Why do creatinine levels fluctuate in dialysis patients?

Question

Hello doctor,

I am on dialysis for kidney failure and I have noticed a fluctuation in my monthly blood work for the creatinine and BUN levels. At the beginning of the year, my creatinine was 11 and it has decreased every month to 7. I was also making more urine as I went along. All of a sudden, last month my creatinine jumped back up to 10. I have not changed anything in my routine or treatments. Does anyone have any ideas?

Answer 1

Hello,

Welcome to icliniq.com.

I have worked as a chief in a hemodialysis center for 20 months. Once the kidneys have failed and the patient is hooked up on dialysis, the creatinine value is always high.

At this time we do not care about the creatinine values because once we start dialysis on a patient, it is assumed that his kidneys have incurred permanent damage and he cannot come back to normalcy.

At this juncture, we use the patient's creatinine value as a measure of protein intake. If a dialyzing patient's creatinine value is high, it is assumed that he is having good protein intake through diet and high creatinine value is desirable in dialysis patients, since intake of much proteins gives them a long life.

When creatinine value drops, we start worrying that the patient is not taking much proteins. So the drop in your creatinine value may be because you have started taking less proteins than usual. In this situation, we advise you to take more protein containing foods.

For a dialyzing patient, the most important parameter is blood urea. See what is your blood urea level before and after a single dialysis session. Ideally, there should be a 60% reduction. Then it can be comfortably assumed that dialysis is effective. If you do not achieve this reduction, complain to the dialysis technician. He will do the needful adjustments with the machine.

The big factor we have to afraid of is potassium. It should never cross 6.

I hope this helps.