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 seven. 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?

Please help.

Thank you.

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 to 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 dialysing patient's creatinine value is high, it is assumed that he is having good protein intake through diet, and a high creatinine value is desirable in dialysis patients, since intake of much protein gives them a longer life.

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

For a dialysing patient, the most important parameter is blood urea. See what your blood urea level is before and after a single dialysis session. Ideally, there should be a 60 percent 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 be afraid of is potassium. It should never cross six.

I hope this helps.

Thank you.