Creatinine during dialysis

[Golferchick]

My dad had a transplant in February 2009. He hadnt been on dialysis prior to the transplant. About 1.5 months ago he developed aspirate pneumonia and the transplanted kidney shut down which has put him on dialysis since then. His creatinine is high during dialysis (5-6 range). Is that normal? Does that number go down at all during dialysis or will it always remain high?

Any information would be helpful and greatly appreciated!

-Marcy

[RichardMEL]

No, creat does not really go down during dialysis (by "during" I am assuming you mean while on dialysis not actually while on the machine during a run). Creat doesn't go down basically because labs are usually taken before a D session so you can get an idea of where the body is at - if it was taken right after a D session it would be artificially lower, because the toxins would be removed. Anyway since the creat is just a measure of the toxins in the blood and the kidneys aren't doing their job it will remain high reflecting the fact that toxins are building up between dialysis sessions(and hence the need for D). Once on dialysis the creatinine measure is mostly irrelevant anyway since you know the kidney function is gone anyway.

[Malibu]

We have pre and post diaysis labs (the post is taken directly after a dialysis session just before the access needles are removed) which measure among other things creatinine.  I don't know if you are talking about the post-lab results -- I have thought of this same question.  RichardMEL's answer answered it tho!

[RichardMEL]

in my experience (here in the land of oz anyway) the post lab is taken to establish your clearance figures (or URR). As in your urea (or BUN if you like) is taken pre, then post, and the difference is thus a measure of your clearance, or how effective dialysis is at removing the toxins. My latest result just last week was 76.8% which I was pretty happy with, though I did get to 82% one time.

[Jie]

Creatinine levels are different between HD and PD patients. PD seems not being able to get rid of much creatinine. I started PD with creatinine about 5 and now 11 months later 7.6. My neph told me that most PD patients have creatinine of 8 or so.  For HD, especially those overnight HD, creatinine can be lowered a lot. I heard that some patients can get it down to about 1.5, about the high end of normal value.

[Golferchick]

My dad is in rehab (in hospital & rehab since 9/15/09) and they draw blood before dialysis. I don't know about afterwards - will check on that. Last week his creatinine was 4.3. Definitely down from 2 weeks prior. Transplant said there is a chance that the kidney could regain function, but if it does happen it will be a very slow process.

It is getting a bit easier on him but still tough. Not used to sitting there.