We’re here to help you delay dialysis. Worsening kidneys are scary. But the good news is that when changes are made early, CKD progression can be slowed and even halted. It’s all about changing your diet.

1. What you need to know
Creatinine &
Kidney Function:
RenalTracker Behavior chan e to help patients delay dialysis

2. i
We are
RenalTracker
We’re here to help you delay dialysis.
Worsenin kidneys are scary. But the ood news is that
when chan es are made early, CKD pro ression
can be slowed and even halted.
It’s all about chan in your
 diet.
This pro ram won the 2019 KidneyX Redesi n Dialysis Prize,
sponsored by the U.S. Department of Health and Human
Services Office of the Chief Technolo y Officer and the
American Society of Nephrolo y.
KidneyX awards innovative medical breakthrou hs that improve
patients’ quality of life, reduce disease and treatment
complica- tions, and minimize burden on the family and care
partner(s).

3. Creatinine & Kidney
Function
1
If you’re readin this article, then you probably have an idea of what “creatinine”
is. You mi ht already know how useful it can be when it comes to determinin
kidney function.
But if you find yourself feelin lost, you’re not alone.

Fi urin out what it really is and what hi h creatinine levels may mean can be
confusin for many chronic kidney disease (CKD) patients.
We came up with this article to clear up some of that confusion. Alon with
 definin
creatinine, we’ll also be discussin many useful topics, like how to lower
 creatinine
levels. We’ve even prepared a creatinine levels chart to help you assess your test
results.
But before all that, let’s start with what creatinine really is and what it has to do
with your kidneys.
What Is Creatinine And Why Does It Matter?
Creatinine is a waste product of the body and is produced mainly throu h muscle
activity. It’s normal for everyone to have some creatinine present in their blood.
But it can’t just stay there.
Like other waste products, the creatinine in your bloodstream has to be removed.
This is a job for your kidneys: they filter creatinine out from your blood and
excrete it from the body in urine.
By measurin the amount of creatinine found in
 someone’s body, doctors can et
an idea of how well their kidneys are functionin . The special thin about
 creatinine
is that it is produced at a constant rate, and filtered almost freely by the kidneys.
This means that the creatinine in your body is at an equilibrium. When the kidneys
are dama ed, they filter waste materials less efficiently. This means the amount of
creatinine in the blood usually increases.
Think of it this way. When you run the tap of a kitchen sink without plu in the
drain, a small layer of water will collect. But the sink will not flow over. However,
when you partially plu the drain, the water level will rise. It will continue to rise

until a new, hi her equilibrium is reached.
Your muscles are like the tap, the kidneys are like the drain and the creatinine levels

4. Creatinine & Kidney
Function
2
in your blood are like the water. If your kidneys become dama ed, the creatinine
starts to increase.
Creatinine Tests
There are two tests that are used to fi ure out your kidney function: the serum
creatinine test and the creatinine clearance test.
1.Serum Creatinine Test
This test measures the creatinine level in your blood. The serum creatinine test is
a common blood test and usually requires no prior preparation. A member of your
healthcare team will simply take a blood sample from you and have it analyzed in a
laboratory.
This is often used as a preliminary test to determine the health of your kidneys.
As kidney function decreases, serum creatinine levels will increase. This can
indicate a problem with your kidneys lon before any other si ns of CKD be in to
appear.
Doctors will usually use additional information, alon with the serum creatinine
test, to determine your level of kidney function more accurately. This is to calculate
your GFR or Glomerular Filtration Rate. It is the speed with which your kidneys can
filter waste from your blood.
However, sometimes, the doctor may not completely trust the GFR. For example,
if your kidney function is very low, or your muscle mass is far lower or hi her than
avera e. This is when a creatinine clearance test is more useful.
2. Creatinine Clearance Test
This test measures how well your kidneys can remove creatinine from your
bloodstream. This is done by comparin the creatinine levels between your urine
and your blood.
A creatinine clearance test requires both a blood sample, and a urine sample
collected within a 24-hour period. Because of this, it involves more preparation and
effort than a serum creatinine test. However, a creatinine clearance test is a much
more precise estimate of actual kidney function, so it’s definitely worth doin .

5. Creatinine & Kidney
Function
3
Mild
SC: 1.3-1.9 m /dl
CR: 56-97 ml/min
SC: 1.2-1.9 m /dl
CR: 56-88 ml/min
60 to 90 ml/min
Severe
SC: > 4.0 m /dl CR: < 35 ml/min
SC: > 4.0 m /dl CR: < 35 ml/min
Less than 30 ml/ min
Creatinine Levels Chart
Now that you have a clearer picture of what creatinine tests are all about, it’s time to
move on the next part—understandin the results.

Serum creatinine is measured by the milli rams (m ) of creatinine per deciliter (dL)
of your blood. The normal levels are:
• 0.6 - 1.2 m /dL for adult males
• 0.5 - 1.1 m /dL for adult females
Creatinine clearance is measured in milliliters (ml) of blood filtered per minute (min).
The normal levels are:
• 97 - 137 ml/min for males
• 88 - 128 ml/min for females
If your numbers aren’t within these ran es, try to find them in the creatinine levels
chart below:
Sta es of
Men Women
Renal Failure
GFR Levels
(both men and
women)
Normal
SC: 0.6-1.2 m /dl
CR: 97-137 ml/min SC: 0.5-1.1 m /dl
CR: 88-128ml/min
Hi her than 90 ml/
min
Moderate
SC: 2.0-4.0 m /dl
CR: 35-55 ml/min SC: 2.0-4.0 m /dl
CR: 35-55 ml/min
30 to 60 ml/min
Important Note: For Serum Creatinine tests, see numbers in “SC” and for Clearance
Rate tests see numbers in “CR”.

6. Creatinine & Kidney
Function
4
It is important to emphasize that the numbers we have here are for eneral
reference. What is “normal” can vary accordin to certain factors, like a e and
race, for example. Also, laboratories can have varyin methods of testin , which m
Reasons For Hi h Creatinine Levels
We’ve said that hi h creatinine levels in your blood is a common indication of
kidney dama e. However, there are exceptions. Your nephrolo ists or anize these
based on three possible causes: pre-renal, renal, and post-renal. This means before
the kidneys, in the kidneys, and after the kidneys.
Creatinine may temporarily increase due to certain conditions. These need to be
considered when creatinine test results are bein analyzed. Otherwise, it may lead
to an inaccurate estimate of kidney function.
Here are some factors (aside from kidney dama e) that may cause hi h creatinine
levels:
Before Renal Failure
• Dehydration
Not drinkin enou
 h water makes it harder for kidneys to filter out creatinine
effectively.
• Muscle destruction
Any condition which causes the breakdown of muscle tissue increases creatinine
in your blood.
• Increased protein intake
If you have a hi h-protein diet, your creatinine levels will be hi her than avera e.
• Hypothyroidism
A dysfunction in your thyroid land can influence your kidney function and
decrease your kidneys’ ability to filter wastes effectively.
• Creatine supplements
Creatine is an amino acid that is frequently added to muscle-buildin
supplements. Intake of these supplements can raise creatinine levels.

7. Creatinine & Kidney
Function
5
Durin Renal Failure

• Certain medications
Hands holdin Medications

Some medications (like certain antibiotics and acid blockers) can raise
creatinine, because they can dama e the kidneys. Always consult with your
doctor.
• Other diseases
Some infections like Hanta virus or other diseases such as diabetes or hi h
blood pressure can cause kidney dama e.
After Renal Failure
• Kidney stones
Kidney stones may block the urine flow from your kidneys, and thereby reduce
kidney function.
• Other obstructions
Sometimes there are other reasons for urine flow to be blocked. The doctor can
make an ultrasound to check if urine is flowin properly.

How To Lower Creatinine Levels
When you do have CKD and reduced kidney function, you should do all you can to
avoid further dama e.
You can help your kidneys by not overworkin them, and one
 way to do that is to
lower your blood creatinine levels. Less creatinine in your system means less waste
for them to filter.
Here are some tips to help you do just that:
1.Hydrate accordin ly
As we’ve mentioned, dehydration is one of the causes of elevated creatinine levels.
Without enou h water in your body, it becomes more difficult for your kidney to
filter out creatinine and other waste products.
The enerally recommended fluid intake is 6-8 lasses (8-oz / 250-ml) of water each
day. But this mi ht not apply to you if you have CKD. Too much liquid in the body can

8. Creatinine & Kidney
Function
6
increase blood pressure which, in turn, puts more stress on your kidneys.
Consult your nephrologist or dietitian about setting a proper limit to your fluid intake.
2. Exercise (within your limits)
We all know that exercise is important to maintainin a healthy body. This is true even

when you have kidney disease.
That said, it’s vital to know your limits. While the recommended amount of
exercise for adults is at least 45 to 60 minutes, four to five times a week, it mi ht
be better for you to follow a less vi orous exercise plan.
Strenuous exercise increases muscle activity, which may lead to a buildup of creatinine
in your system. To keep your creatinine levels stable, try your hand at more low impact
routines, such as walkin and
 yo a.
3. Consult your doctor about medications and supplements
We’ve talked about how certain dru s can increase creatinine in your blood. Some
examples include:
• Acid blockers
• Certain antibiotics, such as entamicin
• Hi h cholesterol medications
• Nonsteroidal anti-inflammatory dru s, such as ibuprofen or naproxen.
• Supplements containin creatine
Ask your doctor if there are possible alternatives to any medications you may be
takin , or if it’s safe to continue takin them even if you have kidney disease.
If you’re takin supplements with creatine in them, it
 mi ht be better for you to find
an alternative that won’t raise your creatinine levels. Or you could o with a well-
planned renal diet instead.
Additionally, kidney disease patients need to be careful about usin herbal
medicines. Some herbal products and remedies can actually worsen your condition
due to their potassium and phosphorus content.
DO NOT change your medications without consulting with your doctor and DO NOT
self-medicate.

9. Fruits Fruits
Blackberries Broccoli, Raw Or Cooked
Cherries Carrots, Cooked
Fruit Cocktails Celery (1 Stalk)
Grapefruit (1/2 Of Fruit) Cucumber
Applesauce Or JuiceAspara us, Raw (6 Spears)
Creatinine & Kidney
Function
7
4. Adjust your diet
Your diet plays an important role in controllin your creatinine levels.

As we’ve said, eatin too much meat and protein-rich foods can lead to
 increased
creatinine and more work for your kidneys. Now mi ht be the time to re-evaluate
your food choices and switch to more kidney-friendly options.
Of course, while too much protein isn’t ood, so is not enou h. You will need to find
the ri ht balance on your diet and set limits on your nutrient intake.
If you’re considerin a more plant-based diet (read more: tips on how to transition
to a plant-based diet) but you’re not sure which foods are ood for your kidneys,
check out this list of ve etables and fruits:
(serving size is 1/2 cup unless otherwise stated)
Apples (1 Medium Fruit) Alfalfa Sprout
Apricots, Canned In Juice Beans, Green Or Waxed
Blueberries Cabba e, Green And/Or Red
Cranberries Cauliflower
Grape, Includin Juice Corn, Fresh (1/2 Ear)
Peaches (1 Small Fruit) E plant

10. Plums (1 Whole Fruit) Lettuce
Strawberries Radish
Watermelon (1 Cup) Watercress
Creatinine & Kidney
Function
8
Fruits Fruits
Pineapple, Includin Juice Kale
Raspberries Peas, Green
Tan erine (1 Whole Fruit) Rhubarb
Reminder: This is not a comprehensive list. Ideal diet may vary for each individual.
Always consult your dietitian before making any diet change.
Partin Words

You’ve reached the end of this article!
Hopefully, we’ve answered some of your questions about creatinine and how it relates
to kidney function.
We’ve discussed a lot today: everythin from what creatinine is, to the types
 of
creatinine tests, interpretin lab results, and how to lower creatinine levels. If it
 feels
like too much, don’t worry! You can always refer back to this article.
Creatinine is a very important part of your trackin and monitorin
 . Keepin control

of your creatinine levels will help you mana e your condition better and live a
healthier life.
We hope that we’ve shared here today can et you one step further in delayin
dialysis and maintainin your kidney
 health.

11. Creatinine & Kidney
Function
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don’t just want to provide you with education about kidney disease
mana ement. We want to ive you all the emotional support you can
have as well. And so…
We would love to have you on our RenalTracker Support Group in
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Anyone who needs help and/or wants to help is very welcome to
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