Creatinine Levels

[PTB]

Hello Dr. Nathan,

I sent my question to Dave, but I did not know this forum was here, so I'll post again:

I just got my bloodwork back.
My creatinine level was 1.42, outside of the normal range of .76 - 1.27
My BUN/Creatinine Ratio was 14 - well within the normal range.

He wants me to stop taking whey protein powders or aminos for 1 month, then
have more bloodwork done to see if the number lowered, however
he encouraged me to still work out and eat regular diet.

He also wants me to take a 24 hr Urine test as well, and he wants that done
now.

Is creatinine elevated by higher levels of protien? And is that higher creatinine
level a good indicator of true kidney function?

I lift weights 5 days per week - moderate heavy to heavy.

Thanks,

[Dr. Joel Nathan]

You are making a common error mixing up the names of two different things.

Creatine is found in meat and is helpful in increasing muscle torque when working out and also drives fluid into the muscle cells that leads to muscle hypertrophy.

What you're actually talking about is Creatinine. Creatinine is a breakdown product of muscle. The more muscular one is the higher the creatinine. Dave is correct about not stressing the kidneys. Since high protein loads can increase intra-renal pressure, this can harm the kidneys. This would cause them not to be able to excrete the creatinine.

I've only met Dave twice at some shows and thanked him for letting me write for RxMuscle. From reading his column here, he is right on point when it comes to your creatinine question.

[PTB]

I'm sorry, let me make a correction:

1.) I AM talking about my CREATININE levels, NOT creatine. I know Creatine is found in meat and what it does.

It was actually my DOCTOR, not Dave, who after seeing my creatinine level at 1.42 who ordered my urine test, and told me to fast from whey protein products for a month, and then to have another blood test.

I emailed Dave first with this exact question, before discovering that you had this Q & A section on this forum. The only thing Dave suggested was that I may have been dehydrated prior to the test, which may have been somewhat true, as I was asked by my doctor before my bloodtest, to fast from food and liquids after 10pm before my bloodtest in the morning.

Sorry for the confusion, but from what you are saying it may be wise for me to obstain from taking additional whey protein supplements until my doctor can isolate why my creatinine level is higher than normal.

[Tatyana]

The BUN and creatinine is often difficult for athletes, the more muscle mass you have, the higher the creatinine levels.

If you were a child or a little old lady with elevated creatinine levels, then it would indicate that you may have some renal impairment.

Your creatinine is 126 umol/L (I am guessing the units for the US mg/dl?) and your urea is is 5 mmol/L.

Urea is from the breakdown of protein, and it can elevate with higher protein consumption or dehydration.

Creatininine can also be affected if you are taking creatine supplements or if you had a cooked meat meal before being bled.

Was your sample fasting?

In the UK, we have dropped the 24 hour urine test as it isn't that accurate, most patients don't want to collect 24 hours worth of urine and it isn't that pleasant for lab staff either.

There is another estimate of renal function called the estimated glomerular filtration rate, it is a calculation based off your serum creatinine levels.

This is quickly becoming the new measurement as it has proven to be more accurate than 24 hour urine and compares favourably with the gold standard, inulin excretion.

Here are two eGFR calculators:

http://www.renal.org/eGFR/

http://www.nephron.com/MDRD_GFR.cgi

There are some issues with the basic eGFR when you have more muscle mass, I would recommend you use the Cockroft-Gault calculator, which does account for body weight.

http://www.cato.eu/gfr-cockcroft-gault.html

http://www.medednhsl.com/meded/phcal...ulator-CGR.asp


I think you will find there isn't an issue.

Typically potassium levels will also elevate slightly with renal impairment.

[gman]

I had that eGFR on my latest labs, just says >59. The reference range is >59, too. Not much info there!

[PTB]

Was your sample fasting?

yes it was. Again, no food or drink after 10pm. I had my test @ 8:00am the next morning.

[Scott Stevenson]

PTB,

What's your bodyweight, height and body fat %?...

-S

[Tatyana]

I had that eGFR on my latest labs, just says >59. The reference range is >59, too. Not much info there!

If you click on one of the links I posted for the eGFR, there are interpretations for the eGFR.

As it is a screening test for the early detection of renal disease/failure, it isn't a highly accurate test, it is a good indication though, although as I mentioned, there are issues for those with more muscle mass, on creatine supps, or if the sample isn't fasted. They basically have a normal stage, or then it starts to indicate the level of chronic kidney disease stages.

With renal disease, once the kidneys start to deteriorate, it is a slippery slope downwards, deterioration can be slowed, but that is about it.

[PTB]

PTB,

What's your bodyweight, height and body fat %?...

-S

Height - 6'3"
Weight - 205
BF ~ 12 -15%

[Tatyana]

Height - 6'3"
Weight - 205
BF ~ 12 -15%

To calculate your eGFR accurately, your age is needed, however, assuming you are 30 years of age, your eGFR (using Cockroft-Gault calculation) is 99 ml/min, which is normal.

The eGFR is now considered to be a much more accurate estimate of renal function than just using serum creatinine.

[PTB]

sorry, I'll be 40 in October.

[Tatyana]

82 ml/min, which is normal.

[Brian]

high creatinine levels can be an indicator of kidney problems.

that might be why he wants you to stop protein powders. I have kidney problems , and protein powders have a history of raising my creatinine levels.

Better to be safe then sorry bro.

My egfr always shows on my blood tests now.

[Brian]

If you click on one of the links I posted for the eGFR, there are interpretations for the eGFR.

As it is a screening test for the early detection of renal disease/failure, it isn't a highly accurate test, it is a good indication though, although as I mentioned, there are issues for those with more muscle mass, on creatine supps, or if the sample isn't fasted. They basically have a normal stage, or then it starts to indicate the level of chronic kidney disease stages.

With renal disease, once the kidneys start to deteriorate, it is a slippery slope downwards, deterioration can be slowed, but that is about it.

that is what I am finding out.

I have CKD. and even if you do everything right ie...keep your blood sugar normal, eat a low potassium diet, and keep blood pressure under control your creatinine levels still may rise.

[Dr. Joel Nathan]

Keep hydrated, follow your creatinine levels every 3 months. If there is a rise over the next 2 times you check, go see a nephrologist.