Creatinine

Creatinine is a chemical waste product in the blood that passes through the kidneys to
be filtered and eliminated in urine. The chemical waste is a by-product of normal muscle
contractions. Creatinine is made from creatine, a supplier of energy to the muscle.
Women usually have lower creatinine levels compared to men, because women have
less muscle tissue. Among adults without kidney disease, men have approximately 0.6
to 1.2 milligrams/deciliters (mg/dL) of creatinine, whereas women have between 0.5 to
1.1 mg/dL of creatinine.
Generally creatinine levels in the blood remain unchanged from day to day because
muscle mass usually stays the same. Taking certain medicines, eating a lot of meat or
building muscles through weight training or other exercise may show higher amounts of
creatinine, even in those who do not have chronic kidney disease. Creatinine levels can
be lower than normal for people who are elderly, malnourished or are vegetarians.
Creatinine tests
Creatinine in the bloodstream is usually checked with regular tests. There are a few
tests which are specifically for creatinine measurement to help determine kidney
function.
Serum creatinine is a blood test that is commonly performed as part of a physical
examination if have blood work done. Blood is drawn and sent to a lab to be analyzed to
find out how much creatinine is in the bloodstream. Serum creatinine helps evaluate
kidney function.
Knowing your serum creatinine allows your doctor to calculate your creatinine level
along with your age, gender and race, to determine your GFR (glomerular filtration rate).
GFR is considered by medical professionals to be the best measure of kidney function.
Creatinine clearance (Ccr or CrCl) measures how much creatinine is cleared out of the
body, or how well kidneys filter waste. Creatinine clearance is a combination of a urine

and a blood test. A creatinine clearance test is usually ordered if the serum creatinine
level is higher than normal or when a person is starting dialysis. Normal creatinine
clearance for men is between 97 to 137 milliliters per minute, and women have a normal
clearance of 88 to 128 milliliters per minute.
BUN/creatinine is the ratio between blood urea nitrogen (BUN), a waste product in the
blood from protein metabolism, and creatinine. This ratio is used to help determine if
kidney function is impaired due to a damaged or diseased kidneys or another factor
outside of the kidneys. If both BUN and creatinine are high, the ratio usually indicates
damage to the kidneys. If BUN is high but creatinine is normal, then the kidney is
generally not damaged but is not getting adequate blood supply due to another problem
such as dehydration or heart failure.

Creatinine and chronic kidney disease

When there is kidney damage or kidney disease, and the kidneys are not able to filter
waste efficiently, there will likely be a rise in creatinine levels in the blood. For adults
with chronic kidney disease, dialysis is recommended when creatinine levels reach 10.0
mg/dL. For babies with chronic kidney disease, dialysis is recommended when their
creatinine level is 2.0 mg/dL.

Symptoms of too much creatinine

Symptoms of high levels of creatinine in the blood are the same as kidney failure
symptoms. Some people find out they have kidney failure when extreme creatinine
amounts show up in routine blood tests, without feeling any symptoms at all. Yet some
people may experience the following:

Weakness, or feeling tired

Dehydration

Confusion

Shortness of breath

Creatinine will be tested

Serum creatinine and BUN/creatinine tests are usually performed during regular blood
work. Your doctor may order a creatinine test if he or she suspects your kidneys are
impaired. During some drug treatments, your doctor may order frequent creatinine tests
to ensure the drug is not harming your kidneys. If you have signs of kidney trouble, your
doctor may order a creatinine clearance test.
Nephrologists use these tests to monitor the kidney function of their patients and track
the progression of their kidney disease. Doctors also use these tests after a patient
reaches end stage renal disease and is on dialysis to check how well dialysis is
cleaning the blood.

Summary
Creatinine tests, such as the serum creatinine, creatinine clearance and BUN/creatinine
help doctors determine if kidneys are not functioning properly. People diagnosed with
chronic kidney disease will likely be tested regularly. Knowing your creatinine level will
help your health care team determine your treatment for kidney disease, including the
amount of dialysis you should receive.
The Renal Clerance Rate
The renal clearance rate(RC) of any substance, in ml/min is calculated from the
equation:
RC= UV/P
where
U= concentration off the substance in urine(mg/ml)
V=flow rate of urine formation(ml/min)
P=concentration of the substance in plasma(mg/ml)

Inulin is the standard used to determine glomerularfiltration rate. A polysaccharide with a

molecular weight of approximately 5000, inulins renal clearance value is equal to the
glomerularfilteration rate. When inulin is infused such that its plasma concerntration is 1
mg/ml (P=1 mg/ml), then generally U=125mg/ml, and V= 1ml/min. Therefore, its renal
clearance is RC=(125x1)/1=125 ml/min, meaning that in 1 minute the kidneys have
removed(cleared) all the inulin present in 125 ml of plasma.