Serum creatinine is slightly higher than normal, which needs to be paid attention to, but it is not necessarily kidney function damage, and the following conditions should be considered first.
1.Young people with muscles: Because creatinine is a metabolite of human muscles, blood creatinine is closely related to the total amount of muscle in the body.
2.Those who consume a large amount of meat 3 days before the blood draw: this condition is considered an increase in exogenous creatinine intake.
3.A large amount of muscle decomposition and muscle damage after strenuous exercise.
4.Sex-related: Men generally have more muscle mass than women, so the normal reference range for serum creatinine is higher for men than for women.
5.Age-related: With the increase of age, renal function will decline physiologically, and it is generally believed that in the general population after the age of 40, the age-related glomerular filtration rate is 1ml min per year, so the elderly can have a slight increase in creatinine (combined with the comprehensive analysis of muscle content in the elderly).
6.Commonly used antihypertensive drugs in clinical practice, such as sartan pril antihypertensive drugs, dilate glomerular efferent arterioles larger than inferior arterioles, when they are taken at the beginning, they will cause transient renal hypoperfusion and increased creatinine, generally no more than 30% of baseline, and can be continued to be used, and long-term use will protect kidney function.
7.In recent years, the commonly used gliflozin hypoglycemic drugs can not only reduce proteinuria, but also protect kidney function and heart function. These drugs can constrict the arterioles entering the ball, and the creatinine may be transiently elevated in the initial stage of the drug, but the renal function is stable with long-term use.
8.Infection, high fever, diarrhea, excessive diuresis, and dehydration caused by various other reasons before blood drawing can cause a transient increase in creatinine, which can return to normal after removing the trigger and **.
9.For those who need to use contrast agents for various reasons, some of them will also cause transient creatinine increases, so it is necessary to pay attention to adequate hydration before and after the use of contrast agents.
10.Related to the test method: the normal range of values varies from hospital to hospital, and the reason for this is that different methods are used to measure creatinine, so it is best to observe creatinine changes in the same hospital.
The above types of elevated serum creatinine are physiological or transient pathological injuries, most of which can be restored to normal and can be reexamined.
What conditions require aggressive management of mildly elevated serum creatinine?
Serum creatinine is slightly higher than normal, and the following conditions should be noted at the same time, which are pathologic creatinine elevations and require specialist diagnosis and treatment.
1.Patients with mildly elevated serum creatinine accompanied by proteinuria and hematuria.
2.People with mildly elevated serum creatinine and high blood pressure should pay attention to this, especially young people.
3.For example, if the creatinine shows a progressive increase, such as a 30-year-old young man, the creatinine was 80umol L 3 years ago, 90umol L 2 years ago, and 110umol L this year, and the weight has not changed much, so it is necessary to pay attention to it and actively find the cause.
4.A previous history of chronic kidney disease (eg, IgA nephropathy) with mildly elevated serum creatinine may indicate progression.
5.If there is a history of hypertension in the past, elevated creatinine should be noted for early hypertensive nephropathy.
6.If there is a history of diabetes mellitus in the past, elevated creatinine should be accompanied by early diabetic kidney disease (some patients do not necessarily have proteinuria).
7.Patients with edema of both lower limbs and whole body should pay attention to exclude hypothyroidism.
8.In the elderly, who are accompanied by short-term weight loss, fatigue and fatigue, attention should be paid to ruling out systemic small vessel vasculitis.
9.Pay attention to drug-induced kidney damage: for example, long-term painkillers for gout, some unknown Chinese herbal remedies, some anti-tumor drugs, etc.
10.Other causes: a variety of other early manifestations of primary or secondary kidney disease also need to be screened.
In summary, if the serum creatinine is slightly higher than the normal value (generally < 130umol L) in the physical examination, further evaluation by a specialist is still required; If creatinine is significantly higher than normal, it is not the scope of this article, and active specialist consultation is more necessary.