Will Dialysis Be Started with Creatinine of 7

Creatinine is the metabolic product of muscles in the body. It is one kind of small molecular wastes which can be filtered out of the glomeruli and there is almost no re-absorption in the renal tubules. That is to say, nearly all the creatinine produced every day will be discharged with urination.

Serum creatinine level is commonly used in clinic to measure kidney functions. Usually dialysis will be ordered or suggested by the doctors when creatinine is as high as 7mg/dL.

But this may not apply to every patients because serum creatinine level should not be the only indicator to begin dialysis and the criterion for measuring creatinine and beginning dialysis varies from country to country and from hospital and hospital.

Serum creatinine level should not be the only indicator of dialysis, weather it is peritoneal dialysis or hemodialysis. There are many factors that need to be taken into account such as complications like severe acidosis, hyperkalaemia, edema, anemia, gastrointestinal and neurological symptoms, etc. Some patients may need to take dialysis when creatinine is 5 while there are others who do not start dialysis even when their creatinine has been more than 10.

Creatinine level is just a reference value and the complications should be considered when determining when to begin dialysis.

In case one of the following conditions, dialysis should be started or at least prepared:

Creatinine higher than 442umol/l, blood urea nitrogen higher than 21.4mmol/l, creatinine clearance lower than 10ml/min;

Severe retention of water and sodium such as acute pulmonary edema and brain edema;

Electrolyte disorders especially hyperkalemia (serum potassium higher than 6.5mmol/l);

High catabolism (daily urea nitrogen increase higher than 14.3mmol/l, creatinine increase higher than 177umol/l);

Oliguria or anuria lasting for more than 2 days

Compared with serum creatinine level, creatinine clearance and GFR are more accurate and proper indicators for measuring kidney functions and starting dialysis. But it is necessary to measure creatinine which can be used to calculate creatinine clearance and GFR. Therefore it is necessary for patients to ask the doctor for their GFR and creatinine clearance besides creatinine so as to have better understanding of their current kidney functions and provide more accurate guidance for dialysis and other treatments.