What level of blood creatinine will eventually face long-term dialysis?

What level of blood creatinine will eventually face long-term dialysis?  How high is the blood creatinine of patients with kidney disease and will eventually face long-term dialysis in the future? Here are 4 key points. 

If the blood creatinine exceeds the normal range, it indicates that the patient’s renal function has been significantly impaired.

The normal value of serum creatinine (SCr) can vary from laboratory to hospital. Generally speaking, it is 44-115μmol/L (0.5-1.3mg/dL) for adults, and 53-115μmol/L (0.6- 1.3mg/dL) and 44-97μmol/L (0.5-1.1mg/dL) for women.

The normal value of blood creatinine in children will be lower, 26.5-70.7μmol/L (0.3-0.8mg/dL). Although the blood creatinine does not exceed normal, it cannot be said that the patient’s renal function is normal, but as long as the patient’s blood creatinine is found to be higher than 115μmol/L (1.3mg/dL), the diagnosis of renal failure can be made: or acute kidney injury ( AKI), or chronic renal insufficiency (CRF).

The blood creatinine in the uremic phase of chronic renal failure will exceed 707μmol/L (8.0mg/dL), but conversely, whether the blood creatinine exceeds 707μmol/L (8.0mg/dL) can not be used as the only basis for diagnosing uremia.

The author found that many people with nephropathy have this idea that nephropathy with high blood creatinine may develop into uremia that eventually requires dialysis. Some people say that when the blood creatinine is as high as 177μmol/L (ie 2.0mg/dL), it will not necessarily develop into uremia that requires dialysis in the future; it is also said that when the blood creatinine is as high as 265μmol/L (ie 3.0mg/dL), dL), you may face dialysis treatment in the future; some people say that when the blood creatinine is as high as 442μmol/L (5.0mg/dL), you will definitely face dialysis treatment in the future; and so on.

Is that so? Or what is the real situation? How high is the blood creatinine, and will eventually face dialysis treatment in the future?

The normal answer is: No matter how high the blood creatinine is, it may not develop into uremic that requires dialysis in the future; on the contrary, even if the blood creatinine is not high or not too high, it may develop into uremic that requires dialysis in the future. That is, if the blood creatinine of a patient with kidney disease is high, whether he will eventually face dialysis treatment in the future depends on the following four aspects.

Key 1: Need to know what kind of kidney disease is the primary disease?

When the patient’s serum creatinine is high, it is important to figure out what kind of kidney disease is the primary cause of the increase in serum creatinine. This is because some kidney diseases are more likely to develop in the direction of uremia, such as diabetic nephropathy stage V, polycystic kidney disease, hereditary nephritis, membranous proliferative nephritis and crescent nephritis; while some nephropathy rarely develops into uremia, such as Minimal change nephropathy, IgA nephropathy with low pathological grade, most membranous nephropathy, and Henoch-Schonlein purpura nephritis.

Key two: Has the elevated serum creatinine been for a long time?

If the blood creatinine rises within a few hours, days or weeks, or is accompanied by a decrease in urine output, resulting in a series of manifestations such as oliguria or anuria and water and electrolyte disorders, it can usually be diagnosed as acute kidney injury . For patients with acute kidney injury, no matter how high the blood creatinine, even if it is as high as 707μmol/L (8.0mg/dL) of the “uremia level” (but not uremic), there is hope to cure kidney failure or reverse blood creatinine. If the blood creatinine rises in a few months or longer, it is easy to develop into uremia that requires dialysis treatment, and the higher the blood creatinine, the easier the development and the faster the development speed.

Key three: Are urine protein and blood pressure still high after treatment?

Glomerulonephritis with excessive serum creatinine is often accompanied by high urine protein and/or hypertension. The reason for the high blood creatinine before may be related to the failure to reduce urine protein and control blood pressure. This is because obvious proteinuria and hypertension are the two major risk factors for the progressive progression of glomerulonephritis. Therefore, in the face of glomerulonephritis with high urine protein and blood pressure, active treatment is needed to reduce the urine protein to a lower level and control the blood pressure to the standard. Otherwise, if the patient’s urine protein and blood pressure are still high after treatment, it is more likely to cause the blood creatinine to continue to rise, until the development of uremia that requires long-term dialysis.

Key four: Has the kidneys shrunk and the renal blood flow signal decreased?

At the same time as the blood creatinine increases, if the patient’s kidneys have been significantly reduced, it means that the kidney injury has developed into irreversible chronic renal insufficiency. The kidney pathology is often manifested as extensive glomerular sclerosis and renal tubular and intervening Qualitative fibrosis. Color Doppler ultrasound will also indicate “abnormal or decreased renal blood flow signals”, indicating that the kidneys filter blood slower or flow through the kidneys less blood, which also indicates that the kidney disease has a longer and irreversible time. These are all manifestations. The high blood creatinine is difficult to recover, and it may develop more or more easily in the direction of uremia.

From the above four key points, it can be seen that the blood creatinine value cannot be used as the basis for long-term dialysis treatment in the future. In other words, blood creatinine in patients with nephropathy is only 132μmol/L (1.5mg/dL), and long-term dialysis treatment may be needed in the future; blood creatinine in patients with nephropathy is as high as 442μmol/L (5.0mg/dL) or even as high as 707μmol/L ( 8.0mg/dL), long-term dialysis may not be needed in the future. Therefore, when patients with kidney disease have elevated blood creatinine, don’t be intimidated by the “higher blood creatinine number”. They should go to a regular hospital for further diagnosis and treatment and active treatment, so that there is no hope of long-term dialysis treatment in the future.

(source:internet, reference only)

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