Indications for the study
Most often, a blood test for creatinine is prescribed if kidney problems are suspected. Also, its results are used to assess the condition of the entire urinary system as a whole. The study is prescribed if drug therapy is planned that poses a potential danger to the kidneys. Healthy people who actively engage in sports and build muscle volume also need to monitor their performance. This is also important for those who follow a protein diet. The analysis can be prescribed during a preventive examination or diagnosis of diseases, independently or in combination with other studies.
Complexes with this research
Female infertility Analysis of the state of women's reproductive health 9,210 ₽ Composition
Kidneys. Extended examination 1,050 ₽ Composition
Biochemistry of blood. 19 indicators Advanced biochemical blood test RUB 3,270 Composition
IN OTHER COMPLEXES
- Women's check-up No. 1 RUB 11,260
- Pregnancy planning. Clinical indicators RUB 3,470
- Joining IVF RUB 13,590
- Examination during pregnancy. 1st trimester 9,380 RUR
- Healthy interest RUB 2,140
General information
Creatinine takes part in the energy supply cycle for muscles. It is formed in constant quantities and is excreted by the kidneys. The level of creatinine can be used to judge the functioning of the kidneys. It must be taken into account that indicators begin to deviate from the norm only after glomerular filtration decreases to critical values.
Creatinine is a more sensitive indicator of kidney health than urea, but this indicator alone is not enough for diagnosis. There are a large number of factors that influence test results. Kidney problems can be suspected if the patient has symptoms such as swelling, change in urine color, pain in the lumbar region, or burning sensation when urinating. Kidney disease affects your general well-being in the following ways: fatigue, high blood pressure, sleep disturbance, loss of appetite.
What is creatinine?
Creatinine is one of the metabolites of biochemical reactions of amino acid-protein metabolism in the body. The formation of this compound occurs constantly and is associated with metabolic processes in muscle tissue. Since muscles constitute one of the main masses of the human body, and contraction requires a constant energy substrate, powerful energy carriers must be embedded in their structure. This is necessary in order to meet emergency energy needs.
The main donor of ATP for muscle tissue is creatine phosphate - the phosphorylated essential amino acid creatine. After synthesis in the liver, it enters the muscles, where it is dephosphorylated by the enzyme creatine phosphokinase. The result of these processes is the formation of energy and creatinine. ATP is used by the muscles to meet energy needs, and the kidneys excrete creatinine in the urine after filtration.
Creatinine, as the final product of breakdown reactions, is not consumed in the body for other metabolic processes. This is a compound that is harmful to tissues and should be eliminated from the body as much as possible. Violation of creatinine metabolism can occur at the stages of its intake, metabolism and excretion!
Interpretation of results
For patients of different gender and age, their own reference values have been established. When interpreting the results, the amount of muscle mass, level of physical activity and other factors are also taken into account. With age, uric acid concentrations decrease as creatinine synthesis in the kidneys changes. The research can be carried out by fermentation or chemical methods.
Based on the test results, diseases of the kidneys, thyroid gland, skeletal muscles, intestinal obstruction and other pathologies are detected. Increased performance is also characteristic of serious muscle injury. Decreased levels may indicate insufficient physical activity or lack of nutrition. In most cases, the results of one test are not enough for accurate diagnosis and selection of effective treatment methods. If deviations from the norm are detected, a comprehensive examination is prescribed. When diagnosing, the results of all examinations are taken into account. This makes it possible to avoid mistakes, quickly make an accurate diagnosis and begin treatment. It must be taken into account that sometimes in the presence of renal failure, indicators remain within normal limits for several years.
References
- Clinical protocol for diagnosis and treatment of acute renal failure, 2014. - 24 p.
- Kucher, A.G., Kayukov, I.G., Yesayan, A.M. and others. The influence of the quantity and quality of protein in the diet on kidney activity. Nephrology, 2004. - Vol. 8(2). — P. 14‐34.
- KDIGO practice guidelines for the diagnosis, prevention and treatment of mineral and bone disorders in chronic kidney disease (CKD-MBD). Summary of recommendations. Nephrology, 2011. - T. 15(1). — P. 88‐95
- Nephrology. National leadership / ed. ON THE. Mukhina. - M.: GEOTAR-Media, 2009. - 720 p.
Elevated creatinine levels
When assessing creatinine metabolism, most often one has to deal with an increase in the concentration of this metabolite. It is very important to correctly interpret the obtained indicators, taking into account the possibility of physiological and pathological increases, age and gender standards. The condition in which an increase in plasma creatinine is recorded is called hypercreatinemia.
Hypercreatininemia does not cause severe abnormalities in the body, since creatinine itself is low-toxic. Its harmful effects on tissue can only appear with sharp deviations from the norm in its concentration. This metabolite is more related to the consequences of various conditions and diseases, signaling their presence. Therefore, isolated hypercreatininemia causes virtually no symptoms.
It is usually combined with other pathological symptoms that may suggest the need for this study:
- Muscle pain;
- Fatigue and muscle weakness;
- Edema;
- An increase or sharp decrease in the amount of daily urine;
- Pathological changes in general urine analysis (protein, leukocytes, erythrocytes).
The pathogenesis of hypercreatinemia can be associated with any of the stages of creatinine metabolism and circulation in the body. It can be influenced by the nature of the diet, the mode of physical activity, the amount of fluid consumed, the use of medications, the anatomical features of muscle tissue and its condition, the functional abilities of the excretory system and liver.
What does elevated creatinine mean?
An increase in creatinine concentration during a biochemical blood test may indicate:
- Increased intake of creatine-containing substances into the body from the environment with increased protein nutrition;
- Excessive or very rapid increase in muscle mass;
- High loads performed by muscles;
- Destruction of muscle tissue;
- Redistribution of blood and disruption of water balance in the body;
- Impaired kidney function in neutralizing and excreting creatinine;
- Toxic effects on the body;
- Endocrine disorders that regulate metabolic processes in the body.
In some cases, one has to deal with a relative increase in creatinine levels, which does not occur due to its excess production or retention in the body. It is associated with a decrease in the volume of circulating plasma as a result of its redistribution, blood loss or dehydration. Relative hypercreatininemia is combined with other signs of hemoconcentration and blood thickening, which helps in its correct assessment. It never reaches large values.
An increase in creatinine levels can be physiological, not due to disease, or pathological. In the second case, the main cause of hypercreatinemia is renal failure in any type of kidney damage, in which creatinine numbers can increase several times. Physiological hypercreatinemia can never be represented by a large deviation from the norm!
Causes of elevated creatinine
The immediate causes of hypercreatinemia, taking into account the severity of the increase in creatinine, are presented in the table.
| Pathological causes of increased creatinine | Physiological reasons for increased creatinine | |
| Moderate hypercreatinemia | Severe hypercreatinemia | |
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|
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How to reduce creatinine in the blood?
After a detailed examination and clarification of the cause of hypercreatinemia, the following recommendations can be given:
- Hospitalization in medical institutions according to the profile in case of detection of diseases. These may be general therapeutic hospitals and specialized departments for the treatment of renal or other types of pathology;
- Taking medications to normalize protein metabolism and remove toxic products of protein metabolism;
- Normalization of water metabolism by selecting optimal volumes of fluid consumed for a particular case, taking into account the capabilities of the kidneys. If hypercreatinemia is caused by physiological mechanisms, then an increase in the daily volume of pure high-quality water will lead to a decrease in the concentration of creatinine and will accelerate its excretion by the kidneys;
- Normalization of diet in qualitative and quantitative terms. It involves the complete exclusion or limitation of the consumption of protein foods and salt, which contribute to an increase in nitrogen compounds or retain fluid in tissues. This, in addition to the absolute increase in creatinine, causes its relative increase due to hemoconcentration;
- Correction of lifestyle and physical activity. They must be brought into line with the actual capabilities of the body. If no pathological causes of increased creatinine have been identified and the only option for this condition is excessive physical activity, they should be reduced as much as possible;
- Extracorporeal detoxification procedures (hemodialysis and its analogues). The use of an artificial kidney is advisable only for severe types of hypercreatinemia caused by decompensated renal pathology or intoxication.
Under no circumstances should you even try to cope with elevated creatinine levels in the blood on your own. This symptom may be the small tip of a large iceberg of illness. Any corrective and therapeutic measures must be supervised by a specialist!
Diet for high creatinine
One of the most important measures to reduce creatinine levels is diet therapy. Its general characteristics include limiting the consumption of protein foods, salt and potassium, enriching the diet with antioxidants and foods that cleanse the body.
Excluded:
- Fatty varieties of animal and poultry meat (pork, duck, goose);
- Fatty fish;
- Whole milk;
- Spicy dishes and spices;
- Coffee and strong tea;
- Dishes made from rich yeast dough;
- Fried foods and smoked meats.
Limited to:
- Dietary meats (chicken, rabbit, turkey, young beef). You can introduce meat days twice a week, when they are included in small quantities in dishes;
- Eggs – up to 2-3 per week;
- Fish. Fish days are organized by analogy with meat days;
- Salt and sugar. With a pronounced increase in creatinine, they are completely excluded;
Recommended:
- Fresh or boiled vegetables and fruits in any quantity;
- Berries, fruit drinks and compotes based on them;
- Nuts and dried fruits. They are limited or completely eliminated only in case of renal failure, when the potassium level is sharply increased;
- Fermented milk products (yogurt, kefir, fermented baked milk);
- Cheese and cottage cheese;
- Butter and vegetable oil;
- Cereals and porridges based on them. Rice is especially useful in this regard;
- Wholemeal bread with added bran and pasta;
- Honey;
- Mineral and purified plain water at least one liter per day. Water loads are minimized only in cases of renal failure.
- Allowed dishes:
- Boiled;
- Steamed;
- Stewed;
- In the form of soup, puree, cream soup, salad, jelly, porridge, casseroles, cutlets, meatballs;
Additional important recommendations: scientific arguments
- Reduce your consumption of red meat.
Research shows that eating large amounts of red meat may increase creatinine levels, at least temporarily. If you eat a lot of red meat, switch to vegetable dishes [1].
- More fiber.
Eating more fiber-rich foods can also help reduce creatinine. For example, a 2014 study published in the European Journal of Clinical Nutrition found a significant reduction in creatinine levels in 143 participants with chronic kidney disease who increased their dietary fiber intake [2]. (on the topic: fiber: benefits, types + TOP products).
- Additives with chitosan.
A 2011 study published in the Journal of Pharmacy and Pharmacology examined the effects of chitosan on 80 patients with kidney failure. Half of the patients were given chitosan three times daily in tablet form, which resulted in a significant reduction in creatinine levels after 4 weeks compared to control patients [3].
Creatinine decreased
Conditions in which a decrease in plasma creatinine levels is recorded are extremely rare. Their appearance indicates a disruption of metabolic processes, accompanied by profound disorders of protein metabolism in the body in general, or isolated in muscle tissue. If hypercreatinemia mainly depends on the functional capacity of the kidneys, then in the case of hypocreatinemia (decrease in creatinine level), their condition does not play a role. Consequently, the main mechanism should be such a depletion of energy reserves in the body that protein resources, which are most abundant in the muscles, are used to repay them. A decrease in creatine phosphate reserves naturally leads to a decrease in the concentration of its metabolites in the blood, which is creatinine.
