Urine levels Of Creatinine
Creatinine is a breakdown product of creatine phosphate in muscle and is usually produced at a fairly constant rate by the body (depending on muscle mass). Serum mcreatinine (a blood measurement) is an important indicator of renal health because it is an easily-measured by-product of muscle metabolism that is excreted unchanged by the kidneys. Creatinine itself is produced via a biological system involving creatine, phosphocreatine (also known as creatine phosphate), and adenosine triphosphate (ATP, the body’s immediate energy supply). Creatine is synthesized primarily in the liver from the methylation of glycocyamine by Sadenosyl methionine. It is then transported through blood to the other organs, muscle, and brain where, through phosphorylation, it becomes the high-energy compound phosphocreatine. During the reaction, creatine and phosphocreatine are catalyzed by creatine kinase, and a spontaneous conversion to creatinine may occur.
Creatinine clearance
Creatinine is removed from the blood chiefly by the kidneys, primarily by glomerular filtration but also via proximal tubular secretion. There is little or no tubular reabsorption of creatinine. If the filtration in the kidney is deficient, creatinine blood levels rise. Therefore, creatinine levels in blood and urine may be used to calculate the creatinine clearance (CrCl), which correlates with the glomerular filtration rate (GFR). Blood creatinine levels may also be used alone to calulate the estimated GFR (eGFR). The GFR is clinically important because it is a measurement of renal function. However, in cases of severe renal dysfunction, the creatinine clearance rate will overestimate the GFR because hypersecretion of creatinine by the proximal tubules will account for a larger fraction of the total creatinine cleared. Ketoacids, cimetidine, and trimethoprim reduce creatinine tubular secretion and, therefore, increase the accuracy of the GFR estimate, in particular in severe renal dysfunction. An alternate estimation of renal function can be made when interpreting the blood (plasma) concentration of creatinine along with that of urea. BUN-to-creatinine ratio (the ratio of blood urea nitrogen to creatinine) can indicate other problems besides those intrinsic to the kidney; for example, a urea level raised out of proportion to the creatinine may indicate a pre-renal problem such as volume depletion. Each day, 1-2% of muscle creatine is converted to creatinine. Men tend to have higher levels of creatinine than women because, in general, they have a greater mass of skeletal muscle. Increased dietary intake of creatine or eating a lot of meat can increase daily creatinine excretion.
