Author: Leo
Key words: nephropathy
Outpatient many patients, in the test of renal function, because serum creatinine increased, the doctor told the renal insufficiency, and even diagnosed as uremia. So, where is the creatinine coming from?
Name: Creatinine Abbreviation: Cre
Category: serum creatinine, creatinine
Reference: male 44-132umol / L, female 70-106umol / L
How does creatinine come from?
Creatinine is a metabolite of muscle in the human body.
There are two major sources of serum creatinine: exogenous creatinine (decomposition of animal lean meat from food) and endogenous creatinine (in vivo muscle breakdown).
Normal serum creatinine reference value:
Male 44-132umol / L, female 70-106umol / L, due to the different hospital testing equipment, the reference range will be some differences.
Usually female creatinine value is lower than men, because the female muscle is not developed by men, the elderly blood creatinine value is lower than the young, because the elderly life, basic metabolism is low, muscle decomposition is slow.
Creatinine is a small molecule, mainly through the kidneys to excreted in vitro, renal tubules rarely absorbed.
Under normal circumstances, because the body's muscle mass and diet is relatively stable, so the amount of creatinine production is relatively constant, the body total creatinine = serum creatinine + urine creatinine.
Urinary creatinine row of the more the better, indicating a strong renal filtration function, and elevated serum creatinine levels that renal damage.
Therefore, the clinical use of serum creatinine as an important indicator of renal injury, and the degree of renal damage was positively correlated.
In addition:
Blood urea nitrogen can also reflect renal function, but it is affected by many factors, such as high protein diet, gastrointestinal bleeding, infection can increase it, and low protein diet, a large number of drinking water, chronic liver disease can lead to blood urea nitrogen concentration Lower, so the evaluation of renal function specificity is poor.
In addition to creatinine:
There are many substances in the human body through the kidney metabolism, but the creatinine metabolic pathway is relatively simple, relatively stable and reliable, so the clinical use of serum creatinine to evaluate the quality of renal function.
Normal serum creatinine function normal?
Check to find their blood creatinine value in the normal range, does not mean that your kidney function is no problem.
because:
Kidney has a strong compensatory function, if the two kidneys are normal, then as long as a kidney function, serum creatinine can be maintained at normal levels.
That is to say:
When the discovery of elevated serum creatinine, nearly half of the kidney has been "broken" the.
How to accurately assess renal function?
Mainly to see glomerular filtration rate (GFR), that is, the amount of time per unit of renal filtration.
However, GFR can not be measured directly, can only be replaced by a certain marker of renal clearance, or calculated by the formula, called the estimated glomerular filtration rate (eGFR).
Inulin removal rate is a recognized standard for the detection of GFR, but because of the cumbersome measurement method, expensive, need continuous infusion and indwelling catheter, so the clinical is not commonly used.
Clinical methods commonly used to evaluate GFR
1, radionuclide labeling (ECT):
That is, intravenous injection of a radioactive substance 99mTc-DTPA, most of this material through the renal filtration, without any other changes, according to the rate of removal of radioactive drugs and the number of eGFR calculated. Compared with the inulin, this check is more simple and easy.
2, endogenous creatinine clearance (Ccr):
Ccr normal value 80-120ml / min. There are two ways to produce creatinine, and when the control of exogenous food and the avoidance of vigorous exercise, the daily production of endogenous creatinine is fairly constant, the endogenous creatinine is treated as a marker, and the endogenous creatinine is discharged by measuring the kidneys In vitro rate, can reflect the renal filtration function.
3, formula:
The formulas for estimating GFR are: CG formula, CKD-EPI formula, MDRD formula. That is, through the serum creatinine, age, sex, race, etc., to calculate eGFR, this method is most commonly used by kidney clinicians.
4, other
In addition, in recent years to check serum cystatin C, retinol binding protein, blood β-2 microglobulin can also reflect renal function early.
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