Is the Kidney Okay with Normal Creatinine Level

2019-02-07 15:39

"Doctor, my creatinine is only a little higher than normal. Is there anything wrong?"

Whenever a patient comes to the clinic to ask this question, I will look him/her up and down: judge the gender, height and weight, and understand his/her diet and exercise status.

If it's a strong man who exercises regularly, it's OK. I'll tell him not to worry, and then eliminate kidney problems by using cystatin C, endogenous creatinine clearance or estimating glomerular filtration rate.

Most of the cases are ordinary people. Especially when meeting women or people with small stature and few muscles, my nerves are tightened at once. It is necessary to inquire about urine examination, blood pressure, blood sugar, medical history including family medical history and make a detailed diagnosis. Why am I so nervous? Because it's likely to have a serious condition for these people.

We all know that healthy young people have normal kidney function and serum creatinine even if they have a kidney removed. Then it's not hard to understand that creatinine is normal when chronic nephritis causes kidney cell necrosis until half of it dies.

When creatinine starts to rise, the kidney loses about 60% of its function. At this time, kidney damage will accelerate in a few months or years, and when another 30% of kidney function loses, it is uremia. Therefore, you should receive as early as possible.

Serum creatinine is different from urinary protein. Increased urinary protein is caused by inflammation. Inhibition of inflammation can reduce urinary protein. Most of them can be cured clinically. The increase of serum creatinine is mostly caused by nephron necrosis. The dead cells can not be revived. Serum creatinine is a "serious indicator" and can not be expected to indicate kidney damage.

Normal serum creatinine does not mean that the kidney is not damaged. Especially for patients with chronic nephritis, Nephrotic Syndrome and diabetes mellitus, they should pay attention to cystatin C, endogenous creatinine clearance rate, estimate glomerular filtration rate (eGFR), microalbumin and other more accurate indicators so as to understand the condition of kidney injury in the early stage and treat it in time.

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