Serum Creatinine (Nursing)

00:01 Now we're going to look at serum creatinine.

00:04 Now creatinine is another waste product.

00:06 Creatinine is the waste product of creatine like muscles use creatine to make energy.

00:12 So if you've been at the gym, you see a lot of people add and creatine to their stuff.

00:16 Right? But creatine is the muscles use that to make energy.

00:22 When the muscles use creatine you end up with creatinine.

00:27 Wow, those names are closed.

00:29 So you might need to pause the video and go go over the a little bit but serum creatinine is looking at the creatinine level in your blood.

00:36 So creatinine is a chemical waste product and it's produced by muscle metabolism.

00:41 Now healthy kidneys can usually get rid of this.

00:43 They can usually filter creatinine from the waste products and other waste products from your blood into your pee.

00:50 That's what it does.

00:51 So we know creatinine it's a chemical waste product.

00:54 It's produced by muscle metabolism from creatine that they use for energy and normal healthy. kidneys can filter this out of the bloodstream and pee it out of their bodies.

01:06 If the kidneys are limping.

01:07 They're not doing well.

01:09 Then we're going to have elevated serum creatinine levels.

01:13 Because they help us assess renal or kidney function and pair of kidneys lead to higher levels of creatinine in the blood because the folk the kidneys can't filter it out of the blood and deposit into the pee to be excreted out, you end up with higher levels remaining in the blood when we do a serum creatinine test, your drawing blood usually from a venous sample.

01:37 And so that's why we can measure that there's a higher level of creatinine in the blood.

01:42 Now serum creatinine can also help give us an estimate of how well the kidneys are able to filter.

01:48 Okay, hang on, because this part gets super cool.

01:50 Now you see we have over there for picture of what? That should look familiar to you.

01:55 Yeah, it's the glomerulus.

01:57 Look at that.

01:57 You got the blood supply coming in the tangle of capillaries that's the Glomerulus.

02:02 It's surrounded by Bowman's capsule that will lead down to the tubules.

02:05 That is some cool kidney stuff. Right? Well, it's much easier to estimate the glomerular filtration rate.

02:12 If I'm healthy, there's some numbers that I can know GFR but as the kidneys begin to have trouble that GFR is going to be lower and lower and lower.

02:23 So the Serum Creatinine, will tell me what the creatinine level is in my blood and if the kidneys aren't functioning well that's going to go up, and also the serum creatinine is used to do the estimate of the glomerular filtration rate.

02:37 Now, there's normal levels of serum creatinine and I know you're not going to be super excited because you see there's two values for this.

02:45 It's because males have one normal value and females have another.

02:50 Now they are pretty close so you can figure out how you want to memorize those.

02:55 But just remember males are slightly higher than females on our slide.

02:59 It's like .1 higher, right? so you can memorize one and no it's either just .1 higher or point one lower.

03:05 Whichever one you want to memorize because this is a very important test of both kidney function and helping us calculate glomerular filtration rate.

03:15 Now, what are some reasons for high creatinine we've talked about some but I want to give you some major examples.

03:22 So if I have a patient who has Chronic Kidney Disease, I would anticipate a relatively high creatinine if they have kidney obstruction.

03:31 Whoa.

03:32 Well, remember we're trying to get the creatinine out of the body through the urine.

03:36 So if there's an obstruction or not letting enough urine of the body that would make sense why creatinine would be high if someone is really really dehydrated both their BUN and their creatinine will be elevated.

03:48 So watch that if I have a patient I know is really intravascularly dehydrated, I would expect there BUN and creatinine to be high when we rehydrate them when we fill up their tank again intravascularly their volume is more imbalance, so they've got more in their veins and arteries, you'll watch that be you in and creatinine come down.

04:10 Now it could also be the patient is eating extremely high amounts of dietary protein that may or may not affect the patient.

04:17 It just depends on the individual patient.

04:20 But if you think about it, you got the issues with dietary protein that might be another cause of high creatinine.

04:26 Now here's a here's a killer one.

04:28 Intense exercise, If you've got someone who's an extreme athlete who's doing some really tough workouts, you might also see higher creatinine levels the kidneys may be fine.

04:38 The reason for the high creatinine is because of the Extreme Workout.

04:42 There's also some medications that can cause it so.

04:45 Okay, that was a lot of information.

04:48 Let's walk back through it again.

04:50 So you see underneath the kidney.

04:52 They just have kidney disease or kidney obstruction, that's going to be high creatinine.

04:57 If they're dehydrated or eating high levels of dietary protein that could also cause it.

05:02 That's why you've got a glass of water next to a big fat steak unless you've got this guy who's running away from Angry pills that are chasing him.

05:10 So that will help you remember intense exercise or certain medications.