Creatinine Test - Creatine Urine Test
What Is Creatinine?
Creatinine
is a waste product of creatine; an amino-acid contained in
muscle tissue and found in urine.
1
Creatinine is a chemical waste
molecule that is generated from muscle metabolism. Creatinine is
produced from creatine, a molecule of major importance for energy
production in muscles. Approximately 2% of the body's creatine is
converted to creatinine every day. Creatinine is transported through
the bloodstream to the kidneys. The kidneys filter out most of the
creatinine and dispose of it in the urine.
There are 2 main types of creatinine tests:
There are 2 main reasons for a creatinine test,
to:
Because the
muscle mass in the body is relatively constant from day to day, the
creatinine level in the blood normally remains essentially unchanged
on a daily basis.
What Is Adulteration? -
Altered Urine Sample
Adulteration is the tampering of a urine specimen
with the intention of altering the test results. The use of
adulterants can cause false negative results in drug tests by either
interfering with the screening test and/ or destroying the drugs
present in the urine. Dilution may also be employed in an attempt to
produce false negative drug test results.
A
person may attempt to foil a test by drinking excessive amounts of
water or diuretics such as herbal teas to “flush” the system.
Creatinine and specific gravity are two ways to check for dilution
and flushing, which are the most common mechanisms used in an
attempt to circumvent drug testing. Low creatinine and specific
gravity levels may indicate dilute urine. The absence of creatinine
(<5mg/dl) is indicative of a specimen not consistent with human
urine.
One of the best ways to test for adulteration or
dilution is to determine certain urinary characteristics such as
creatinine, pH, and specific gravity and to detect the presence of
glutaraldehyde, nitrite and oxidants /pyridinium chlorochromate
(PCC) in urine.
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Urine Creatinine Test -
Specimen Validity
Test (S.V.T.) |
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Description
#DUC-111 - One Step
Specimen Validity Test (SVT) (25 tests per bottle).
Urine Adulteration Test Strips provide rapid,
semi-quantitative detection of 7 parameters (Creatinine, Nitrite,
Glutaraldehyde, pH, Specific Gravity, Oxidants /
pyridinium chlorochromate
(PCC) in human urine.
-
7 testing parameters
-
Easy to interpret color chart
-
2 year shelf life
- 1 minute
read time
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One of the best ways to test for adulteration or
dilution is to determine certain urinary characteristics such as
creatinine, pH, and specific gravity and to detect the presence of
glutaraldehyde, nitrite and oxidants /pyridinium chlorochromate
(PCC) in urine.
-
Creatininene
is a waste product of creatine; an amino-acid contained in
muscle tissue and found in urine.
1 A
person may attempt to foil a test by drinking excessive amounts
of water or diuretics such as herbal teas to “flush” the system.
Creatinine and specific gravity are two ways to check for
dilution and flushing, which are the most common mechanisms used
in an attempt to circumvent drug testing. Low creatinine and
specific gravity levels may indicate dilute urine. The absence
of creatinine (<5mg/dl) is indicative of a specimen not
consistent with human urine.
-
Specific gravity tests for sample
dilution. The normal range is from 1.003 to 1.030. Values
outside this range may be the result of specimen dilution or
adulteration.
-
Nitrite
tests for commonly used commercial adulterants such as Klear or
Whizzies. They work by oxidizing the major cannabinoid
metabolite THC-COOH.2
Normal urine should contain no trace of nitrite.
Positive results generally indicate the presence of an
adulterant.
-
Glutaraldehyde tests
for the presence of an aldehyde. Adulterants such as UrinAid and
Clear Choice contain glutaraldehyde which may cause false
negative screening results by disrupting the enzyme used in some
immunoassay tests.³ Glutaraldehyde is not normally found in
urine; therefore, detection of glutaraldehyde in a urine
specimen is generally an indicator of adulteration.
-
pH
tests for the presence of acidic or alkaline adulterants in
urine. Normal pH levels should be in the range of 4.0 to 9.0.
Values outside of this range may indicate the sample has been
altered.
-
Oxidants/PCC (Pyridinium Chlorochromate)
tests for the presence of oxidizing agents such as bleach
and hydrogen peroxide. Pyridinium chlorochromate (sold under the
brand name UrineLuck) is a commonly used adulterant.³ Normal
human urine should not contain oxidants or PCC.
One Step Specimen Validity Test (S.V.T.)
A rapid, one step screening test for the
simultaneous detection of Creatinine, Nitrite, Glutaraldehyde, pH,
Specific Gravity, and Oxidants/Pyridinium Chlorochromate (PCC) in
human urine.
For forensic
use only.
INTENDED USE
The One Step S.V.T. is a semi-quantitative, color
comparison screen for the detection of creatinine, nitrite,
glutaraldehyde, pH, specific gravity, and oxidants / pyridinium
chlorochromate (PCC) in human urine.
This test provides a preliminary screen only. A
more specific alternate chemical method must be used in order to
obtain a confirmed analytical result. Abnormal results should be
sent to a laboratory for confirmation.
SUMMARY
Each of the plastic strips contains six (6)
chemically treated reagent pads. One (1) minute following the
activation of the reagent pads by the urine sample, the colors that
appear on the pads can be compared with the printed color chart on
the canister. The color comparison provides a semi-quantitative
screen for creatinine, nitrite, glutaraldehyde, pH, specific
gravity, and oxidants / pyridinium chlorochromate (PCC) in human
urine which can help assess the integrity of the urine sample.
PRINCIPLE
The test is based on the color derived from the
chemical reaction between the chemical reagent on each test pad and
the urine sample.
REAGENTS
|
Adulteration Pad |
Reactive indicator |
Buffers and non-reactive
ingredients |
|
Creatinine |
0.04% |
99.96% |
|
Nitrite |
0.07% |
99.93% |
|
Glutaraldehyde |
0.02% |
99.98% |
|
pH |
0.06% |
99.94% |
|
Specific Gravity |
0.25% |
99.7% |
|
Oxidants / PCC |
0.36% |
99.64% |
PRECAUTIONS
-
For
forensic use only. Do not use after the expiration date.
-
The
adulteration strips should remain in the sealed canister until
use.
-
All specimens
should be considered potentially hazardous and handled in the
same manner as an infectious agent.
-
The used test
strip should be discarded according to federal, state and local
regulations.
STORAGE AND STABILITY
Store as packaged in the sealed canister at
15-30°C. The test strips must remain sealed in the canister until
use. DO NOT FREEZE. Do not use beyond the expiration date. Avoid
direct exposure to sunlight.
SPECIMEN
COLLECTION AND PREPARATION
Urine Assay
The urine
specimen must be collected in a clean and dry container. Test urine
as soon as possible after collection.
Specimen Storage
For best results, test specimens immediately
following collection. Storage of urine specimens should not exceed 2
hours at room temperature or 4 hours refrigerated (2-8°C) prior to
testing.
MATERIALS
Materials Provided
Materials Required But Not Provided
DIRECTIONS FOR USE
-
Allow the adulteration strip to
equilibrate to room temperature (15-30 C) prior to testing.
-
Remove the
strip(s) from the canister and recap tightly.
-
Dip test
strip into the urine specimen and remove immediately.
-
Blot the test
gently on its side to remove excess urine. NOTE: It is important
to blot the test strip for consistent results.
-
Read results
in one (1) minute by comparing each pad with the color chart
printed on the canister. Do not interpret test results after
4 minutes.
-
If the test
indicates adulteration, refer to your Drug Free Policy for
guidelines on handling adulterated specimens.
INTERPRETATION OF RESULTS

(Please refer to the illustration above)
Semi Quantitative
results are obtained by visually comparing the reacted color blocks
on the strip to the printed color blocks on the canister. No
instrumentation is required.
Quality Control
Control standards are not supplied with this kit.
However, it is recommended that positive and negative specimens or
controls be tested as good laboratory practice to confirm the test
procedure and to verify proper test performance.
LIMITATIONS
1.
The adulteration tests included with this
product are meant to aid in the determination of abnormal specimens.
While comprehensive, these tests are not meant to be an
“all-inclusive” representation of possible adulterants.
2.
Creatinine: Normal creatinine
levels are between 20 and 350 mg/dL. Under rare conditions,
certain kidney diseases may show dilute urine.
3.
Nitrite: Nitrite is not a
normal component of human urine. However, nitrite found in urine may
indicate urinary tract infections or bacterial infections. Nitrite
levels of > 20 mg/dL may produce false positive glutaraldehyde
results.
4.
Glutaraldehyde: Is not
normally found in urine. However certain metabolic
abnormalities such as ketoacidosis (fasting, uncontrolled diabetes
or high-protein diets) may interfere with the test results.
5.
Specific Gravity:
Elevated levels of protein in urine may cause abnormally high
specific gravity values.
6.
Oxidants/PCC: Normal
human urine should not contain oxidants or PCC. The presence
of high levels of antioxidants in the specimen, such as ascorbic
acid, may result in false negative results for the oxidants/PCC pad.
BIBLIOGRAPHY OF SUGGESTED READING
1.
Tietz NW. Textbook of Clinical Chemistry. W.B. Saunders Company.
1986, 1734.
2.
Tsai, S.C. et.al., J. Anal. Toxicol. 1998; 22 (6): 474
3.
Cody, J.T., “Specimen Adulteration in drug urinalysis. Forsenic Sci.
Rev., 1990, 2:63.
4.
Mikkelsen, S.L. et.al., Clin. Chem. 1988; 34: 648
5.
Hardman J, Limbird LE (Eds). Goodman & Gilman’s The
Pharmacological Basis of
Therapeutics, 10th Ed.,
McGraw-Hill Publishing. 2001, 1010.
Creatinine Reveals Important Information About Your Kidneys
What is creatinine?
Creatinine is a chemical waste molecule
that is generated from muscle metabolism. Creatinine is produced from
creatine, a molecule of major importance for energy production in
muscles. Approximately 2% of the body's creatine is converted to
creatinine every day. Creatinine is transported through the bloodstream
to the kidneys. The kidneys filter out most of the creatinine and
dispose of it in the urine.
Because the muscle mass in the body is
relatively constant from day to day, the creatinine level in the blood
normally remains essentially unchanged on a daily basis.
A creatinine test
reveals important information about your kidneys.
Creatinine is a
chemical waste product that's produced when you use your muscles or eat
meat. Healthy kidneys filter creatinine and other waste products from
your blood. The filtered waste products leave your body in your urine.
If your kidneys aren't functioning properly, an increased level of
creatinine may accumulate in your blood. A serum creatinine test
measures the level of creatinine in your blood.
Creatinine can also be
measured in your urine.
Because diabetes can
damage the kidneys, regular creatinine tests are often recommended for
people who have type 1 or type 2 diabetes. If you have kidney disease,
creatinine tests can help your doctor monitor your condition. Creatinine
tests can also impact your treatment plan, since several medications may
not be safe to take if your kidneys aren't working well.
Creatinine Blood Test
How is the creatinine blood
test used?
The creatinine blood test is
used along with a BUN (blood urea nitrogen) test to assess kidney
function. Both are frequently ordered as part of a basic or
comprehensive metabolic panel (BMP or CMP), groups of tests that are
performed to evaluate the function of the body’s major organs. BMP or
CMP tests are used to screen healthy people during routine physical
exams and to help evaluate acutely or chronically ill patients in the
emergency room and/or hospital. If the creatinine and BUN tests are
found to be abnormal or if you have an underlying disease, such as
diabetes, that is known to affect the kidneys, then these two tests may
be used to monitor the progress of kidney dysfunction and the
effectiveness of treatment. Blood creatinine and BUN tests may also be
ordered to evaluate kidney function prior to some procedures, such as a
CT (computed tomography) scan, that may require the use of drugs that
can damage the kidneys.
A combination of blood and
urine creatinine levels may be used to calculate a creatinine clearance.
This test measures how effectively your kidneys are filtering small
molecules like creatinine out of your blood.
Urine creatinine may also be
used with a variety of other urine tests as a correction factor. Since
it is produced and removed at a relatively constant rate, the amount of
urine creatinine can be compared to the amount of another substance
being measured. Examples of this are when creatinine is measured with
protein to calculate a urine protein/creatinine ratio (UP/CR) and when
it is measured with microalbumin to calculate microalbumin/creatinine
ratio (also known as albumin/creatinine ratio, ACR). These tests are
used to evaluate kidney function as well as to detect other urinary
tract disorders.
Serum creatinine measurements
(along with your age, weight, and gender) also are used to calculate the
estimated glomerular filtration rate (eGFR), which is used as a
screening test to look for evidence of kidney damage.
When is it ordered?
Creatinine may be ordered
routinely as part of a comprehensive or basic metabolic panel, during a
health examination. It may be ordered when you have non-specific health
complaints, when you are acutely ill, and/or when your doctor suspects
your kidneys are not working properly. Some signs and symptoms of kidney
dysfunction include:
-
Fatigue, lack of
concentration, poor appetite, or trouble sleeping
-
Swelling or puffiness,
particularly around the eyes or in the face, wrists, abdomen, thighs
or ankles
-
Urine that is foamy,
bloody, or coffee-colored
-
A decrease in the amount of
urine
-
Problems urinating, such as
a burning feeling or abnormal discharge during urination, or a change
in the frequency of urination, especially at night
-
Mid-back pain (flank),
below the ribs, near where the kidneys are located
-
High blood pressure
The creatinine blood test may
be ordered, along with BUN test and microalbumin, at regular intervals
when you have a known kidney disorder or have a disease that may affect
kidney function or be exacerbated by dysfunction. Both BUN and
creatinine may be ordered when a CT scan is planned, prior to and during
certain drug therapies, and before and after dialysis to monitor the
effectiveness of treatments.
What does the test result
mean?
Increased creatinine levels
in the blood suggest diseases or conditions that affect kidney function.
These can include:
-
Damage to or swelling of
blood vessels in the kidneys (glomerulonephritis) caused by, for
example, infection or autoimmune diseases
-
Bacterial infection of the
kidneys (pyelonephritis)
-
Death of cells in the
kidneys’ small tubes (acute tubular necrosis) caused, for example, by
drugs or toxins
-
Prostate disease, kidney
stone, or other causes of urinary tract obstruction
-
Reduced blood flow to the
kidney due to shock, dehydration, congestive heart failure,
atherosclerosis, or complications of diabetes
Creatinine blood levels can
also increase temporarily as a result of muscle injury and are generally
slightly lower during pregnancy.
Low blood levels of
creatinine are not common, but they are also not usually a cause for
concern. They can be seen with conditions that result in decreased
muscle mass.
Levels of 24-hour urine
creatinine are evaluated with blood levels as part of a creatinine
clearance test.
Random urine creatinine
levels have no standard reference ranges. They are usually used with
other tests to reference levels of other substances measured in the
urine. Some examples include the microalbumin test and urine protein
test.
NOTE: The result of your blood creatinine test is measured by your
doctor against a reference range for the test to determine whether the
result is “normal” (it is within the range of numbers), high (it is
above the high end of the range), or low (it is below the low end of the
range). Because there can be many variables that affect the
determination of the reference range, the reference range for this test
is specific to the lab where your test sample is analyzed. For this
reason, the lab is required to report your results with an accompanying
reference range. Typically, your doctor will have sufficient familiarity
with the lab and your medical history to interpret the results
appropriately
While there is no such thing as a “standard” reference range for blood
creatinine, most labs will report a similar, though maybe not exactly
the same, set of numbers as that included in medical textbooks or found
elsewhere online. For this reason, we recommend that you talk with your
doctor about your lab results. For general guidance only, we are
providing the reference range for this test below from the classic
medical text, Tietz Textbook of Clinical Chemistry and Molecular
Diagnostics.
Is there anything else I
should know?
Drugs such as aminoglycosides
(vancomycin, gentamicin) can cause kidney damage and so creatinine is
monitored. Other drugs, such as cephalosprins (cefoxitin), may increase
creatinine concentration without reflecting kidney damage.
Why Get Tested?
To determine if your kidneys
are functioning normally and to monitor treatment for kidney disease
When to Get Tested?
Routinely as part of a
comprehensive or basic metabolic panel; if your doctor suspects that you
are suffering from kidney dysfunction or if you are acutely or
chronically ill with a condition that may affect your kidneys and/or be
worsened by kidney dysfunction; at intervals to monitor treatment for
kidney disease or kidney function while on certain medications
Creatinine and Creatinine
Clearance
Creatinine and creatinine
clearance tests measure the level of the waste product creatinine in
your blood and urine. These tests tell how well your kidneys are
working. The substance creatine is formed when food is changed into
energy through a process called metabolism. Creatine is broken down into
another substance called creatinine, which is taken out of your blood by
the kidneys and then passed out of your body in urine. See a picture of
the kidneys.
Creatinine is made at a
steady rate and is not affected by diet or by normal physical
activities. If your kidneys are damaged and cannot work normally, the
amount of creatinine in your urine goes down while its level in your
blood goes up.
Three types of tests on
creatinine can be done:
Blood creatinine level
The blood creatinine level
shows how well your kidneys are working. A high creatinine level may
mean your kidneys are not working properly. The amount of creatinine in
the blood depends partly on the amount of muscle tissue you have; men
generally have higher creatinine levels than women.
Creatinine clearance test
A creatinine clearance test
measures how well creatinine is removed from your blood by your kidneys.
A creatinine clearance test gives better information than a blood
creatinine test on how well your kidneys are working. A creatinine
clearance test is done on both a blood sample and on a sample of urine
collected over 24 hours (24-hour urine sample).
Blood urea
nitrogen-to-creatinine ratio (BUN:creatinine)
The levels of blood
creatinine and blood urea nitrogen (BUN) can be used to find the
BUN-to-creatinine ratio. A BUN-to-creatinine ratio can help your doctor
check for problems, such as dehydration, that may cause abnormal BUN and
creatinine levels.
Urea is a waste product made
when protein is broken down in your body. Urea is made in the liver and
passed out of your body in the urine. A blood urea nitrogen (BUN) test
measures the amount of urea in your blood. Like creatinine, it can help
your doctor see how well your kidneys are working.
Why It Is Done
A blood creatinine level or a
creatinine clearance test is done to see:
-
if your kidneys
are working normally.
-
if your kidney
disease is changing.
-
how well the
kidneys work in people who take medicines that can cause kidney damage.
-
if severe
dehydration is present. Dehydration generally causes BUN levels to rise
more than creatinine levels. This causes a high BUN-to-creatinine ratio.
Kidney disease or blockage of the flow of urine from your kidney causes
both BUN and creatinine levels to rise.
How To Prepare
Do not do any strenuous
exercise for 2 days (48 hours) before having creatinine tests.
Do not eat more than 8oz of
meat, especially beef, or other protein for 24 hours before the blood
creatinine test and during the creatinine clearance urine test.
It is important to drink
enough fluids during the 24-hour urine collection but do not drink
coffee and tea. These are diuretics that cause your body to pass more
urine.
How It Is Done
Collection of the blood
sample
The health professional
drawing blood will:
-
Wrap an elastic band
around your upper arm to stop the flow of blood. This makes the veins
below the band larger so it is easier to put a needle into the vein.
-
Clean the needle site
with alcohol.
-
Put the needle into
the vein. More than one needle stick may be needed.
-
Attach a tube to the
needle to fill it with blood.
-
Remove the band from
your arm when enough blood is collected.
-
Put a gauze pad or
cotton ball over the needle site as the needle is removed.
-
Put pressure to the
site and then a bandage.
Collection of the 24-hour
urine sample
-
You start collecting
your urine in the morning. When you first get up, empty your bladder but
do not save this urine. Write down the time that you urinated to mark
the beginning of your 24-hour collection period.
-
For the next 24 hours,
collect all your urine. Your doctor or lab will usually provide you with
a large container that holds about 1 gal (4 L). The container has a
small amount of preservative in it. Urinate into a small, clean
container and then pour the urine into the large container. Do not touch
the inside of the container with your fingers.
-
Keep the large
container in the refrigerator for the 24 hours.
-
Empty your bladder for
the final time at or just before the end of the 24-hour period. Add this
urine to the large container and record the time.
-
Do not get toilet
paper, pubic hair, stool (feces), menstrual blood, or other foreign
matter in the urine sample.
How It Feels
Blood test
The blood sample is taken
from a vein in your arm. An elastic band is wrapped around your upper
arm. It may feel tight. You may feel nothing at all from the needle, or
you may feel a quick sting or pinch.
Urine test
There is no pain while
collecting a 24-hour urine sample.
Risks
Risks of a blood test
There is very little chance
of a problem from having blood sample taken from a vein.
-
You may get a small
bruise at the site. You can lower the chance of bruising by keeping
pressure on the site for several minutes.
-
In rare cases, the
vein may become swollen after the blood sample is taken. This problem is
called phlebitis. A warm compress can be used several times a day to
treat this.
-
Ongoing bleeding can
be a problem for people with bleeding disorders. Aspirin, warfarin
(Coumadin), and other blood-thinning medicines can make bleeding more
likely. If you have bleeding or clotting problems, or if you take
blood-thinning medicine, tell your doctor before your blood sample is
taken.
Urine test
There is no chance for
problems while collecting a 24-hour urine sample.
Results
Creatinine and creatinine
clearance tests measure creatinine levels in your blood and urine to
give information about how well your kidneys are working. The creatinine
clearance value is found from the amounts of creatinine in the urine and
blood and from the amount of urine you pass in 24 hours. This value is
the amount of blood cleared of creatinine per minute, based on your body
size.
Normal
Normal results may vary from
lab to lab.
|
Blood creatinine
and creatinine clearance
|
|
Blood creatinine: |
Men:
0.7–1.2 milligrams per deciliter (mg/dL)
Women:
0.6–1.0 mg/dL
Teen:
0.5–1.0 mg/dL
Child:
0.3–0.7 mg/dL
Newborn:
0.3–1.2 mg/dL |
|
Creatinine
clearance: |
Men:
90–140 milliliters per minute (mL/min) or 1.78–2.32 milliliters
per second (mL/sec)
Women:
87–107 mL/min or 1.45–1.78 mL/sec |
Creatinine clearance values
normally go down as you get older (normal values go down by 6.5 mL/min
for every 10 years past the age of 20).
|
BUN-to-creatinine
ratio
|
|
Over 12 months of
age: |
10:1 to 20:1
|
|
Infants less than
12 months of age: |
Up to 30:1 |
High values
-
High creatinine blood
levels. High creatinine blood levels can mean serious kidney damage or
disease is present. Kidney damage can be caused by a life-threatening
infection, shock, cancer, or low blood flow to the kidneys. Other
conditions that can cause high blood creatinine levels include blockage
of the urinary tract (such as by a kidney stone), heart failure,
dehydration, excessive blood loss that causes shock, gout, or muscle
conditions (such as rhabdomyolysis, gigantism, acromegaly, myasthenia
gravis, muscular dystrophy, and polymyositis). Usually a high blood
creatinine level means that the creatinine clearance value is lower than
normal.
-
High creatinine
clearance. High creatinine clearance values can be caused by strenuous
exercise, muscle injury (especially crushing injuries), burns, carbon
monoxide poisoning, hypothyroidism, and pregnancy.
-
High BUN-to-creatinine
ratio. High BUN-to-creatinine ratios occur with sudden (acute) kidney
failure, which may be caused by shock or severe dehydration. A blockage
in the urinary tract (such as a kidney stone) can cause a high
BUN-to-creatinine ratio. A very high BUN-to-creatinine ratio may be
caused by bleeding in the digestive tract or respiratory tract.
Low values
-
Low blood creatinine
levels. Low blood creatinine levels can mean lower muscle mass caused by
a disease, such as muscular dystrophy, or by aging. Low levels can also
mean some types of severe liver disease or a diet very low in protein.
Pregnancy can also cause low blood creatinine levels.
-
Low creatinine
clearance. Low creatinine clearance levels can mean serious kidney
damage is present. Kidney damage can be from conditions such as a
life-threatening infection, shock, cancer, low blood flow to the
kidneys, or urinary tract blockage. Other conditions, such as heart
failure, dehydration, and liver disease (cirrhosis), can also cause low
creatinine clearance levels.
-
Low BUN-to-creatinine
ratio. A low BUN-to-creatinine ratio may be associated with a diet low
in protein, a severe muscle injury called rhabdomyolysis, pregnancy,
cirrhosis, or syndrome of inappropriate antidiuretic hormone secretion
(SIADH). SIADH sometimes occurs with lung disease, cancer, diseases of
the central nervous system, and the use of certain medications.
What Affects the Test
Reasons you may not be able
to have the test or why the results may not be helpful include:
-
Taking medicines, such
as methyldopa, trimethoprim (Proloprim, Trimpex), vitamin C (ascorbic
acid), cimetidine (Tagamet), some diuretics, and cephalosporin
antibiotics, especially cefoxitin (Mefoxin). These affect the blood
creatinine levels.
-
Taking medicines, such
as vitamin C (ascorbic acid), phenytoin (Dilantin), some cephalosporin
antibiotics, captopril, aminoglycosides, trimethoprim (Proloprim,
Trimpex), cimetidine (Tagamet), quinine, quinidine (Cardioquin,
Quinaglute, Quinidex), procainamide, and the antifungal medication
amphotericin B. These affect the creatinine clearance levels.
-
Taking medicines, such
as cimetidine (Tagamet), steroids, and tetracycline antibiotics. These
can affect the BUN-to-creatinine ratio.
-
Doing strenuous
exercise 2 days before creatinine clearance test.
-
Eating more than 8oz
of meat, especially beef, in the 24 hours before a blood creatinine test
and during a creatinine clearance urine test.
What To Think About
-
A high blood
creatinine level is generally seen with a low creatinine clearance level
because creatinine in the blood is normally removed by the kidneys. If
the kidneys are not able to remove creatinine (low creatinine
clearance), levels of creatinine in the blood go up (high blood
creatinine level).
-
If you are pregnant,
your doctor can check the amount of creatinine in amniotic fluid to see
how developed, or mature, your baby's kidneys are. This can be helpful
if there is a chance your baby will be delivered early. A baby who has
mature kidneys will make more creatinine than a baby whose kidneys are
still developing.
-
A normal blood
creatinine level does not rule out kidney disease. To help see whether
kidney damage may be present, a BUN level is also measured. Other tests
may also be done to check for kidney disease. For more information, see
the medical test Blood Urea Nitrogen.
-
Creatinine levels
increase more slowly than blood urea nitrogen (BUN) levels, so an
increase in creatinine may mean chronic kidney problems.
-
A glomerular
filtration rate may be done for people with chronic kidney disease to
regularly check how well the kidneys are working.
-
Diabetes experts
recommend that blood creatinine levels be done every year for people
with diabetes. The creatinine level is used to find the glomerular
filtration rate, which shows how well the kidneys are working.
-
The amount of
creatinine in the blood depends partly on the amount of muscle tissue;
blood creatinine levels are generally higher in men than in women. Also,
people who have large muscles, such as athletes, normally have
above-average blood creatinine levels.
-
A one-time urine
sample to measure urine creatinine and sodium is sometimes done along
with blood creatinine and sodium levels to help find the fractional
excretion of sodium (FENA). This test can help your doctor see whether a
problem with blood flow to the kidneys is caused by dehydration or shock
or by damage to the kidneys themselves.
Why is it important to check blood creatinine levels?
The kidneys maintain the blood creatinine
in a normal range. Creatinine has been found to be a fairly reliable
indicator of kidney function.
As the kidneys become impaired for any
reason, the creatinine level in the blood will rise due to poor
clearance by the kidneys. 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
the blood. A more precise measure of the kidney function can be
estimated by calculating how much creatinine is cleared from the body by
the kidneys and it is referred to creatinine clearance.
What are "normal" blood creatinine levels?
Normal levels of creatinine in the blood
are approximately 0.6 to 1.2 milligrams (mg) per deciliter (dl) in adult
males and 0.5 to 1.1 milligrams per deciliter in adult females. (In the
metric system, a milligram is a unit of weight equal to one-thousandth
of a gram, and a deciliter is a unit of volume equal to one-tenth of a
liter.)
Muscular young or middle-aged adults may
have more creatinine in their blood than the norm for the general
population. Elderly persons, on the other hand, may have less creatinine
in their blood than the norm. Infants have normal levels of about 0.2 or
more, depending on their muscle development. In people with
malnutrition, severe weight loss, and long standing illnesses the muscle
mass tends to diminish over time and, therefore, their creatinine level
may be lower than expected for their age.
A person with only one kidney may have a
normal level of about 1.8 or 1.9. Creatinine levels that reach 2.0 or
more in babies and 10.0 or more in adults may indicate severe kidney
impairment and the need for a dialysis machine to remove wastes from the
blood.
What are the reasons for elevated blood creatinine?
Any condition that impairs the function
of the kidneys will probably raise the creatinine level in the blood. It
is important to recognize whether the process leading to kidney
dysfunction (kidney failure, azotemia) is longstanding or recent.
The most common causes of longstanding
kidney disease in adults 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.
Are there any symptoms associated with elevated blood creatinine levels?
The symptoms of kidney dysfunction (renal
insufficiency) vary widely. Some people may have a incidental finding of
severe kidney disease and elevated creatinine on routine blood work
without having any symptoms at all. In others, depending on the cause of
problem, many different symptoms may be present including:
Creatinine is a chemical waste molecule
that is generated from muscle metabolism. Creatinine is produced from
creatine, a molecule of major importance for energy production in
muscles. Creatinine has been found to be a fairly reliable indicator of
kidney function. As the kidneys become impaired the creatinine level in
the blood will rise. Normal levels of creatinine in the blood vary from
gender and age of the individual.
Why it's done
A serum creatinine
test — which measures the level of creatinine in your blood — can
indicate whether your kidneys are working properly. How often you need
creatinine tests depends on any underlying conditions and your risk of
kidney damage. For example:
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If you have type 1 or type 2
diabetes, your doctor may recommend a creatinine test at least once a
year.
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If you have kidney disease, your
doctor may recommend creatinine tests at regular intervals to monitor
your condition.
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Your doctor may recommend
creatinine tests if you have an illness that may affect your kidneys or
you're taking medication that may affect your kidneys.
How you prepare
The serum creatinine
test is a common blood test. If your blood sample is being tested only
for creatinine, you can eat and drink normally before the test. If your
blood sample will be used for additional tests, you may need to fast for
a certain amount of time before the test. Your doctor will give you
specific instructions.
What you can expect
During the serum
creatinine test, a member of your health care team simply takes a sample
of blood by inserting a needle into a vein in your arm. The blood sample
is sent to a lab for analysis. You can return to your usual activities
immediately.
In some cases, your
doctor may measure the level of creatinine in your urine as well. For
this test, your doctor may ask you to collect 24 hours' worth of urine
in a special container and submit it for analysis. The urine creatinine
test can help your doctor more accurately assess the presence or degree
of kidney failure.
Results
Results of the
creatinine blood test are measured in milligrams per deciliter (mg/dL).
The normal range for creatinine in the blood may be 0.6 to 1.2 mg/dL,
although this can vary from lab to lab, between men and women, and by
age. Since the amount of creatinine in the blood increases with muscle
mass, men usually have higher creatinine levels than do women.
Generally, a high
creatinine level means that your kidneys aren't working well. Your
creatinine level may temporarily increase if you're dehydrated or you
take certain medications — including some blood pressure drugs and
nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin,
others). The dietary supplement creatine can have the same effect.
If your creatinine
level is higher than normal, your doctor may want to confirm the results
with another blood or urine test. If kidney damage is a concern, it's
important to control any conditions that may be contributing to the
damage. It's especially important to manage your blood pressure, which
often requires medication. You can't undo permanent kidney damage, but
with appropriate treatment you may be able to prevent further damage.
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