During a routine medical checkup in 2018, Ritika (name changed on request), a 26-year-old from Bengaluru, came across unusually high creatinine levels in her blood. As she was under the assumption that she was in perfect health, Ritika found the elevated creatinine levels perplexing. She jumped to the conclusion that her kidneys had failed and she would have to undergo dialysis. However, her speculations were soon proved wrong.
“The culprit behind her high creatinine levels was dehydration and the regular use of painkillers,” explains Dr Deepak Kumar Chitralli, senior consultant nephrologist and transplant physician at Manipal Hospital, Yeshwantpur, Bengaluru, who treated her. “Ritika’s creatinine levels were 4.5 mg/dL, while the normal level ranges between 0.6–1 mg/dL.”
Ritika, an IT professional, was experiencing stress-induced headaches and had been popping painkillers daily for a month, causing her creatinine to shoot up.
What is creatinine?
“Creatinine is a nitrogenous waste product released by the muscles into the blood during metabolism [chemical reactions that change food into energy]. Our kidneys filter creatinine out from the blood and excrete it through urine, along with other nitrogenous waste products,” explains Dr Deepak. “When the kidneys don’t eliminate creatinine properly, it can build up in the body, causing a rise in creatinine levels,” he adds.
What causes high creatinine levels?
The cause of elevated creatinine levels is kidney damage or chronic kidney disease, which makes the kidneys inefficient to excrete the creatinine from the body, causing a buildup.
“Any kind of kidney damage can consequently cause a rise in creatinine,” says Dr Sandeep Kumar Mandal, consultant nephrologist, Manipal Hospital, Gurugram, Haryana. He further adds that creatinine levels in the blood are a marker of kidney function. Kidney function is calculated from serum creatinine levels.
Conditions that can cause high creatinine
Dr Mandal lists some of the common conditions that can cause kidney damage and thereby a rise in creatinine levels:
- Diabetes
- Hypertension
- Severe dehydration
- Medication like painkillers
- Gastroenteritis
- Kidney infections
- Heart diseases
What happens when creatinine increases?
“A mild elevation in creatinine levels (1.5–2 mg/dL) does not elicit symptoms. When there is a large elevation (8 ml/dL), symptoms are seen,” says Dr Deepak.
Symptoms of high creatinine levels:
Treatment and management
Following her diagnosis, Ritika discontinued her painkillers and was given medication for dehydration and to lower her creatinine level. It came down to 0.7 mg/dL, and she was discharged in three or four days. Her creatinine has been stable ever since.
However, the treatment depends on the underlying cause of the low creatinine levels. “Acute kidney injury (AKI) can have causes like heavy and unregulated use of painkillers, dehydration, gastroenteritis or kidney infections. These levels can be restored to normalcy by stopping painkillers, administering fluids and treating the infection, as required” says Dr Deepak. And if the kidney damage is due to underlying conditions such as diabetes or hypertension, doctors prescribe their strict management. Following kidney-friendly diets is also advised.
“In case of end-stage kidney disease, dialysis or kidney transplant are the available treatment options,” notes Dr Deepak. However, according to him, most cases of kidney damage can be treated if detected early.
Citing Ritika’s example, he says, “Had she not sought timely medical attention and continued taking painkillers, she could risk permanent kidney damage. Her prompt action helped her nip it in the bud,” Dr Deepak concludes.
Takeaways
- Creatinine is a waste product released by the muscles during metabolism.
- It is excreted from the blood by the kidneys through urine.
- High levels are an indication of kidney damage.
- The normal levels of creatine range between 0.6–1 mg/dL.
