Creatinine is "insensitive" and patients with kidney disease should not be pitted by this indicator.

Recently, a patient with chronic renal failure, with a creatinine concentration of 172 μmol/L, entered the third phase of kidney disease.
It is regrettable to read his previous inspection report. At the 2016 medical exam, creatinine was already 109, and creatinine was 115 at 8 months before. Surprisingly, almost two years later, he had not taken any medicine or had any treatment. I asked him:
"In September of the previous year, your creatinine exceeded, and you should know?"
"know."
"How hasn't been treated?"
“I think that the high creatinine point is okay, then I'm going to have a bit high transaminase and my blood pressure is always high. Our normal creatinine value is 54-106, and the feeling of a hundred nodded creatinine is not big, but now creatinine is getting higher and higher. It's up."
"At that time, you should consult the Department of Nephrology."
"I was seeing a doctor at the time. I had a buddy, a doctor in neurology. I asked him if my creatinine was too tight. He said that the problem was not serious. Continue to review, or go to the Department of Nephrology. I think the problem is not great. Look at the Kidney Kidney and don't go."
"In fact, you should treat it two years ago. Is there fatty liver?"
"Yes, five or six years."
"And your weight, you should also control it. Isn't fatty liver treated?"
“Most of the people around me have fatty liver. As we are 40 years old, who hasn’t got a fatty liver? The doctor I said doesn’t include you. When I was doing B-ultrasound this year, the front six people lined up. All have fatty liver, and I'm a little bit of that team."
"Is blood pressure high?"
"About 140/85, sometimes more than 140, up to 145."
............
Throughout the conversation, the patient's expression of carelessness. Only when I talked about edema of the lower extremities I was anxious and wanted to eliminate edema.
Because of edema, it is difficult for patients to wear shoes now.

Creatinine is a "severe indicator"

People often misunderstand creatinine and think that a slight overshoot is a “small problem”. In fact, creatinine is not the same as blood pressure, blood lipids, etc. It is a kind of "insensitive indicator."

Creatinine is born half a beat, and it is indifferent when the kidneys begin to become damaged:

Glomerular inflammation, creatinine did not respond.

Leakage of the protein through the membrane, and creatinine did not respond.

Then the renal tubules were damaged and creatinine did not respond.

Even some nephrons have necrotic fibrosis, and creatinine may still not reach the upper limit of normal.

Creatinine will only exceed the standard if it is severely damaged and the loss of renal cells is more than 2/3.
Creatinine's lag in kidney problems makes it a "serious indicator." This is also the reason people generally think that creatinine is difficult to reduce: At this time, the kidney disease is already very serious. Therefore, it is recommended that kidney friends look at cystatin C when checking kidney function. This indicator is sensitive and can reflect early kidney damage.

For example, this patient, you see his creatinine 101, within the normal range; but cystatin C reached 1.58, indicating that the kidneys have been damaged, very serious, and the kidneys are soon exhausted.
If he checks the glomerular filtration rate, it will show that kidney function is not enough.

Also, what kind of disease is it? Doctors are not all-powerful, have division of labor, and are like rivers and mountains.

Distorted health concept

The creatinine problem is still superficial, and the most fundamental is the change of concept.

The current concept of this era makes me more and more unable to understand:

"People around have fatty liver, afraid of moles"

"Now this society has normal hypertension."

"Nothing transaminase is okay, but don't donate blood."

"Uric acid is high, normal, and joints don't hurt."

............

As if there were no one or two metabolic diseases on the body, it would be "out of touch" with society and "not keep up with the times." Middle-aged people keep low-salt, low-fat, high-quality, low-protein diets and regular exercise. The body is not as bad as young people.

The concept is ill and the whole body is ill.

May readers not follow the crowd. See the glitz and treasure yourself.