Why Creatinine Level is Still High after Dialysis

Why creatinine is still high after dialysis? Dialysis is designed as an approach to discharge metabolic toxins out of the body. So elevated creatinine level can be effectively brought down after dialysis. However, in prolonging course, the patients find their creatinine rises faster after dialysis, and they will need to do dialysis more frequently. So why this happens? Does it mean that the illness condition has worsened? What should be done?

“I am patient with kidney failure. Both creatinine and potassium levels are high. At first I do dialysis for two times a week, but now has to do it three times a week. I have been on dialysis for one and a half years. Body weight has increased and now I almost don’t make urine. I get cold easily, and each time after infections, the illness condition gets deteriorated. Why creatinine is very high even if I have been on dialysis for such long time?”

Creatinine is produced in proportional to muscle activity and is filtered out of the body by the kidneys freely. The kidneys have compensatory abilities, which mean that if kidneys are damaged moderately, serum creatinine will not increase. Thereby, normal range of creatinine doesn’t necessary mean that the kidneys are not damaged. But when serum creatinine level increases kidney function will have been halved. High creatinine often accompanies some symptoms/complications, such as vomiting, nausea, weakness, shortness of breath, etc. The patients may be suggested to start dialysis by their doctors based on their creatinine level, presence of complications, lab results, etc.

We should not deny the role of dialysis in treatment of kidney failure. Through dialysis wastes circulating in blood such as creatinine and blood urea nitrogen will be discharged out of the body. So after dialysis, the people have their creatinine reduced. However, as we know, the production of creatinine is not produced day by day. So in days after dialysis creatinine increases and people need another dialysis. In addition, dialysis only replaces part of renal functions.

In long-term of dialysis, management of high blood pressure, stable dry body weight, improving renal anemia and many other aspects will greatly affect the prognosis in kidney failure. In long-term of dialysis, the remaining part of functioning renal cells gradually get damaged thus kidney function gets less and less, in this process, duration of creatinine elevation gets shortened, dialysis frequency is reduced and risks of complications increase. Management through daily nursing care to keep every lab index under control is essential to improve quality of life and reduce threatening complications.