Does Hydration Affect Serum Creatinine Levels in Chronic Kidney Disease?

Factors affecting elevated creatinine levels?

I have chronic kidney disease and have been undergoing regular follow-ups.
However, the results of my kidney function tests have shown significant fluctuations this year (ranging from the 50s to the 30s).
Therefore, I would like to ask the doctor whether the amount of water intake before a blood test for kidney function can affect the concentration of creatinine in the blood (I have not engaged in vigorous exercise before the blood draw).

Mr. Zhang, 50~59 year old female. Ask Date: 2020/07/01

Dr. Wu Jiyu reply Internal Medicine

Based on the data you provided, it falls within the range of stage 3 chronic kidney disease.
Sometimes, we monitor kidney function by looking at a broader range and trends over several years, rather than just comparing the most recent outpatient visit with the previous one.
In your case, it might be a range of 40 ± 10 (30-50), while another patient might be 40 ± 5 (35-45).
Each individual is different, so it's best to compare with oneself.
The key is to manage the controllable factors, such as hypertension, diabetes, uric acid levels, proteinuria, and also to pay attention to diet and exercise.
Regarding your question about water intake, unless there is extreme dehydration or excessive fluid intake, it generally has little impact.
Thank you for your inquiry; the Nephrology Department at Changhua Hospital cares about you.

Reply Date: 2020/07/01

More Info

Hydration plays a significant role in influencing serum creatinine levels, especially in individuals with chronic kidney disease (CKD). Creatinine is a waste product generated from muscle metabolism and is primarily eliminated from the body through the kidneys. Therefore, fluctuations in serum creatinine levels can provide valuable insights into kidney function.

In patients with CKD, the kidneys' ability to filter waste products, including creatinine, is compromised. As a result, any factors that affect kidney perfusion and function can lead to variations in serum creatinine levels. One such factor is hydration status. When a person is well-hydrated, the kidneys can effectively filter and excrete creatinine, leading to lower serum creatinine levels. Conversely, dehydration can result in reduced kidney perfusion, causing an increase in serum creatinine levels due to decreased clearance.

In your case, the fluctuations in your serum creatinine levels from the 50s to the 30s could be attributed to variations in hydration status before blood tests. If you were more hydrated during one test compared to another, it could explain the differences in creatinine levels. It is essential to maintain consistent hydration, especially before blood tests, to obtain accurate and reliable results.

Moreover, other factors can also influence serum creatinine levels, such as dietary protein intake, muscle mass, medications, and acute illnesses. For example, a high-protein diet can temporarily elevate serum creatinine levels due to increased production, while certain medications can either increase or decrease creatinine levels.

In clinical practice, it is common to assess kidney function using a combination of serum creatinine levels, estimated glomerular filtration rate (eGFR), and urine tests. The eGFR is calculated based on serum creatinine levels, age, sex, and race, providing a more comprehensive view of kidney function. It is crucial to interpret these values in the context of your overall health, hydration status, and any underlying conditions.

If you notice significant fluctuations in your serum creatinine levels, it is advisable to discuss this with your nephrologist. They may recommend monitoring your hydration status, adjusting your fluid intake, or conducting additional tests to assess your kidney function more accurately. Regular follow-ups and communication with your healthcare provider are essential in managing chronic kidney disease effectively.

In summary, hydration does affect serum creatinine levels in individuals with chronic kidney disease. Maintaining consistent hydration can help provide more stable and accurate assessments of kidney function. If you have concerns about your kidney health or fluctuations in your test results, it is essential to consult with your healthcare provider for personalized advice and management strategies.

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