Creatinine

Creatinine
‡ Creatinine is a break-down product of creatine phosphate in muscle ‡ Usually produced at a fairly constant rate by the body (depending on muscle mass). ‡ Important form of energy being a store of high energy phosphate. ‡ More specific indicator of renal function.

‡ Creatinine is chiefly filtered out of the blood by the kidneys (glomerular filtration and proximal tubular secretion). ‡ There is little-to-no tubular reabsorption of creatinine. ‡ If the filtering of the kidney is deficient, blood levels rise.

Clinical significance
‡ Elevated levels relates to glomerular filtration rate. ‡ BUN:Creatinine ratio helps to differentiate between pre-renal and renal causes of azotemia ‡ High creatinine blood levels may indicate serious kidney damage or disease due to life threatening infections, shock, cancer or reduced blood flow to kidneys.

Clinical significance
‡ Other conditions that can cause increased blood creatinine levels include blockage of urinary tract, heart failure, dehydration, excessive blood loss that causes shock, gout, or muscle conditions like myasthenia gravis, muscular dystrophy, acromegaly, gigantism. ‡ Usually increased creatinine level means that creatinine clearance value is below normal ‡ A rise in blood creatinine levels is observed only with marked damage to functioning nephrons.

Useful for
‡ Serum creatinine test is not suitable for detecting early stage kidney disease. ‡ A better estimation of kidney function is given by the creatinine clearance test. Creatinine clearance can be accurately calculated using serum creatinine concentration and some or all of the following variables: sex, age, weight, and race. ‡ Estimated creatinine clearance rate (eCCr)

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