Creatinine in our body mainly comes from creatine produced by muscle metabolism and it is mainly excreted outside the body through the kidneys and there is nearly no re-absorption in the renal tubules.
Generally since the muscle mass is constant, therefore serum creatinine level mainly depends on how much creatinine is discharged by the kidneys.
Under normal circumstances, healthy kidneys have great compensatory function. If both kidneys are healthy and then when one kidney functions, it can maintain that creatinine within normal range. Usually when more than half kidney functions are damaged and when glomerular filtration rate (GFR) falls below 1/3 can there be obvious high creatinine level. But at this time, the kidneys have been severely damaged and patients will develop a series of pains and discomforts such as vomiting, nausea, dizziness, etc.
Serum creatinine can reflect renal parenchymal damages, but it is not sensitive. Creatinine will be still normal in the early stage of renal diseases when kidney functions are still above 50.
High creatinine level means that kidneys have been severely damaged. As we have analyzed above, creatinine level is mainly up to glomerular filtration rate (GFR) which is determined by kidney functions. When kidneys are damaged by various factors, the damaged renal intrinsic cells will have phenotypic transformation. Gradually other normal renal tissues will be affected and kidney functions will experience progressive decline. Since most metabolic wastes and toxins need to be discharged through the kidneys. Due to declined kidney functions, these harmful products will stay in patients’ body instead of being cleared outside. As a result, there will be elevated serum, BUN, decrease of urine creatinine and bilateral glomerular filtration rate. At the same time, patients will also have high blood pressure, swelling and other symptoms.
Creatinine can also be used to calculate GFR (glomerular filtration rate) and Ccr (creatinine clearance rate). GFR can better reflect the remaining kidney functions and Ccr can indicate severity of renal damages.
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