medical aids is assessed by the attending physician and prepares a digital card for the purchase of a medical aid with a benefit. To purchase a medical aid, you need to contact a pharmacy or a company that has entered into an agreement with the Health Insurance Fund and present an identity document taken with you.

You can read more information about subsidized medicines and medical aids on the website.

Aids

Assistive products are a product or a means by which it is possible to prevent an emerging or congenital defect in health or the progression of a disease, to compensate for functional impairment caused by any damage or defect in health, as well as to maintain physical and social independence, performance and activity.

Assistive products can be purchased or rented on the basis of a personal assistive product card.

The basis for the application for a personal card of assistive products is a certificate from a doctor or the need for an assistive device, which has been identified by the rehabilitation team. The need for an assistive device should not be recorded in a doctor’s certificate or rehabilitation plan with the precision of the ISO code, but should be recorded in a form that is understandable to all.It should be clear from it what kind of auxiliary means a person needs. In the case of some assistive devices (for example, lower leg prostheses, wheelchairs, invarollers, etc.), the need can only be determined by a specialist doctor or a rehabilitation team of specialists.

You can find more detailed information on aids on the website.

Performance assessment

Starting from January 1, 2017, the ability to work is assessed instead of incapacity for work.The ability to work and / or health defect is determined individually for each person, according to his state of health. The work capacity is assessed by the unemployment insurance fund and the health defect is determined by the Social Insurance Board.

Assessment of the working capacity is the final determination of the working capacity of a person, taking into account the state of health of the person and the assessment of his working capacity by the person himself. The unemployment insurance fund confirms partial or no work ability for a period of up to five years, up to no longer than a year of entering the retirement age.You can find more information about the assessment of the work ability on the website of the unemployment fund.

Definition of health defect

A defect, a lack of health is a handicap or deviation caused by a state of health, in which case a person has obstacles and problems with the ability to cope with daily activities and participation in the life of society.

It is possible to apply for the establishment of a health defect if:

• Health problems make it difficult for you to cope with daily activities and participate in the life of society
• Compared to your peers, you need more guidance, supervision and assistance

Health defect is established both for children and people of working age, and for old-age pensioners.Detailed information can be found on the website.

1. About Chronic Kidney Disease: a Guide for Patients. National Kidney Foundation. 2013–2014.
2. Chronic Kidney Disease (CKD). National Institute of Diabetes and Digestive and Kidney Diseases.
3. Description of High Blood Pressure.
4. Diabeet. Patsiendi infomaterjal. Ida-Tallinna Keskhaigla.
5. D-vitamiinist. Patsiendijuhend.TÜ Kliinikum 2014.
6. End Stage Renal Disease. New Patient Education Manual 2012. Carolinas HealthCare System Renal Services. Charlotte, North Carolina.
7. Kidney Disease Education. DaVita Inc.
8. Hidden Health Risks. Kidney Disease, Diabetes, and High Blood Pressure. National Kidney Foundation, 2014.
9. Kroonilise neeruhaiguse ennetus ja käsitlus, RJ-N / 16.1-2017 Ravijuhendite nõukoda. 2017.
10. Kuidas tervislikult toituda.
11. Living with Kidney Disease A comprehensive guide for coping with chronic kidney Disease. Second edition. Ministry of Health and Kidney Health New Zealand. 2014. Wellington: Ministry of Health.
12. National Kidney Foundation. A to Z Health Guide.
13. Rosenberg, M., Luman, M., Kõlvald, K., Telling, K., Lilienthal K., Teor, A., Vainumäe, I., Uhlinova, J., Järv, L. (2010). Krooniline neeruhaigus – vaikne ja salajane haigus. Tartu Ülikooli Kirjastus.
14. Sprague, S.M. (2012). The value of measuring Bone Mineral Density in CKD non-dialysis & dialysis patients. Compact Renal.
15. The Emotional Effects of Kidney Failure.
16. Täiskasvanute kõrgvererõhktõve patsiendijuhend, PJ-I / 4.1-2015 Ravijuhendite Nõukoda. 2015
17. Virtanen, J. Metaboolne atsidoos. Eesti Arst 2016; 95 (10): 650–655.

Blood test for creatinine – to hand over a biochemical blood test in Moscow

Creatinine is the end product of protein metabolism.Formed by the breakdown of creatine and creatine phosphate. It is freely filtered in the kidneys, without undergoing reabsorption and secretion in the tubules. The content of creatinine in the blood depends on gender, age, muscle mass. In men, the concentration is noticeably higher than in women; in the elderly, the synthesis of creatinine decreases.
The level of creatinine reflects the state of renal filtration – with its deterioration, the level of creatinine increases. Allows you to judge the degree of renal failure.
Also, by the level of creatinine in serum and in daily urine, it is possible to determine the glomerular filtration rate, which is important in the diagnosis of glomerulonephritis.

Also, this analysis is prescribed before and after the hemodialysis procedure. It allows the doctor to see how effective the procedure has been. For patients with kidney disease, this test is done regularly to monitor their function. The frequency of the analysis is determined by the doctor depending on the patient’s state of health, individual characteristics of the course of treatment.

General information

Creatinine is produced by the exchange of creatine, which is needed to provide the body with the energy it needs to contract muscles.Most of creatinine is excreted by the kidneys. Its level is an indicator of the work of these bodies. The concentration of creatinine directly depends on the weight of a person and the volume of his muscles, therefore, normally in men this indicator is much higher than in women and children.

Creatinine is excreted by glomerular filtration (about 85% of the total) and is secreted by the tubules. The concentration of this substance in the blood deviates from the norm only when the filtration decreases to a critical level.This is especially true for people with low muscle mass.

Department of CT and MRI NII SP named after N.V. Sklifosovsky

Home
– Patients
– Contraindications

For CT

1. Body weight over 120 kg
2. Pregnancy

Intravenous administration of a contrast agent significantly increases the information content of CT studies, however, it has its own contraindications.

Contraindications to the administration of iodine-containing contrast medium are:

• History of severe contrast reactions (shock, respiratory or cardiac arrest, convulsions).
• Bronchial asthma, diabetes mellitus in the stage of decompensation.
• Severe hyperthyroidism.
• Severe renal or hepatic impairment.

Before CT examination with intravenous contrast, it is necessary to control the level of creatinine in the blood (take a biochemical blood test from a vein for creatinine). An appointment for a CT scan with intravenous contrast is performed only in cases where the creatinine level is not increased.

For MRI

A. Availability of the patient:

1. Pacemakers of any kind
2. Prosthetic stapes or any other implanted hearing aids
3. Hemostatic or other clips in the central nervous system and other organs, cava filters
4. Metal fragments or other foreign metal objects in the patient’s body, iron-containing (steel) metal structures after osteosynthesis, etc.
5. Insulin pumps, electronic, magnetic or mechanical stimulators, electrodes, wires, etc.
6. Metallized make-up and tattoos
7. Patches with drugs

B. Patient’s condition

8. Claustrophobia (fear of confined space) – mainly for high-field closed-type MRI
9. Congestive heart failure
10. Pregnancy I and III trimester
11. Body weight over 120 kg

90,000 to be tested in Voronezh, private clinic “Children’s Doctor”

Description

Such a substance as creatinine is the result of metabolic processes in the human body.Creatinine is formed due to the destruction of creatine, which our body needs to maintain energy metabolism and the ability of muscles to contract.

Creatitine enters the bloodstream, then passes through the filtration mechanism in the kidneys using tubules and glomeruli and is “evacuated” along with urine.

The process of production and excretion of creatinine is constant, respectively, in the body you can always find a certain amount of this compound, and this level is stable.The more a person’s body weight and the greater the percentage of the weight are muscles, the higher the creatinine level will be. Men have a higher level of this indicator due to their physiological characteristics.

Since the kidneys are involved in the removal of creatinine, it is possible to obtain information about the state of this organ by its level in the blood.

As long as the kidneys are functioning normally, creatinine in the blood will be within normal limits, if glomerular filtration is impaired, its level will rise. This is the diagnostic value of a creatinine blood test.

Causes of elevated blood creatinine

Above normal creatinine is not always a pathology provoked by kidney problems, for example, this can be observed if the patient falls into one of the following categories:

• is professionally involved in sports and regularly receives significant physical activity
• Adheres to a high-protein meal plan
• takes medications, in particular antibiotics of the tetracycline and cephalosporin groups

Causes of low blood creatinine

Low creatinine – an abnormality that can be associated with the following reasons:

• Unbalanced diet, including strict vegan and vegetarianism
• Pregnancy involves an increase in plasma volume, relative to which creatinine falls
• Muscle dystrophy.

Preparation for Creatinine Test

You can take the test on your own or as directed by a doctor. The procedure does not require complex preparation – standard measures are sufficient. Before visiting the laboratory, the patient is advised to avoid physical overstrain, refrain from eating for 8-12 hours, before the analysis itself, you can drink only water. To take a blood test for creatinine offers the clinic “Children’s Doctor” in Voronezh.

Creatinine – what is it, the rate of creatinine in the blood and what to do if it is elevated

Updated on July 23, 2021

1. Creatinine in the blood – what is it
2. The norm for women, men and children
3. Signs of impaired creatinine production
4. Methods laboratory diagnostics
5. What the low level says
6. When creatinine is elevated

Hello, dear readers of the KtoNaNovenkogo blog.ru. One of the informative diagnostic procedures is a biochemical blood test.

It is difficult for a person without medical education to understand his testimony. After all, blood is not only shaped elements – platelets (what are they?), Red and white bodies.

It is also an extensive complex of organic substances (lipids, proteins, including specifically colored ones, carbohydrates, vitamins and enzymes (what is this?), Inorganic and low molecular weight nitrogenous substances).

By the level of content in the blood plasma of each of them, one can judge the state of the human body and the pathological processes occurring in it.

Today’s topic is devoted to one of the representatives of low molecular weight nitrogenous substances – creatinine. What is this substance, what role does it play in the body, what is the physiological norm, and what its imbalance can tell about.

Creatinine in the blood – what is it

Creatinine belongs to the group of low molecular weight nitrogenous substances. In fact, it is an anhydride (chemical compound) of creatine (nitrogen-containing carboxylic acid), which provides the muscle tissue of the body with the necessary energy.

Formed as a result of metabolic processes in the structure of muscle tissue by cleavage of enzyme proteins (dephosphorylation) and non-enzymatic dehydration (decomposition) of nitrogen-containing carboxylic acid.

The “energy raw material” necessary for tissues is produced by the pancreas, kidneys and liver.

After its formation, it is delivered through the bloodstream to the cellular structure of muscle tissues. Here, as a result of reaction with the enzyme, kinase is converted into the form of creatine phosphate, or phosphocreatine.The addition of phosphate acids to the process gives the reaction of the formation of powerful energy for the contractile function of the muscles.

It is during the process of energy formation that creatine is temporarily transformed into creatinine. Subsequently, the substance is excreted from the body with urine.

Our body stably produces creatinine and creotene in a certain amount, maintaining the necessary balance. Up to 2% of creatine is converted to creatinine every day. Its value in the body is constant, since the muscle mass in humans is virtually unchanged.

Creatinine levels can fluctuate depending on muscle mass, gender and age of the patient. Almost all of the energetic substance is produced by glomerular filtration in the kidneys, only 15% is secreted by the renal tubules.

Since the substance is excreted from the body through the urinary system, then according to the creatinine clearance (the volume of blood passed through the kidneys and purified from the substance in 1 minute) in urine, one can judge the efficiency of glomerular filtration processes and the efficiency of the kidneys themselves.

Therefore, the concentration of creatinine in the blood plasma, which does not go beyond a certain norm, is a good indicator of the functional viability of the kidneys, or a sensitive indicator of their pathologies.

This is interesting. Since fish and meat are considered the richest foods in creatinine, many “experts” believe that providing the necessary energy to muscle tissue can only be through a balanced diet.

At the same time, completely unaware that for a normal “load” of creatinine into the body, it will take up to 5 kg, among other products, in the daily diet for a week.pure meat.

The norm of creatinine in the blood in women, men and children

The level of creatinine in the blood depends on the development of muscles and their volume. Accordingly, the reference (normative) indicators for people of different sex and age differ.

The average norm is considered:

In addition , there is a norm for patients with one working kidney – this is 180.0 – 190.0 micromol / l.In the elderly, long-term ill, and malnourished people, the reference values ​​can be greatly underestimated.

But with a pathological increase in the substance in children up to 200.0 micromol / l and in adults up to 400 micromol / l inclusive, it can talk about the development of a pathological process in the body.

The norm of the glomerular filtration rate (GFR) in men – from 125 ml per minute, in women – from 110 ml / min. The higher the GFR (clearance), the less creatinine is in the urine.

Signs of impaired creatinine formation

The most indicative symptom is impaired renal function, accompanied by:

1. general fatigue;
2. increased fatigue;
3. Difficulty shallow breathing;
4. various forms of impairment of consciousness;
5. pain and a feeling of heaviness in the lumbar region.

Methods of laboratory diagnostics

To detect the real level of creatinine in the body, various methods laboratory diagnostics are used, which help to make a correct assessment of the functional characteristics of many organs and systems, to determine the nature of changes in the general state of the human body by capillary or venous blood.

These are:

1. Complex diagnostics biochemistry blood.
2. Hemorenal tests (Reberga – Tareeva) – determination of the level of endogenous substance by GFR.
3. Azotemia is the standard for early diagnosis of renal pathologies (protein / creatinine ratio).

To exclude errors in the readings of laboratory tests, two days before the examination, power loads should be abandoned.

24 hours before donating blood, exclude protein and meat foods from the diet, especially beef. A plentiful drinking regime is useful, but on the eve of blood sampling, strong tea and coffee should not be consumed.

Based on the results of each of these tests, the patient’s health condition can be judged.

What a low creatinine level says

1. Reduced creatinine titers in a biochemical blood test can be caused by a sharp decrease in muscle tissue as a result of: poor nutrition due to a protein-free or low-protein diet, muscular dystrophy or impaired liver function.
2. The clearance of creatinine in the blood decreases when the blood supply to the renal tissues is disturbed, the development of oncological processes in them, or when there are signs of cardiac failure.
3. In the analysis of azotemia, a decrease in creatinine in the blood can indicate a lack of protein in the diet, muscle injuries, pregnancy, destruction of cells in the tissue structure of muscles (rhabdomyliosis), and the presence of liver cirrhosis.

When creatinine is elevated

The only reason why elevated blood creatinine levels are not considered a pathology is the deliberately voluntary use of various dietary supplements with a high concentration of an endogenous component for greater endurance and artificial muscle building.

This is often observed in professional athletes.

In other cases, increased titers of the endogenous component in the biochemical analysis of blood plasma give grounds for a more complete examination of patients, since may indicate :

1. About the presence of pathological processes in the urinary system caused by kidney injury, impaired renal blood supply, development of urolithiasis diseases or neoplasms of an oncological nature.
2. Increased parameters of the substance according to the hemorenal test are a characteristic symptom of high physical exertion, the body’s reaction to a soft burn or muscle tissue bruises.
3. A high level of creatinine in the analysis of azotemia can be a sign of failure of renal functions, severe dehydration (dehydration) of the body, obstruction of the urinary tract, or the presence of hemorrhagic processes (bleeding) in any organ or system of the body (respiratory system, digestive tract, etc.).).

Biochemical laboratory screening of blood and a competently diagnosed doctor allow you to choose reasonable treatment tactics and prevent complications in time.

Article author: pediatric surgeon Victoria Mikhailovna Sitchenko

Good luck! See you soon on the pages of the blog KtoNaNovenkogo.ru

This article belongs to the headings:

Analysis No. AN22CRE, Creatinine for dogs and cats: indicators, norm

Creatinine is the end product of the degradation of creatinine and creatine phosphate, which are present mainly in muscle tissue and are the most important energy substrates.

1. Preanalytics
2. Interpretation of the result
3. Reference values ​​

Arginine, glycine and methionine are involved in the biosynthesis of creatinine, from which glycocyamine (guanidine acetate) is formed in the kidneys as a result of transamination, which is released into the blood and enters the liver, where the biosynthesis of creatinine is completed. The conversion of glycocyamine to creatinine occurs with the participation of enzymes and vitamin B12. From the liver, creatinine re-enters the bloodstream and is used by muscle and other tissues.During this process, a small amount of creatinine is usually filtered by the kidneys and thus appears in the urine. With a heavy meat diet or with the use of creatinine to improve athletic performance, levels in the blood and urine can increase.

Creatinuria is a pathophysiological criterion for extensive myopathy (for example, in the late stage of fasting, excess glucocorticoids, thyrotoxicosis, in poorly controlled diabetes mellitus). Also, creatinuria can appear in growing young animals, in females during pregnancy and immediately after giving birth.

Excretion of creatinine from the body occurs mainly by renal excretion, as a result of glomerular filtration. The amount of creatinine formed in the body and excreted is relatively constant, depends on muscle mass and, in general, is less susceptible to the influence of extrarenal factors than urea nitrogen. However, in some animal species, colonic bacteria can catabolize creatinine and affect serum concentration. Creatinine is not reabsorbed in the renal tubules, and when the glomerular filtration rate decreases, plasma creatinine levels rise.

An increase in creatinine concentration (azotemia) can result from any disorder that causes a decrease in glomerular filtration rate (GFR) and / or a decrease in renal blood flow. Plasma creatinine levels can also increase in severe tubular dysfunction. Small amounts of creatinine are secreted by the proximal tubules of the nephron in male dogs. Plasma creatinine is a better marker of glomerular dysfunction than urea. These two indicators do not always increase simultaneously, and their relationship is not always linear.The change in the concentration of creatinine and urea in blood plasma is caused by a significant decrease in renal function (that is, a decrease in GFR by 40% -60%, which will lead to a doubling of the values ​​of these parameters in blood plasma).

Creatinine is evenly distributed in all body fluids, but diffuses more slowly than urea. Approximately four hours are required to equilibrate the creatinine concentration (compared to one and a half hours for urea). This feature can help in the diagnosis of certain pathological conditions.

Preanalytics:

The sample is stable at room temperature for one week, when stored in a refrigerator (+ 2 ° C …- 8 ° C) – up to one month, when frozen (-18 ° C and below) – indefinitely.

Interpretation:

The results of the study contain information exclusively for physicians. The diagnosis is made on the basis of a comprehensive assessment of various indicators, additional information and depends on the diagnostic methods.

Units of measurement: μmol / L.

Dogs: 34-124 μmol / L, large – up to 136 μmol / L.
Cats: 44-160 μmol / L.
Horses: 80-180 μmol / L.
Cattle: 62-162 μmol / L.
MRS: 106 -168 μmol / l.
Ferrets: 35-78 μmol / l – albinos; 18-53 μmol / L – dark.

When interpreting the results of the study, the level of creatinine in the blood should be compared with the indicator of the relative density of urine. In hypersthenuria, when the relative urine density is> 1.030 (in dogs) or> 1.035 (in cats), prerenal azotemia (decreased renal perfusion) is suggested.If azotemia of renal origin (primary kidney disease), isostenuria is observed with a relative density of urine in the range of 1.008-1.012, or there is a decrease in the specific gravity of urine (1.012-1.030). Postrenal azotemia usually correlates with hypostenuria.

Greyhound dog breeds (eg Greyhound) have higher plasma creatinine values. Kittens up to 2 months of age usually have higher blood creatinine levels than adults. An increase in creatinine is not always a specific indicator of kidney disease and may change under the influence of extrarenal diseases.

Increase in rate:

Prerenal:

Decreased GFR / renal blood flow:

• Hypovolemia (decreased blood pressure, dehydration).
• Heart failure.
• State of shock.

Increase in creatinine production (slight increase):

• Consumption of red meat.
• Increased protein catabolism.

Renal:

• Acute and chronic renal failure.

Inflammation / infection:

• Glomerulonephritis, pyelonephritis, tubulointerstitial nephritis, leptospirosis, hemolytic uremic syndrome.

Effects of toxic substances:

• Ethylene glycol, aminoglycosides.
• Myoglobin.
• Phenylbutazone, cisplatin, plants (eg Easter lilies, grapes, raisins), heavy metals.
• Hyperglycemia.
• Amyloidosis.
• Hydronephrosis.
• Congenital hypoplasia or aplasia.

Post-renal:

• Obstruction of the lower urinary tract.
• Leakage of urine from the urinary tract (rupture of the bladder or urethra, trauma to the ureters or obstruction of the pelvic-ureteric segment).

Decrease in indicator:

Increase in GFR / blood flow through the kidneys:

• Pregnancy.
• Hyperthyroidism.
• Cachexia.

Often not of clinical relevance.

Creatinine – Clinic 1

Creatinine is a non-enzymatic breakdown product of creatine and creatine phosphate, which is formed in the muscles. It is excreted from the body by the kidneys.

Creatine enters a cycle that provides the body with energy for muscle contraction. After 7 seconds of intense physical activity, creatine phosphate is converted to creatine, then converted to creatinine, which is filtered in the kidneys and excreted in the urine.Creatine and creatinine are stably produced by our body in constant quantities. Almost all creatinine is excreted by the kidneys, so its concentration in the blood is a good indicator of their function. The amount of creatinine produced depends on the total body weight and, in particular, muscle mass. Therefore, for example, creatinine levels in men will be significantly higher than in women and children.

What is the research used for?

• For the assessment of renal function.
• To assess the function of major organs and systems (in conjunction with other studies).
• To assess renal impairment and the effectiveness of its treatment if creatinine or urea is abnormal and the patient has an underlying chronic disease, such as diabetes, which affects kidney health.
• If you know the level of creatinine in the blood and urine, you can calculate the clearance of creatinine (Rehberg test) – this test shows how effectively the kidneys filter small molecules from the blood, such as creatinine.
• To calculate the glomerular filtration rate to confirm renal damage.

When is the study scheduled?

• At regular intervals with known kidney disease or disease that can cause deterioration of kidney function (in conjunction with a test for urea and microalbuminuria).
• In the diagnosis of skeletal muscle diseases.
• Before and after hemodialysis.
• For symptoms of kidney dysfunction:
  • weakness, fatigue, decreased attention, poor appetite, sleep problems,
  • edema on the face, wrists, ankles, ascites,
  • foamy, red or coffee colored urine,
  • decreased urine output,
  • problems with the act of urination: burning sensation, intermittency, change in frequency (predominance of nocturnal urine output),
  • pain in the lumbar region (especially on the sides of the spine), under the ribs,
  • high pressure.
• For any pathological conditions accompanied by dehydration.
• In preparation for computed tomography.
• Before prescribing drugs that can cause damage to kidney tissue.

Research cost

.