Decreased creatinine in the blood. Increased blood creatinine in men: causes, treatment

The main reserve energy source produced by the human body is creatine phosphate. When muscle fibers contract, the substance breaks down into creatinine and phosphate, resulting in the release of a certain amount of energy. Subsequently, creatinine enters the bloodstream and is removed from the body by the kidneys.

• With increased intake of creatinine from muscle tissue;
• Deterioration of the kidneys, which can not cope with the excretion of creatinine.

The most common reasons contributing to the increase in the content of the substance are as follows:

• Acute or chronic renal failure;
• Heart failure;
• Endocrine disorders;
• Malignant neoplasms;
• extensive trauma;
• Radiation sickness;
• Dehydration.

Indications for analysis

Hypercreatininemia can have a negative impact on the human body only with significant deviations from the norm. As a rule, the level of creatinine rises against the background of certain symptoms that require a more accurate blood test. Among these signs:

• Severe muscle pain;
• The appearance of a feeling of fatigue and weakness in the muscles with minor loads;
• The occurrence of edema;
• Change in the volume of daily urine;
• Deviation from the norm of indicators of the general analysis of urine.

To obtain correct data and exclude the influence of physiology on the day preceding blood donation for analysis, a number of important recommendations should be followed:

• Refuse meat and alcohol;
• Do not engage in strenuous physical labor;
• Eliminate situations that can provoke nervous disorders.

Plasma creatinine is measured in µmol/L. At the same time, in different categories of patients, the normative value is within the following limits:

• In infants up to one year of age - 18-35;
• In children under 14 years old - 27-62;
• In women - 53-97;
• In men - 80-115.

During pregnancy in women, the creatinine content can decrease by 40%, while the level of the substance can be in the range of 35-75 µmol / l.

Advice! You should be aware that low creatinine levels during pregnancy in women who are thin or who follow a vegetarian diet can be very dangerous. This can lead to improper development of the fetus, which means that you need to urgently balance the diet in order to normalize weight.

Treatment of hypercreatininemia

Since the reasons for the increase in the content of creatinine in the blood can be very diverse, it means that it may take a lot of time to conduct a detailed study in order to make the right appointments.

When the level of creatinine is elevated due to kidney failure or other serious pathologies, the treatment is carried out in a hospital. It is in a medical institution that measures should be taken to detoxify the human body.

As a rule, treatment is carried out with droppers, with the help of which special solutions of sorbents are administered intravenously. In severe cases, when a blood test shows an elevated creatinine level, hemodialysis may be used. Other ways to lower creatinine levels include:

• Special drugs are prescribed to normalize protein metabolism, such as: ketosteril or lespefan;
• The daily volume of water consumed is selected.
• The diet is normalized, both quantitatively and qualitatively.
• Reduced physical activity.

After any treatment to reduce the level of creatine in the blood, a second analysis should be carried out. And only after the normalization of the indicator, the treatment is considered successful.

Advice! It should be understood that if a biochemical analysis showed an increase in the level of creatinine, then this indicates that there are certain disorders in the body. Despite the fact that they are not critical, the decision to treat in order to reduce the rate is always made by the doctor. You cannot self-medicate.

One of the effective ways to lower the level of a substance in the blood is diet therapy. The following foods are completely excluded from the diet:

• Fatty varieties of meat and fish, and this type of product should be consumed no more than twice a week;
• Milk with high fat content;
• Spicy, smoked and fried foods;
• Coffee and strong tea;
• Sweet flour products based on yeast dough.

You also need to limit the consumption of eggs and minimize the use of sugar and salt. In this case, the diet should be as saturated as possible:

• Vegetables, berries, fruits, raw and boiled;
• Nuts;
• Dried fruits;
• Dairy products.

Knowing why plasma cretinin is elevated is necessary to clarify the diagnosis of various diseases. Therefore, a biochemical analysis can be prescribed by a doctor of any specialization. Only after diagnosing and establishing the cause of the disease, the doctor will decide how to reduce creatinine in the blood.

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 massifs of the human body, and contraction requires a constant energy substrate, powerful energy carriers must be laid in their structure. This is necessary in order to meet emergency energy needs.

The main donor of ATP for muscle tissue is creatine phosphate, a phosphorylated non-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 consumed by the muscles to meet energy needs, and the kidneys excrete creatinine in the urine after filtration.

Creatinine, as the final product of decomposition reactions, is not consumed in the body for other metabolic processes. This is a compound harmful to tissues, which should be removed from the body as much as possible. Violation of creatinine metabolism can occur at the stages of its intake, metabolism and excretion!

Creatinine norm

All creatinine cannot be filtered and excreted by the kidneys. This is due to the fact that it is constantly released into the blood while the muscle tissue is viable. Blood plasma should contain a relatively stable concentration of creatinine, which may vary depending on age, muscle activity and nutrition. Therefore, there are maximum and minimum limits for the norm of creatinine, which take into account all these points and speak of the normal functioning of organs.

To eliminate errors in the results of a biochemical blood test for creatinine levels, it is imperative to adhere to the general rules for blood sampling. The study must be carried out in the morning on an empty stomach. It is advisable to avoid strong muscle loads and overheating or hypothermia before direct blood sampling.

For clarity, the variations in creatinine standards are shown in the form of a table:

The norm of creatinine in women

Plasma creatinine concentration in women should be lower than in men. This is due to the physiological mechanisms of its formation, distribution and circulation in the blood.

The mechanisms behind this phenomenon are:

The muscle mass of a woman is less than that of a man;

Less muscle stress;

The activity of metabolic processes in the female body is reduced;

Food products of the female diet contain less exogenous creatinine entering the body;

Influence of sex hormones and pregnancy.

The norm of creatinine in men

The creatinine of the male body should almost always be higher than that of women of the same age group. This is due to the peculiarities of lifestyle and differences in the functioning of organs and systems. Age characteristics also affect the process of creatinine metabolism, both upward and downward. Recently, many men visit gyms and use doping containing creatine to increase muscle performance. This must be taken into account when assessing the norm of creatinine.

The norm of creatinine in children

The concentration of creatinine in the plasma of a child is more dependent on his age. The main fluctuations of this indicator are associated with growth activity and the degree of increase in muscle mass over a certain period of time. Newborns, due to the high loads that their body had to experience during childbirth, have creatinine levels the same as in adults. The same feature is typical for adolescents, which is explained by the active growth of the body. School-age children grow relatively steadily, so their creatinine levels are slightly lower than those of adults.

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 a physiological and pathological increase, 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 has low toxicity. Its harmful effects on tissues can manifest themselves only with sharp deviations from the norm of its concentration. This metabolite is more related to the consequences of various conditions and diseases, signaling their presence. Therefore, isolated hypercreatininemia practically does not cause manifestations.

It is usually combined with other pathological symptoms that may suggest the need for this study:

Muscle pain;

Rapid fatigue and muscle weakness;

Increase or sharp decrease in the amount of daily urine;

Pathological changes in the general analysis of urine (protein, leukocytes, erythrocytes).

The pathogenesis of hypercreatinemia can be associated with any of the stages of creatinine metabolism and circulation in the body. The nature of nutrition, the mode of physical activity, the amount of liquid consumed, the intake of medications, the anatomical features of the muscle tissue and its condition, the functional abilities of the excretory system and the liver are able to influence it.

What does elevated creatinine mean?

An increase in the concentration of creatinine in a biochemical blood test may indicate:

Increased intake of creatine-containing substances from the environment into the body with enhanced protein nutrition;

Excessive or very rapid increase in muscle mass;

Destruction of muscle tissue;

Redistribution of blood and violation of water balance in the body;

Impaired kidney function for the neutralization and excretion of 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 the level of creatinine, which is not 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 clotting, which helps in its correct assessment. It never reaches high values.

An increase in creatinine levels can be physiological, not due to diseases, and 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 as a big deviation from the norm!

Causes of increased creatinine

The immediate causes of hypercreatinemia, taking into account the severity of the increase in creatinine, are presented in the table.

How to lower blood creatinine?

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 can be general therapeutic hospitals and specialized departments for the treatment of renal or other types of pathology;

taking drugs to normalize protein metabolism and remove toxic products of protein metabolism (ketosteril, lespeflan, lespenefril);

Normalization of water metabolism by selecting the optimal volumes of fluid consumed for a particular case, taking into account the capabilities of the kidneys. If hypercreatinemia is due to 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 accelerate its excretion by the kidneys;

Normalization of the diet in qualitative and quantitative terms. It involves the complete exclusion or restriction of the use of protein foods and salt, which contribute to an increase in nitrogenous compounds or retain fluid in the 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 an increase in creatinine have been identified and the only option for this condition is excessive physical activity, they are minimized as much as possible;

Folk remedies (rice infusion and decoction, medicinal plants and fees);

Extracorporeal detoxification procedures (hemodialysis and its analogues). The use of an artificial kidney is advisable only in severe types of hypercreatinemia caused by decompensated renal pathology or intoxication.

In no case should you even try to cope with an increased level of creatinine in the blood on your own. This symptom may be the small tip of a large iceberg of illness. Any corrective and therapeutic measures should 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 are to limit the intake of protein foods, salt and potassium, enrich the diet with antioxidants and products that cleanse the body.

Excluded:

Fatty varieties of animal and poultry meat (pork, duck, goose);

Fatty varieties of fish;

Whole milk;

Spicy dishes and spices;

Coffee and strong tea;

Dishes from rich yeast dough;

Fried foods and smoked meats.

Restricted:

Dietary meats (chicken, rabbit, turkey, young beef). You can enter meat days twice a week, when they are included in a small amount in the composition of the 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 generally excluded;

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 excluded only in renal failure, when the level of potassium is sharply increased;

Dairy products (yogurt, kefir, fermented baked milk);

Cheese and cottage cheese;

Butter and vegetable oil;

Cereals and cereals based on them. Rice is especially useful in this regard;

Wholemeal bread with bran and pasta;

Mineral and purified plain water at least one liter per day. Water loads are minimized only in renal failure.

Dishes allowed:

• steamed;

• In the form of soup, puree, cream soup, salad, jelly, cereal, casseroles, cutlets, meatballs;

Conditions in which a decrease in plasma creatinine levels are recorded are extremely rare. Their appearance indicates a violation of metabolic processes, accompanied by profound disorders of protein metabolism in the body in general, or in isolation in muscle tissue. If hypercreatinemia mainly depends on the functional ability of the kidneys, then in the case of hypocreatinemia (decrease in creatinine), 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 are used to redeem them, which are most in the muscles. A decrease in creatine phosphate reserves naturally leads to a decrease in the concentration of its metabolites in the blood, which is creatinine.

Causes of low creatinine

The immediate causes of hypocreatinemia can be:

Cachexia against the background of chronic diseases and starvation;

Depletion of the body with a vegetarian diet or strict diets;

Weight loss due to inconsistency of physical activity with the nature of nutrition;

Muscle dystrophy against the background of their diseases;

Atrophy of large muscle masses with their disability;

Treatment with glucocorticoids;

First trimester of pregnancy.

A decrease in the level of blood creatinine is not a diagnostic criterion for any pathology. This is a sign that is an absolute regularity in typical cases, does not require special therapeutic measures!

About the doctor: From 2010 to 2016 practicing physician of the therapeutic hospital of the central medical unit No. 21, the city of Elektrostal. Since 2016, she has been working at the diagnostic center No. 3.

The formation of creatinine constantly occurs in the muscle mass, after which it partially enters the circulatory system and is then excreted along with the urine. Therefore, the measurement of creatinine concentration in the blood is often used in the diagnosis of renal diseases, namely renal failure.

The reason for the increase in the indicators of this substance is identified in specialized medical institutions, by conducting the necessary tests.

There are certain norms for the amount of creatinine: for this indicator it ranges from 57 to 93 micromoles per liter of blood, - from 87 to 123 micromoles per liter. Significant excesses of these indicators are very dangerous and may indicate the presence of any hidden diseases, for the identification of which it is necessary to contact a specialized medical institution.

Instruction

Urea and are the waste products of body cells. Urea is a secondary metabolite that is formed in the liver. As a result of cell energy exchange, toxic acetone is formed. To eliminate its damaging effect, the liver processes it into a secondary metabolite - urea, which enters the bloodstream. Urea is filtered out by the kidneys and accumulates in the urine. Since blood is filtered by the kidneys constantly, the level of urea in a healthy person is approximately the same for a long time. If the indicators of biochemical analysis are different from the norm, then the kidneys suffer and do not fully perform their function.

Creatinine is a nitrogenous metabolite that is formed as a result of the vital activity of skeletal and smooth muscle cells. As a result of the creatine phosphate reaction, energy is released from the cells and creatinine is formed. Like any metabolite, creatinine must be excreted from the body, and this is also a function of the kidneys. Therefore, the level of creatinine is an important indicator of kidney activity.

At up to 1 year - 18-35 µmol / l;
- from 1 to 12 years - 27-62 µmol/l;
- adolescents from 13 to 18 years old - 44-88 µmol / l;
- women from 18 to 60 years old - 53-97 µmol/l;
- women from 60 to 90 years old - 53-106 µmol/l;
- women over 90 years old - 53-116 µmol/l;
- men from 18 to 60 years old - 80-115 µmol/l;
- men from 60 to 90 years old - 71-115 µmol/l;
- men over 90 years old - 88-150 µmol / l.

Creatinine arises from the metabolite creatine, which is essential for energy metabolism in muscle and nerve cells. In fact, it is a by-product of everyday muscle contractions. Under normal conditions, it is filtered by the kidneys and excreted in the urine.

Normal blood creatinine levels are 60 to 110 µmol/L for men and 44 to 97 µmol/L for women.

Excessively elevated creatinine can be a signal of kidney damage or chronic kidney failure.

Functional kidney damage may be due to severe infection or low blood flow to the kidneys. In turn, decreased blood flow or low blood pressure is a possible result of heart failure, heart disease, or severe dehydration.

A temporary increase in creatinine may occur regardless of kidney function due to:

• taking certain supplements or medications
• dehydration
• eating a lot of meat or protein
• building muscle mass through weight lifting exercises.

Another reason for the increase in creatinine in the blood is the lost glomerular function of the kidneys. Diseases that affect the microscopic blood vessels in the glomerulus, such as diabetes, inflammatory or autoimmune kidney diseases, can damage the delicate structure involved in kidney filtration. Some hereditary conditions (such as Goodpasture's syndrome), response to infectious agents (such as streptococci), and problems caused by medications can also lead to poor kidney function.

In athletes with a large amount of muscle mass, the level of creatinine can be increased, there is nothing dangerous in this.

Most of the underlying causes of elevated creatinine cause a few specific symptoms, but a doctor can learn the exact cause by looking at the following "clues":

1. Medication History: a number of drugs can cause an increase in creatinine levels. These include, in particular, the antiulcer drug Cimetidine, angiotensin receptor blockers, non-steroidal anti-inflammatory drugs, the antihypertensive drug Captopril, and the immunosuppressive drug Cyclosporine. Elderly male patients with cardiovascular disease who are taking ACE inhibitors and/or thiazolidinedione drugs are more likely to have an increase in serum creatinine within a few months of starting treatment. Although discontinuation of the drug leads to a decrease in creatinine levels, the long-term effect of a brief increase in serum creatinine on the progression of renal disease is not known.
2. Food history: A vegetarian diet is associated with a decrease in creatinine, and the consumption of boiled meat causes a transient increase in serum creatinine. Creatine is often taken as a supplement to increase muscle mass and increase athletic performance. Long-term consumption of creatine (more than 10 g per day) can increase the concentration of creatinine in the blood serum.
3. Recent Operations: Elevated creatinine may indicate hypovolemia (decrease in circulating blood volume), renal ischemia due to arterial occlusion during cardiac surgery, or problems with the kidney transplant. Skin lesions, blue toes, pancreatitis, stroke, or angina following arterial manipulation, vascular surgery, stent placement, or cardiac catheterization may result from multiple organ failure syndrome. People with one kidney will have higher creatinine levels (up to 160 µmol/L) than people with both kidneys.
4. Anamnesis: It is important to establish whether the patient has a history of chronic or acute renal failure. Other underlying conditions that can cause creatinine levels to rise include: hypertension (hypertensive nephropathy), diabetes (diabetic nephropathy), inguinal lymphadenitis in men and women, autoimmune diseases (vasculitis), cirrhosis of the liver, lymphoproliferative disorders, and infections (cryoglobulinemia).
5. Pregnancy: increased creatinine level - suspicion of preeclampsia. However, kidney disease is often exacerbated during pregnancy and should be ruled out first.

Proper nutrition with increased creatinine in the blood

Many foods should be avoided when creatinine levels are above average. The goal of nutrition with elevated blood creatinine is to protect residual kidney function and prevent kidney failure.

Doctors know that people with kidney problems always have elevated blood creatinine and its level rises to a dangerous degree, usually at least 560 µmol/L. This leads to the need for hemodialysis or a kidney transplant.

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Eating certain foods can increase creatinine levels, so the following should be avoided in the diet:

1. Foods high in protein

   A low protein diet is usually recommended for patients with kidney disease, and this is because protein intake increases the workload on the kidneys, and therefore leads to an increase in creatinine levels. Beans, beans, fish, milk, egg whites and lean meats are all high protein foods and should be limited. However, to meet the physical needs of the body, patients with kidney disease can eat small amounts of fish, milk, and lean meats. They contain high-quality protein and the kidneys do not carry a heavy burden. Peggy Harum, a dietitian with the American Kidney Association, explains that patients should consume 0.6 grams of protein for every kilogram of body weight per day. How much protein to consume every day? It depends on the degree of damage to the kidneys and the condition of the disease. Only the attending physician can give an accurate recommendation. Limiting the consumption of meat and other members of the “protein family” is not a permanent method for lowering creatinine levels, but it is a simple and useful method for controlling high creatinine levels.

2. Foods rich in phosphorus and potassium

   Elevated levels of potassium and phosphorus in the body, due to insufficient levels of kidney function, are a typical problem for patients with kidney disease and elevated creatinine.

Therefore, if blood tests show that the amount of potassium and phosphorus is increased, foods containing these substances should be strictly limited.

• Contains a lot of potassium: avocado, ground red pepper, chocolate, dried apricots, prunes, currants, raisins, pistachios, various nuts, pumpkin seeds, sunflower seeds and so on.
• Phosphorus is found in foods such as: bran, pumpkin seeds, sunflower seeds, wheat germ, cheese, sesame seeds, nuts, bacon, and so on.

Since malnutrition with elevated blood creatinine increases the risk of diabetes, high blood pressure and cardiovascular disease, patients should consult an experienced nutritionist. He will develop a nutrition plan to help manage kidney disease and any other medical conditions.

Is it possible to lower blood creatinine with drugs, foods and dialysis

Creatinine is simply a product of metabolism in our body. Together with other waste products, it leaves the body through urine. With increased creatinine, a large amount of toxins will accumulate in the blood and poison the body. Therefore, high creatinine also means high levels of toxins in the blood.

Dialysis is a medical procedure in which the blood is purified using a special machine, and then the purified blood is poured back into the body through a tube. Dialysis helps in lowering creatinine, but it is not a long-term solution because the procedure does not repair kidney damage to restore kidney function. That is, dialysis is just a way to temporarily cleanse the blood of toxins.

How to lower the level of creatinine in the blood without resorting to dialysis?

As a result, the conversion of creatine to creatinine is slower and less toxins are formed in the blood.

Aim for six to nine hours of sleep per night, seven or eight hours is ideal. In addition, sleep deprivation can lead to physical stress. As a result, the kidneys will be less able to filter out creatinine.

• Take hypoglycemic drugs(after consulting a doctor). One of the common causes of kidney damage is diabetes. It is very important for diabetics to maintain normal insulin levels. There are certain medications you can take to control your insulin levels. One of the most commonly prescribed hypoglycemic drugs is Repaglinide.
• Creatinine is lowered by lowering blood pressure. Hypertension is a contributing factor to kidney damage. The doctor may prescribe drugs with benazepril and hydrochlorothiazide.
• Take medication to lower creatinine levels. For this purpose, the doctor may prescribe Ketosteril. The regular dose is usually 4 to 8 tablets per day. Other creatinine-lowering drugs: alpha-lipoic acid (an antioxidant) can be used to help activate the kidneys and neutralize toxins and chitosan, a weight management supplement that can also reduce blood creatinine. Obese people should be regularly tested to determine the level of creatinine and cholesterol in the blood. The norm of cholesterol in the blood (total, that is, both “bad” and “good”) is up to 5.2 mmol / l or 200 mg / dl.
• Avoid intense physical activity. This will prevent the conversion of creatine to creatinine.
• Cinnamon- one of the plants used at home to reduce high levels of creatinine. It is considered as a diuretic that can help increase diuresis. People with urinary problems can drink cinnamon tea or add it as a condiment to lower blood creatinine. In addition, patients with kidney disease may (with the permission of their physician) take cinnamon in combination with ginseng and dandelion.

What does high creatinine in urine mean?

Rhabdomyolysis is the medical term for the breakdown of muscle cells that elevated creatinine in the urine can cause.

This may happen due to:

• long distance running;
• muscle injury;
• kidney problems;
• electric shock;
• as a result of certain infections.

Kidney problems that can lead to elevated urinary creatinine include the following:

• kidney failure;
• glomerulonephritis;
• obstructions within the urinary tract.

To find out how much creatinine is in the blood and urine, a special test (creatinine clearance) is performed.

It includes blood sampling and the usual act of urination and does not cause any discomfort. There are also no risks associated with this test.

Why do you need a creatinine clearance test?

This test is done to see if the kidneys are working properly. It gives clearer results than a single blood test. Creatinine is removed from the body and this "duty" lies entirely with the kidneys. Elevated creatinine in the urine may indicate a kidney problem; that is, the kidneys are unable to excrete creatinine. It could also mean a muscle problem, as the muscle cells send creatinine to the kidneys.

How the test is performed:

After the patient provides a urine sample, it is tested in a laboratory.

How to prepare for the test

• Your doctor may ask you to temporarily stop taking certain medications so that they do not interfere with the results of the test. Be sure to tell your healthcare provider about all medications you are taking. These include antibiotics with cefoxitin or trimethoprimacimetidine.
• Do not do any strenuous exercise for 2 days before the test.
• Do not eat more than 227 g of protein food during the day before the blood creatinine test and urinalysis.
• Drink water, juices, and herbal teas while collecting urine, but avoid coffee and black tea. The latter are diuretics.

Normal urinalysis results

• Urinary creatinine (a 24-hour sample collected during both daytime and nighttime urination) can vary in men under 40 years of age within 106-140 ml / min, and in women under 40 years of age - within 85-105 ml /min
• Another way of expressing the normal range for test results is 14 to 26 mg per kg of body weight per day for men and 11 to 20 mg per kg of body weight per day for women.

Abnormal urine creatinine results may be due to any of the following conditions:

• Passion for meat products.
• Kidney problems, such as tubular cell damage or pyelonephritis.
• Too little blood flow to the kidneys.
• Destruction of muscle cells (rhabdomyolysis), or loss of muscle tissue (myasthenia gravis).
• Obstruction of the urinary tract.

The presence of a low level of creatinine in the blood shows nothing but the effective work of a pair of kidneys.

With normally functioning kidneys, the level of creatinine in the urine compared to the blood should be high.

Conversely, if the level of creatinine in the urine is low and the level in the blood is high, this indicates a problem that should be seen by a doctor.

Measurement of creatinine concentration in plasma or serum is included in the standard list of biochemical blood tests. The obtained indicators are used to diagnose the work of the kidneys.

Creatinine: a brief educational program

Creatinine is the end product in the metabolic breakdown chain of creatine phosphate, an organic compound involved in the process of rapid energy production during muscle contractions. From a chemical point of view, it is formed when the phosphate group is cleaved from creatinine phosphate and the further conversion of creatine into creatinine. In the body of a healthy person, creatinine is constantly formed, so its concentration in the blood is quite stable and is determined mainly by the volume of muscle mass. This explains the higher content of creatinine in the blood in men: as a rule, the ratio of muscle mass to total body weight in them is much higher than in women.

The concentration of creatinine in the blood increases with age in both men and women. A physiological decrease is observed in pregnant women, which is associated with an increase in the volume of circulating blood.

Creatinine is eliminated from the body in the urine. This compound is a "non-threshold" substance: normally, it is completely filtered out in the renal glomeruli. It is not reabsorbed and is completely eliminated from the body in the urine. It follows from this that if creatinine in the blood is increased, then, most likely, the level of renal filtration is reduced, i.e. impaired kidney function. An important diagnostic role is played by the Rehberg test: knowing its content in the blood and the total amount excreted in the urine, creatinine clearance is easily calculated.

The formation of creatinine in the body of an elderly person is significantly reduced due to muscle atrophy, therefore, when examining kidney function, one should not rely only on this indicator: the degree of kidney failure can be much more serious than that determined by the results of a blood test for creatinine.

From the point of view of hemodynamics, the kidneys have hidden reserve capabilities, therefore, according to the normal value of creatinine in the blood, one cannot conclude that there are no kidney diseases. Even with the defeat of a significant part of the renal tissue, its level can remain normal. The diagnostic picture is supplemented by data on the content of urea in the blood, the concentration of which directly indicates the state of the kidneys.

Chemical molecule - creatinine

Blood is taken for analysis in the morning, before meals. The unit of measure for creatinine concentration in the blood is micromoles per liter (µmol/l) or millimoles per liter (mmol/l). The following values ​​\u200b\u200bare considered normal (µmol / l):

Indications for the appointment of a blood test for creatinine are suspicion of skeletal muscle disease and a study of kidney function.

Reasons for deviation from normal values:

Increased level of creatinine in the blood: impaired renal function in their diseases of any origin; increased physical activity; destruction of muscle tissue (prolonged compression syndrome, necrosis, gangrene, Crash syndrome); excessive consumption of foods high in protein; extensive burns; dehydration of the body; endocrine diseases (hyperthyroidism, gigantism, acromegaly); radiation injury, heart failure.

False elevated blood creatinine: excess muscle mass; violation of metabolic processes; taking certain medications (cefazolin, roserpine, ibuprofen, levodopa, ascorbic acid); long-term use of drugs that have a nephrotoxic effect (sulfonamides, barbiturates, salicylates, some tetracycline antibiotics).

Decreased creatinine concentration: prolonged fasting, vegetarian diet, muscle atrophy, pregnancy (1st and 2nd trimester). A false decrease is possible when taking corticosteroid hormones before taking the test. The decrease in the level of its concentration has no diagnostic value.

Elevated blood creatinine

• an unbalanced diet with a high protein content activates the synthesis of creatine phosphate and, as a result, creatinine;
• prolonged fasting leads to increased protein catabolism, since the body, due to a lack of nutrients from the outside, begins to use proteins as a reserve source of energy. Increased protein breakdown causes an increase in creatinine concentration;
• profuse internal bleeding (ulcers, tumors, etc.): blood, being a high-protein "food", is absorbed through the intestinal walls and leads to the activation of creatinine synthesis;
• when the body is dehydrated, a natural increase in the concentration of all components in the blood occurs.

Consequences of high concentration of creatinine in the blood

If creatinine in the blood is elevated, then patients in most cases have clinical signs of kidney damage:

• pain in the lower back;
• violation of diuresis from anuria (urine is not excreted at all) to polyuria (excretion of more than 2 liters of urine per day);
• increased blood pressure;
• puffiness;
• detection of erythrocytes and protein in the urine (hematuria and proteinuria).

If the level of creatinine rises, while its clearance decreases, then the following symptoms are noted in patients: increasing fatigue, confusion, convulsions, loss of appetite, nausea, shortness of breath, anemia.

How to lower creatinine in the blood

First of all, you need to understand that it is strictly forbidden to take any action without first consulting a doctor. Only after a complete examination can a list of recommendations for reducing the concentration of creatinine be developed. With a significant increase, as a rule, drugs are prescribed that normalize the processes of protein breakdown. If the data of a biochemical blood test indicate a slight increase in creatinine and there are no warning symptoms, then a lifestyle review and dietary adjustment may be quite sufficient.

First of all, you need to consult with nutritionists about proper nutrition. You should not thoughtlessly refuse meat, but reducing its consumption to 200g two or three times a week is fully justified. At the same time, it is better to refuse fatty meat dishes altogether, giving preference to rabbit, veal, white meat chicken or turkey. The recommended daily protein intake is best obtained from fermented milk products, eggs, fish, nuts. It is necessary to enrich the diet with fiber, eat more fruits and vegetables, as well as cereals cooked in water, and yeast-free bread with bran.

Particular attention should be paid to the drinking regime: every day you need to drink at least a liter of clean water. Water is best drunk in the morning on an empty stomach and between meals, but never with meals.

Correctly calculated physical activity and good rest will help to reduce the level of creatinine in the blood. Relaxing exercises, aromatherapy, yoga classes will help relieve fatigue.