Ask any dialysis patient worth the little salt he eats which is the blood test he would most commonly associate with kidney disease and chances are that the answer would be creatinine. From the time you get diagnosed, everyone talks about creatinine. "How much is your creatinine?" is a question I have been asked the most, even more than, "What is the secret of your good looks?"

I have talked a lot about Creatinine in a recent post here.

However, a very interesting perspective about Creatinine was offered by Dr. Ashwin Aiyangar at the patient meet we had at NephroPlus recently. What he said was that Creatinine is a product of the breakdown of a certain compound in the muscle. So, if your muscle mass increases, your Creatinine increases.

Many people on dialysis in India have a huge malnutrition problem. Many nephrologists do not impose any diet restrictions on such patients. Heck, they are not even getting the basic nutrients; what is the point in asking them not to eat this or that? Many dialysis patients are so malnourished that their potassium and phosphorus are below normal!

So, in this context, the Creatinine is a good measure of how well you are eating. This is true for those dialysis patients that are on maintenance hemodialysis or those with End Stage Renal Disease. (Note that the end stage is not end stage as in end stage of life but end stage of kidney function!) These patients need not worry when their creatinine is too high. All that means is that they are eating well and they don't need to worry about being malnourished. These patients should check their creatinine only to serve as a marker of nourishment, never as a marker of kidney function.

In patients who are in the early stages of kidney function, the creatinine serves as a marker of kidney function and they should be worried if their creatinine is going high.