When patients are diagnosed with acute or chronic kidney disease, this is one question I frequently encounter. Through this article, I am addressing the various questions and doubts regarding creatinine levels and how they change before and after dialysis.
Creatinine is a waste product of Muscle Metabolism in the body. The normal blood creatinine levels vary from 0.8-1.21mg/dl. The levels may vary based on age, gender, medical history, etc. Generally, men have a higher creatinine level than women because of the higher muscle mass.
Along with urea, the kidneys also filter creatinine and so, kidney disease can affect the urine and blood concentration of creatinine.
Other factors include potassium levels, acid load on the body, fluid accumulation, blood urea level, progression of renal disease, etc. Overall patient condition is taken into account while starting dialysis. This means that a patient with a creatinine level of 3mg/dl may need dialysis while another with a level of 9mg/dl may not.
Generally, a serum creatinine level of more than 1.2mg/dl in females and more than 1.4mg/dl in males suggests early kidney damage. But again, these levels are subjective and are influenced by many other factors.
Most patients should start preparing for dialysis once creatinine level is above 4mg/dl. The exact creatinine level at which dialysis is needed can’t be predicted in each and every patient. It is always better to be prepared well in advance rather than try to second guess what one’s creatinine level is going to be in a few weeks/months down the line.
In acute renal disease, as the kidney regains its normal function, it will effectively start removing urea and creatinine. Therefore, dialysis for creatinine removal may no longer be needed.
But in CKD, as the damage is more of the permanent kind, creatinine levels will keep on rising again and again and will need to be removed by dialysis. This means that patients suffering from CKD may need lifelong dialysis.
In acute kidney disease, creatinine levels can rapidly increase, indicating increasing damage to the kidney. In chronic cases, the levels do not fluctuate too much but it can vary from person to person.
Dialysis can provide aid in reducing this serum creatinine effectively. The duration of dialysis needed to ensure good health varies with the unique history of the patient but it is safe to say that patients with a chronic renal disease may need lifelong dialysis to function effectively.
Creatinine is a waste product of Muscle Metabolism in the body. The normal blood creatinine levels vary from 0.8-1.21mg/dl. The levels may vary based on age, gender, medical history, etc. Generally, men have a higher creatinine level than women because of the higher muscle mass.
Along with urea, the kidneys also filter creatinine and so, kidney disease can affect the urine and blood concentration of creatinine.
Creatinine levels for dialysis
While blood creatinine levels guide me in the treatment of kidney disease, the decision to start dialysis is not dictated only by creatinine levels.Other factors include potassium levels, acid load on the body, fluid accumulation, blood urea level, progression of renal disease, etc. Overall patient condition is taken into account while starting dialysis. This means that a patient with a creatinine level of 3mg/dl may need dialysis while another with a level of 9mg/dl may not.
Generally, a serum creatinine level of more than 1.2mg/dl in females and more than 1.4mg/dl in males suggests early kidney damage. But again, these levels are subjective and are influenced by many other factors.
At what creatinine level is dialysis started in India?
The creatinine levels to start dialysis in India is similar to anywhere else in the world. As mentioned above, creatinine level is just one of the factors that guides the start of dialysis. It is influenced by various factors. The type of kidney disease, the age of patients, their gender, medical history, etc are also taken into account before dialysis is suggested. Consult your nephrologist for more details.Highest creatinine levels before dialysis
I am somewhat reluctant to answer this question that patients often ask me. This is because if I say that the highest I have seen is a creatinine level of 29mg/dl before starting dialysis, every patient will believe he/she can wait till blood creatinine levels are 29mg/dl before he/she needs to start dialysis. This will harm the patients.Most patients should start preparing for dialysis once creatinine level is above 4mg/dl. The exact creatinine level at which dialysis is needed can’t be predicted in each and every patient. It is always better to be prepared well in advance rather than try to second guess what one’s creatinine level is going to be in a few weeks/months down the line.
What will be the creatinine level after dialysis?
Through dialysis, the various waste products and metabolites are removed from the body. Therefore, dialysis is an effective way to reduce serum creatinine levels in patients. We generally observe that blood creatinine levels fall by 50-60 at the end of each session of dialysis.What happens over the few days after dialysis to creatinine levels?
As you may have guessed, the serum level of creatinine goes up again after a few days of dialysis. Since creatinine is a metabolite of muscle breakdown and the normal wear and tear of muscles will go on throughout the life of an individual, creatinine will have to be removed again and again through dialysis.In acute renal disease, as the kidney regains its normal function, it will effectively start removing urea and creatinine. Therefore, dialysis for creatinine removal may no longer be needed.
But in CKD, as the damage is more of the permanent kind, creatinine levels will keep on rising again and again and will need to be removed by dialysis. This means that patients suffering from CKD may need lifelong dialysis.
Can creatinine levels change quickly?
Creatinine is produced as a result of muscle cell breakdown in the body.In acute kidney disease, creatinine levels can rapidly increase, indicating increasing damage to the kidney. In chronic cases, the levels do not fluctuate too much but it can vary from person to person.
Conclusion:
Creatinine is a waste product, which is excreted through the kidney, and kidney disease can hamper the effective removal of creatinine. This will result in increased levels of creatinine in the blood.Dialysis can provide aid in reducing this serum creatinine effectively. The duration of dialysis needed to ensure good health varies with the unique history of the patient but it is safe to say that patients with a chronic renal disease may need lifelong dialysis to function effectively.