At laboratory researches of urine measurements of various components are made. In the process of urine biochemistry, a whole group of products of organic origin is revealed, the level of which helps to diagnose a variety of pathological conditions. One such product is creatinine.
Creatinine in urine
Creatinine refers to the nitrogenous residual component and the final protein-exchange product, by the number of which specialists can evaluate the condition of the muscular system and the functionality of the kidney structures. In addition to creatinine, residual ammonia is referred to as ammonia, urea, uric acid, i.e., non-proteinaceous blood components that have nitrogenous compounds and are to be excreted by the kidneys. According to the content of creatinine, a specialist can determine how high the excretory renal activity is.
Diagnostic value of
Creatinine values in urine are of great diagnostic value. In clinical biochemistry, its level is important in assessing the reabsorption and filtration abilities of kidney structures. A skilled and experienced doctor can say a lot on his level. Creation of creatinine occurs after muscle contraction, after which it is utilized by the kidneys. If they work fully, the creatinine is excreted completely, so the blood gets rid of it without a trace. The Rebberg test is based on this principle of creatinine utilization.
Indications for the study of creatinine in urine are conditions like pregnancy and diabetes, pituitary and thyroid pathologies, kidney diseases, as well as a sharp decrease in muscle mass. The increase in the substance is one of the main manifestations of deficiency of the kidney structures, against which the filtration glomerular activity decreases. Conditions such as intense physical muscle activity, protein foods, acromegaly or thyroid hyperfunction, dehydration can also become factors that increase creatinine. In addition, this component of residual nitrogen is important for the diagnosis of muscular lesions such as heart attack, etc.
On the video about the causes and treatment of decreased and elevated creatinine in the urine:
Diagnostic methods
All methods for the diagnosis of creatinine in urine are divided into enzymatic and colorimetric.
In general, the following substances are used to determine this substance:
- Creatinine clearance or Reberg's test.
- Test strips.
The Reberg test is one of the most accurate laboratory diagnostics for determining the exact state and functionality of the kidneys. It is usually recommended for patients with renal disorders and pregnant women to prevent the development of gestosis and hypertension, hypertension, etc.
Actually, creatinine clearance can be considered a routine laboratory study of urine aimed at determining the rate of filtration activity of the glomeruli. To ensure that the Reberg sample is as accurate as possible, appropriate preparation is necessary.
Before passing urinalysis to the level of creatinine it is necessary:
- To exclude alcohol, strong tea and coffee;
- Avoid physical overloading;
- Observe the traditional drinking regimen, ie, drink as much liquid as usual during the day, without lowering or exceeding it;
- Restrict meat consumption.
The result may be affected by any drug( methylprednisolone or furosemide, corticotropin or thyroxine), so it is better to stop taking medication on the eve and on the day of collecting the biomaterial. Women with menstruation also can not conduct such a diagnosis. Before collecting urine, it is necessary to make hygiene of the genital organs, that is, carefully wash it.
Then all the urine is mixed in one dish and the exact volume is measured. Distinguish about 50-80 ml in a clean container for further laboratory tests.
The use of test strips for the determination of creatinine is a dry chemistry technique, since it involves the use of paper or plastic strips sorbed by reagents that stain the strip in a certain color when the required component is detected. The obtained shade of the segment on the strip test is compared with the attached diagram and the results are evaluated. Each strip test is applied only once, after which it is disposed of.
Urine for testing should be collected according to certain rules. Before collecting the biomaterial, it is necessary to thoroughly wash and wipe the genitals dry. For the study, you need to take an average portion of urine. For this, a couple of seconds pass into the toilet, then into the urine collection tank, and finish urinating again into the toilet. Diagnosis should be carried out immediately after collection of urine.
The strip test is dropped into the urine for a certain period of time indicated on the package. After the study, comparing the data on the strip with a special diagram, the decryption of the data is done.
Norm
The normal creatinine values in patients of different sex and age groups differ markedly:
- Babies up to 12 months - 71-177 μmol / l;
- In children 1-12 years old - 71-194 μmol / l;
- In adolescents - 71-265 μmol / l;
- In adult women - 97-177 μmol / l;
- In men it is 124-230 μmol / l.
To maximize the diagnostic capabilities, it is recommended to conduct a parallel measurement of creatine in the blood. In addition, the ratio of creatinine in plasma and urine is critical in clinician practice.
Deviations from the norm
Any abnormalities in creatinine from the normal may indicate the occurrence of pathological disorders in the kidney tissues, especially if the patient experiences a variety of symptoms such as kidney pain, urinary disorders, or excessive swelling of various parts of the body.
An analysis is important for creatinine and for the diagnosis of pyelonephritis or glomerulonephritis. In general, abnormalities are classified according to the decrease or increase in creatinine.
Increased
In some clinical situations, the creatinine values in the urine are markedly increased in comparison with the generally accepted norms. High creatine is determined if the rates in men are above 230, and in women above 177 micromol / l.
Increase in creatinine in the urine is typical for many diseases or conditions:
- Kidney infectious or inflammatory lesions;
- Continuous reinforced workouts or heavy physical labor;
- Endocrine pathologies( diabetes, thyroid dysfunction);
- Burn damage. With severe thermal damage, muscle necrosis occurs, which causes an increased filtration of the creatinine by the kidneys, while an increase in this component is also observed in the plasma;
- Adenohypophysis pathology. In such a case, there is an increased production of somatotropin, which causes an increase in creatinine. A similar phenomenon is characteristic of gigantism or acromegaly;
- Excessive love for meat products;
- In severe traumatic injuries, the body rebuilds the activity of most internal structures for recovery. One of the side effects is an elevated creatinine level.
Lowered
If the creatinine content of urine in women is less than 97, and in men less than 124 μmol / l, it is said about the lowered values of this component. But, what does lowering the indicator mean?
This phenomenon is typical for many conditions, which often do not have pathological origin:
- The first trimester of gestation, when a patient is troubled by severe toxicosis, it is the reason for the lowered creatinine level;
- Vegetarianism or consumption of insufficient volume of animal protein foods. In this case, a factor that lowers creatinine is protein deficiency in food;
- Frequent abuse of strict dietary nutrition programs;
- Intensified activity of the thyroid gland;
- Propensity to hyperintelligence;
- Paralyzing;
- Abuse of drugs of the corticosteroid group;
- Pathological thinning of muscle tissue against a background of a variety of diseases.
Lowered creatinine does not have such an important diagnostic value than its elevated indices, because it is only a consequence of certain conditions and has no negative effect on the body.
To determine the exact cause of abnormalities in the creatinine level, the patient is referred for examination. Therapy is prescribed in accordance with the etiological factor of deviation and is often limited only to diet therapy with increased or increased consumption of meat products.