Creatinine is a waste product of muscle
breakdown. It is removed from the blood through your kidneys and high levels
can signal kidney issues. This test therefore helps assess kidney function.
Some people with a “normal”
creatinine levels can also have kidney disease. This is because a “normal”
creatinine level can change depending on multiple factors like age, sex and
body size0.
The best way to understand how
well your kidneys are functioning is to look at eGFR (estimated glomerular
filtration ratio) which is calculated using serum (blood) creatinine level, age
and sex, height and weight.
The serum (blood) creatinine derived
eGFR is used:
- To establish a diagnosis of kidney dysfunction - AKI
(acute kidney injury) or CKD (chronic kidney disease)
- To classify the stage of CKD
- To monitor changes in kidney function over time in
people with CKD
- To decide if any medication needs to be stopped or
modification of dose
Evaluation of kidney functions includes
a combination of history, clinical examination and laboratory tests.
The baseline blood tests range
from CBC, blood urea/ creatinine, electrolytes (Na/K), calcium/ phosphorus/
uric acid, serum protein/ albumin etc. Urine examination involves physical
examination for colour/ turbidity, chemical analysis for protein/ blood/ sugar,
microscopic evaluation for WBC/ RBC/ Casts/ Crystals etc and urine culture.
Radiological studies include USG, X Ray, CT scan & Radionuclide scan. Specialized
tests like iPTH, iron studies and serological/ immunological tests may also be
required depending on associated illness.
Kidney biopsy may be indicated in
certain situations. It is a bedside procedure done under L/A using real-time
USG guidance. Tissue is examined after staining with special stains.
Therefore only looking at a
creatinine level is not the best way to completely understand kidney health.
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