Do you Know what Creatinine Is?
What is creatinine?
- Do you know if your kidneys are working well?
- Do you know that kidney failure is asymptomatic until late stages of the disease?
- Do you know that a simple and inexpensive blood test called creatinine can identify the kidney disease in its initial phase?
- So, do you know what is your creatinine level ?
Chronic kidney disease (CKD) is a worldwide public health problem. There is a rising incidence and prevalence of kidney failure in almost all countries.Until the end of this decade, there will be in the U.S.A, more than 600.000 patients with end stage renal disease. The major concern is the fact that only half of these individuals have knowledge of their disease.Many diseases can lead to chronic kidney disease, but 6 of them are responsible for the majority of cases:
-Hypertension
- Diabetes
- Polycystic kidneys
- Glomerulonephritis
- Recurrent urinary tract infections
- Kidney stones
You may be thinking:- My kidneys are good, they don’t ache, I don’t feel any pain when a I pee, and my urine has good volume and appearance.As I said before, the chronic kidney disease does not usually cause symptoms until well advanced stages of disease. Most patients who need to start hemodialysis still have a good urine volume.
The urine aspect alone does not tell if the kidneys work perfectly. Of course, if you have blood or a very foamy urine, you might have renal disease, but don’t rely solely on these symptoms specially if you have one of the diseases described above.When we talk about the urine volume, you must know that the control of body water is just one of the many functions of the kidneys.
The renal system also act on:
- Excretion of blood substances as drugs or toxins
- Control of blood levels of electrolytes such as potassium, sodium, magnesium, calcium and phosphorus.
- Production of hormones that stimulate the red cells production
- Heath of bones and vitamin D activation
- Control of blood coagulation system
- Control of blood pH
- Control of blood pressure
It’s important to know that renal failure is not a cause of renal or back pain!The pain usually occurs in cases of pyelonephritis (infection of the kidneys), kidney stone or urinary obstruction. If you have end stage renal disease, but not because of those, you won’t feel any pain at all. So again, don’t rely on pain to diagnose renal problems.
OK I see. So, how do I know if my kidneys are working properly?
2 simple and inexpensive tests can be done:
- Determination of creatinine and urea (BUN) levels in blood.
- Urine tests
And who should take these tests?
- People with hypertension and/or diabetes
- Age above 60
- Family history of glomerulonephritis or polycystic kidney disease
- Family history of end stage renal disease
- Chronic use of non-steroidal anti-inflammatory drugs (NSAID)
- Recurrent urinary tract infection
- History of renal stones speccially if more than once)
- Diffuse or focal edemas (swelling)
- Anemia without apparent cause.
- Severe cardiac disease, especially heart failure
- Signs of bleeding or foamy urine
- People with weight loss, nausea, weakness, loss of appetite without apparent cause.
- Treatment with potentially nephrotoxic drugs
- Obesity or metabolic syndrome
- Smokers
- People with Hepatitis C virus infection
- People with HIV infection
- Cancer
The creatinine is a chemical waste molecule that is generated from muscle metabolism. It is filtered and eliminated by the kidneys. When they are not working well, the levels of creatinine rises. As it is generated by the muscles, the strongest you are, the highest will be your basal levels of creatinine.
So, you don’t expect an old lady to have the same levels as a young athlete.Normal levels of creatinine in the blood are approximately 0.6 to 1.2 mg/dl (71 to 106 µmol/L)But it’s a result that must be interpreted by your doctor. If you have a large mass of muscles it can be a little higher and still be normal. If you are very thin old women, a result of 1,2 mg/dl is probably too much for you and might indicate renal failure.
With the creatinine levels in hands, your doctor can do a simple calculation and find out the glomerular filtration rate (GFR), which is the actually the rate of blood filtration.Normal kidneys filtrates 180 liters of blood per day (120 ml per minute). When GRF falls bellow 60 ml/min we call it established chronic kidney disease.As the kidneys stop working, there are only 2 options, dialysis or kidney transplantation.
The early referral to nephrologist (kidney specialist) can slow the progression of kidney failure and avoid unpleasant outcomes for the patient and his family.
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