In the stage of chronic kidney disease, creatinine level over 700umol/L is called uremia. However, a patient’s creatinine level is over 1000umol/L but the doctor tells him not to start dialysis. What the hell determines dialysis?
The doctor explains that though creatinine level is over 700, it is not the key point that determines dialysis. It is kidney size, urinary volume and complications that determine dialysis.
1. Kidney size
When kidney disease develops to uremia, kidneys will shrink severely and also 80% kidney nephrons can be atrophic and dying. If your kidney size is normal, you have no need to take dialysis even though your creatinine level is over 1000umol/L. Because elevated creatinine level at this time is caused by other factors like high blood pressure, infection and medicine damage. If kidney patients want to know your kidney size, you can take B ultrasound to check your kidney size.
2. Urine volume
If creatinine level is close to dialysis or the patient has been in uremia stage, doctors will always ask such a question that “do you still pass urine?”.
Urine volume in healthy people is about 2000-3000ml. Urine volume below 400ml is called oliguria. Urine volume below 100ml is called anuria.
Normal urine volume indicates that glomerular filtration function and renal tubule reabsorption function are not damaged severely. At this time, even if your creatinine level is 1000umol/L, but you still have healthy kidney cells, it is no need to begin dialysis.
3. Complications
The complications of uremia is heart failure, acidosis, hyperkalemia and renal anemia etc. These complications can endanger your life at any time. If you have no these serious complications, you do not need to start dialysis.
Therefore, when you find that your creatinine level is very high, what you should do is to find out the root cause instead of starting dialysis ordered by your doctor. If your high creatinine level is caused by infection, high blood pressure, strenuous exercise and drug damage, then you are very lucky and do not need to take dialysis.
In a word, creatinine level is not the only indicator of kidney function. Do not need to worry too much.
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