Creatinine Clearance Test

[TxTechKimmy]

I just got my test results back from my creatinine clearance test, and the number was 57..which according to the 'normal' range on the results, is low. I did a little research and found that means there is some kidney damage. I haven't heard back from my doctor yet so I was curious if any of y'all know exactly how 'bad' that is. :questionm

[camjen1]

What was the reference ranges on your lab results? Each labs reference ranges are different. Did you also submit a 24 hour urine?

[TxTechKimmy]

Yes that was from the 24 hour urine. However the blood creatinine was in normal range. The range from the lab is 75 - 115.

[BriOnH]

Creatinine clearance of 54 isn't too bad. What is more important, at this point, is how much free creatinine is circulating in your blood. Did you have blood work as well? Look at your Creatinine, bun, potassium, and sodium (that order is in importance as well) levels if so. If you have a low creatinine level (which isn't bad, high is when you worry about failure) in your blood, of course your clearance is going to be low in your urine. Was creatinine clearance the only test of concern? How about microalbumin, protienurea?

[TxTechKimmy]

I sure did have the blood work done too. Those levels of creatinine showed as 'normal'. The bun came back as a 17, potassium was 4.3 and sodium, i'm not sure. can't find it on here. I don't see the albumin...then again, a lot of this is greek to me so I could be staring right at it and not know.

[BriOnH]

What was your creatinine level? If clearance is the only thing off, I personally wouldn't worry about it too much. Just get it checked again. Your BUN is excellent, and sodium and potassium 4.1-4.7 are really good as well. I'd make sure the next time you get tested to ask for a microalbumin, and also make sure (bigger) protien levels are good too.

[TxTechKimmy]

Well I see a couple of creatinines/proteins on here...so.. I'll give them all to you :). One called C-reactive protein was .20, CK Creatinine Kinase or CPK was 57 and one that just sasys creatinine was .8. Can you interpret those for me? What is the BUN? You'd think after having diabetes for 29 years I would know this stuff, but this is the first endo I have been to that has run such extensive work on me.
signed,
Lost in Lab Work Land

[BriOnH]

Well I see a couple of creatinines/proteins on here...so.. I'll give them all to you :). One called C-reactive protein was .20, CK Creatinine Kinase or CPK was 57 and one that just sasys creatinine was .8. Can you interpret those for me? What is the BUN? You'd think after having diabetes for 29 years I would know this stuff, but this is the first endo I have been to that has run such extensive work on me.
signed,
Lost in Lab Work Land

Your Cretinine was .8?? That's awesome. I think that could explain the clearance. You aren't going to clear much cretinine in your urine if there is not much circulating in your blood. Creatinine is a biproduct produced by muscle, BUN is Blood urea nitrogen (wastes the kidney filters out). You're kidneys are in excellent shape, especially having diabetes for as long as you have. Just get a microalbumin(ualbumin), and just a regular protien check, but I am 99.99% certain from your current results that they'd come back great.

[TxTechKimmy]

Really??? Awww awesome! You've made me feel much better. I kinda figured if the doctor hadn't called, then no news is good news. But when I started surfing around and saw the 57 on the urine creatinine was low, I started to worry. What does the albumin measure? I'm sorry for all the questions and I really appreciate your helping explain it all to me.

[TxTechKimmy]

I see you were diagnosed around the same time I was back in the 70s. Did you start off on the lovely pork/beef insulin like I did?

[BriOnH]

No problem on the questions, I love biochemistry. If your creatinine in your blood was higher then 1.5 mg/dl there would be concern for your clearnace test. This would mean that more creatinine is building up in your blood and your kidneys are not able to filter it out. Your case is quite the opposite which is great. Microalbumin is a very, very, small protien, and is more of a faint signal of kidney disease; protienurea are the larger protiens and can be checked with chemstix at home. In diabetic kidney disease the nephrons(cells which compose the majority of the kidney) usually start to get wider and let not only wastes through the urine, but also valuable protiens that can be used, and are lost. At 29 years of diabetes, your Kidneys are doing awesome. Make sure you get your eyes checked too.

[TxTechKimmy]

Thank you! Are you a biochemist?
Oh yeah I am religious on the eyes. I have had several laser treatments for the proliferative retinopathy..and one vitrectomy. That one was fun lemme tell you. Have you had any issues with your kidneys or eyes?

[BriOnH]

Thank you! Are you a biochemist?
Oh yeah I am religious on the eyes. I have had several laser treatments for the proliferative retinopathy..and one vitrectomy. That one was fun lemme tell you. Have you had any issues with your kidneys or eyes?

Not a practicing biochemist, just a trained one. I am a programmer/software architect for a logistics company. I see you work for Southwest, I come from a family of United Airlines workers. My grandfather was CEO in the 80's early 90's. I have some damage to my kidneys and eyes, but nothing that I am too worried about. Good control and a strong faith in god seem to get me by. I was started on the beef/pork insulin. Caused me some really bad hypos when younger.

I am surprised you had such problems with your eyes, considering the shape of your kindeys.

[TxTechKimmy]

Gotcha! I'm in IT too...and yes at Southwest (I love this company!). I am a 'Weather Systems Analyst'. What language do you code in?
Really? That's awesome about your granddaddy! I suppose you got to fly free quite a bit. :) Nice perk isn't it??
Have you had any laser treatments? Yes my faith in God has gotten me through many, many situations. We are never dealt anything we can't handle! I too started on the beef/pork. I had some issues with my body reacting to the antibodies in the insulin. Weird stuff. These newby diabetics don't know how good they have it! LOL Yeah it is kind of strange isn't it? Perhaps it is because I take an ace inhibitor for my high blood pressure and I know that is supposed to help the kidneys out some.

[Georgia]

I have microalbumin & it really peeves me off that the doctors won't put me on an ACE Inhibitor. I know it's because I am hoping to have a baby in the future, & the ACE Inhibitors aren't suitable for pregnancy, but I know that a lot of women are on these meds until they conceive. Frustrating & worrying!!

You have great results Kimmy :)

[BriOnH]

Southwest has great prices. I don't get to fly for free anymore. I did when my dad worked there. He has retired from united and still gets free first class travel anytime, anywhere with my mom too. I work for his company right now, but am building my own company too, which will be released sometime this year. It's not anything that's going to make me much money, if any at all, but hope it will greatly impact the diabetic healthcare system. I program in C#(my personal favorite and the majority of my work), Java, MS SQL, and will do C++ and perl if I have to. I've been building e-commerce sites for quite some time now. Do you work in the tower? That's great you like the company you work for, very important. I love planes. That's good you are on an ACE inhibitor too, they help the kidneys a lot.

[TxTechKimmy]

That has to be frustrating Georgia. ::( But maybe your endo will put you on one once you have your baby.

[Georgia]

Yes but who knows how long it will take to actually have a bun in the oven (ha ha) :burnout:

[TxTechKimmy]

Brian,
What's first class? ;) (since we only have coach on our SWA aircraft). I love that we get to fly anywhere SWA goes for free. Such a wonderful perk.
Congratulations on the new company! That is awesome and I wish you luck. I am sure it'll all work out well for you. I don't get to work in the tower, I am in our headquarters building. I have my own weather station set up here at my desk, which is kinda cool (I am a big weather geek). I spend a lot of time down in the dispatch area. They and the meteorologists are my main customers. I too love planes. They fascinate me.

[TxTechKimmy]

Good point Georgia! Do you have any children yet? I just wonder how type 1 plays into pregnancy. I just have 3 stepkids and 4 dogs, no beings that I am a biological mother to. ;)

[Georgia]

No children yet. It's all about good control of your diabetes pre-conception & during pregnancy & although there are higher risks involved (than a non-diabetic woman) having good control reduces these. I know it will be hard work but the rewards are definitely worth it :thumbsup:

[TxTechKimmy]

Yes they will definitely be worth it! :)

[JasonSmithMT]

Creatinine clearance is used to assess what is called glomerular filtration rate, or GFR since we like to abbreviate everything in medicine. Measuring GFR is the best way to determine kidney function. While you can do an estimated GFR from a single serum level of creatinine, the most accurate way is with a timed urine (usually 24 hours) and a serum creatinine collected within that 24 hour period.

The most common (and most convenient) method used to get a picture of kidney function is using the serum BUN and creatinine levels. However, this isn’t nearly as sensitive and accurate as doing the creatinine clearance determination from the urine and the blood. The blood levels alone are subject to pre-renal and post-renal factors. That is factors outside of kidney function has an impact on the blood levels. In addition a decrease in GFR is usually seen much earlier than an elevation in BUN and creatinine is seen in renal impairment.

If you have no prior history of renal problems and you blood pressure it under control I wouldn’t get too worked up about a creatinine clearance of 57 ml/min at this point especially considering your other values look great. It is definitely something to take note of and to monitor periodically. Talk with your physician at your next appointment. It could very well be the ACE inhibitor decreasing your GFR. ACE inhibitors are commonly referred to as a double edged sword when it comes to the kidney. It has been well demonstrated that ACE inhibitors are renal protective but on the flip side in some people they have been known to decrease the GFR.

Jason

[TxTechKimmy]

Thank you Jason...that is great info!

[VanDamage]

heh i did my 24 hour urine test and blood work and doctor said i was supp to be around 20 on the creatine and i was 240 quess thats why im on kidney pills.

[BriOnH]

heh i did my 24 hour urine test and blood work and doctor said i was supp to be around 20 on the creatine and i was 240 quess thats why im on kidney pills.

You'd be on dialysis if your creatinine was 20 mg/dl; 240 and you'd be dead. Might want to check those numbers agaian :) .