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Blood creatinine increases, what is the clinical significance of detecting serum creatinine?

2018-02-07 17:15

Endogenous blood creatinine is the product of muscle metabolism in human body. In muscle, creatine slowly forms creatinine through irreversible non-enzymatic dehydration reaction, which is released into the blood and excreted with urine. Therefore, serum creatinine is closely related to the total amount of muscle in the body. Not easily affected by diet.

Blood creatinine increases, what is the clinical significance of detecting serum creatinine?

Creatinine is a small molecule that can be filtered through the glomeruli, rarely absorbed in the renal tubules, and almost all of the creatinine produced in the body is excreted with urine. Blood creatinine is one of the most commonly used methods for understanding renal function. Elevated serum creatinine indicates damage to renal function; when serum creatinine levels exceed 177umolrl, renal dysfunction occurs. The serum creatinine accumulates to be a harmful toxin to human body. The normal value of serum creatinine is 88.4-176.8 micromoles / liter.

Serum creatinine concentration mainly depends on glomerular filtration function, but creatinine and creatinine clearance rate are not exactly consistent, creatinine clearance rate is more sensitive than serum creatinine. When the glomerular filtration rate decreased to more than 50%, the creatinine began to rise rapidly, so when the serum creatinine was significantly higher than normal, Because creatinine clearance rate is also affected by glomerular concentration function, blood creatinine is the most reliable index to reflect glomerular function.

Because of the large compensatory capacity of the kidney, serum creatinine levels do not generally increase in the early stages of kidney disease, and only when the glomerular filtration capacity is reduced by half or more does the serum creatinine concentration increase. Therefore, its sensitivity is poor. Once a sustained increase in serum creatinine occurs, the prognosis is often serious. Creatinine detection is mainly found in acute or chronic glomerulonephritis and other renal diseases, but also in polycystic kidney disease.

When the above diseases cause glomerular filtration dysfunction, because of the strong reserve and compensatory capacity of the kidney, the creatinine concentration in the blood can be normal at early or mild damage. Only when glomerular filtration function drops to 1/3 of normal people does serum creatinine increase significantly.

The simultaneous determination of serum creatinine and urea nitrogen is more significant, if both increase at the same time, indicating that the renal function has been seriously damaged, therefore, the blood creatinine increase and reference urea nitrogen determination.

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