Creatinine a chemical waste molecule that is generated in blood or created by normal breakdown from the muscle metabolism, a molecule of major importance for energy production in muscles. The process of filtration of creatinine done by kidney’s out of blood and put it in urine to leave from body. Average 2% of body’s creatine converted to creatinine every day and transported through bloodstream to kidneys. Normally, muscle mass in body is relatively constant, creatinine level in blood remains essentially unchanged on daily basis. Kidney’s maintain the blood creatinine in a normal range. Creatinine is chiefly filtered out of blood by the kidneys, though a small amount is actively secreted by kidneys into urine. If filtering of kidney is deficient, blood levels then rise. Therefore, creatinine levels in blood and urine used to calculate the creatinine clearance (CrCl) which reflects the glomerular filtration rate (GFR), clinically an important aspect to measure the renal function.
However, in cases of severe renal dysfunction, creatinine clearance rate will be “overestimated” because the active secretion of creatinine will account for a larger fraction of total creatinine cleared. A more complete estimation of renal function can be made when interpreting the blood (plasma) concentration of creatinine along with that of urea.
BUN-to-creatinine ratio (ratio of urea to creatinine) can show other problems besides those intrinsic to kidney; a urea level raised out of proportion to creatinine may show a prerenal problem such as volume depletion. Normally, men tend to have higher levels of creatinine because they generally have more skeletal muscle mass than women. It has also been observed that vegetarians to have lower creatinine levels too.
When kidneys become impaired for any reason, creatinine level in blood will rise due to poor clearance, means unable to filter it properly. Abnormally high levels of creatinine thus warn of possible malfunction or failure of the kidneys. It is for this reason that standard blood tests routinely check the amount of creatinine in blood.
A more precise measure of kidney function can be estimated by calculating how much creatinine cleared from body and it is referred to creatinine clearance. Normal levels of creatinine in the blood are about 0.6 to 1.2 milligrams (mg) per deciliter (dl) in adult men and 0.5 to 1.1 milligrams per deciliter in adult women. In the metric system a milligram is unit of weight equal to one-thousandth of a gram, and a deciliter is a unit of volume equal to one-tenth of a litre. Whatever the condition that impairs the function of kidneys will probably increase the creatinine level in the blood. It is important to recognize whether the process leading to kidney dysfunction.
The liver is responsible for urea and passed out-of-body through urine. If kidneys are not able to remove urea from the blood; normally, BUN level rises. Heart failure, dehydration, or a diet high in protein can also make BUN level higher. (BUN) test to see if severe dehydration is present. Kidney disease or blockage of the flow of urine from kidney causes both BUN and creatinine levels to go up.
•High values BUN can mean kidney injury or disease is present. Kidney damage caused may be because of diabetes or high blood pressure that directly affects. High BUN levels can also be caused by blockage of the urinary tract (by kidney stone or tumor) or low blood flow to the kidneys caused by dehydration or heart failure. A high BUN value is caused by a high-protein diet, or from bleeding in the gastrointestinal digestive tract or respiratory tract.
•Low value BUN is caused by a diet very low in protein, malnutrition, or severe liver damage. Drinking excessive amounts of liquid may cause dehydration that cause low BUN value. A low BUN-to-creatinine ratio may be caused by a diet low in protein. Taking diuretics that can also cause dehydration.
Gastrointestinal bleeds; it is useful for the diagnosis of upper gastrointestinal bleeding in patients who do not present with overt vomiting of blood.
The most common causes of longstanding kidney disease are high blood pressure and diabetes mellitus. Certain drugs can sometimes cause abnormally elevated creatinine levels. Serum creatinine can also transiently rise after ingestion of large amount of dietary meat.
Why kidneys get damage; most kidney diseases attack neurons causing them to lose their filtering capacity. Damage to the nephrons may happen quickly, often as result of injury or poisoning. But most kidney diseases destroy neurons slowly and silently. It may take years or even decades for damage to become apparent. The two most common causes of kidney disease are diabetes and high blood pressure.
Signs; Early stages of kidney disease may not feel sick at all, first sign: one may be having feeling of tiredness or itchiness all over the body or frequent headaches. If disease gets worsen, need to urinate more often or less often. May lose appetite, experience nausea and vomiting. Swelling of hands or feet or may feel numb. May get feeling of drowsiness or having trouble in concentrating, skin may darken and have muscle cramps. Some people may have an incidental finding of severe kidney disease and higher creatinine on routine blood work without having any symptoms at all. In others, depending on the cause of problem, many symptoms may be present including: feeling dehydrated, fatigue, shortness of breath, confusion, or many other nonspecific symptoms.
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