What is palpation in dentistry. Palpation - a method of dental examination

Why get tested?

If the patient has symptoms of kidney disease, all three tests are indicated.

These symptoms usually include:

• Constant feeling fatigue;
• Insomnia;
• Loss of appetite;
• swelling of the face;
• Pain in the lower back (near the kidneys);
• Frequent calls to urination;
• high blood pressure;
• Nausea and vomiting.

Kidney problems can be caused various diseases:

• Glomerulonephritis - inflammation of the glomeruli of the kidneys;
• Pyelonephritis;
• Inflammation of the prostate (in men);
• Stones in the kidneys;
• cystitis (in women);
• Heart failure, diabetes(types 1 or 2), dehydration;
• The death of kidney cells due to the use of narcotic drugs.

AND muscle tissue is creatinine. Its concentration in serum is constant, and its production does not depend on daily rhythms, loads. Even food has little effect on its content. The amount of creatinine in the blood may increase, but the causes are various pathological processes. That is why the deviation of creatinine from the norm is an important diagnostic sign.

Causes of increased creatinine

Creatinine is the end product of protein breakdown, and its precursor, creatine phosphate, synthesized from creatine, is involved in energy metabolism. This nitrogenous compound is a non-threshold substance, that is, it is simply excreted by the kidneys from the body (not secreted, not reabsorbed in the tubules), so its concentration is constant. In many ways, the amount of creatinine depends on the amount of muscle mass. Deviations from the norm indicate the pathology of the kidneys, the musculoskeletal system and metabolic disorders.

The doctor directs for research if the patient makes such complaints:

• pain in the lower back or kidney area;
• thirst, dry mouth;
• vomit;
• sweating;
• amyotrophy;

And if creatinemia is detected, the doctor will suspect:

• and kidney disease;
• stagnant;
• muscle diseases (dystrophy,);

With extensive injuries, especially due to muscle damage, creatinine is produced faster and therefore its concentration increases greatly.

Naturally, to establish an accurate diagnosis, it is not enough just to determine the level of creatinine in the blood. For example, to identify kidney pathology, in order to find out the glomerular filtration rate, it is necessary to conduct a Rehberg test. To confirm hyperthyroidism, function should be examined thyroid gland so you have to go additional examinations.

When making a diagnosis, it is necessary to take into account factors that affect serum creatinine levels:

1. Elderly age. After 55 years, less of it is synthesized in the body, so even if the concentration is slightly increased, the degree of kidney damage can be much greater.
2. Pregnancy. Due to an increase in blood volume, an increase in renal plasma flow, the level decreases.
3. Floor. In men, creatinine circulates more in the blood, because its amount depends on muscle mass. It is for this reason that an increased content is recorded in athletes, but such creatininemia is physiological.
4. Food. Although it has a slight effect, but with insufficient consumption of protein (containing arginine and glycine - precursors of creatine), it is not produced enough. And if the patient consumes a lot of meat food rich in these amino acids, then creatininemia is detected.
5. Medicines. False elevation occurs due to certain medications ( vitamin C, acyclovir, amiodarone, amphotericin B, aspirin, captopril, diclofenac, vasopressin, streptomycin, etc.).

There is a significant increase in serum levels kidney failure, but with mild and moderate kidney damage, more important diagnostic value is the ratio of its concentration in urine and blood. In addition, creatinemia is detected in diseases of the skeletal muscles, pathologies of the endocrine glands, extensive. What caused the deviation from the norm, the specialist will establish.

What is the normal level of creatinine in the blood

The concentration of creatinine depends on gender and age, moreover, laboratories can use different research methods, and therefore normal performance may vary. Almost all tests are based on the Jaffe reaction, which was described as early as 1886. Since then, this method has been significantly improved.

Normal levels of creatinine in the blood:

Although creatinine in the blood is contained in extremely small quantities, it is of great diagnostic value, especially for the timely detection of pathologies of the kidneys and skeletal muscles.

A significant increase is recorded when 50% of nephrons are affected. In severe renal insufficiency, its concentration can reach 800–2650 µmol/L.

With the destruction of muscle tissue and other pathologies, the concentration will increase significantly. That's why you don't need to guess what caused creatinemia, just consult a doctor. Specialist based on the results of the analysis and other accompanying symptoms make an accurate diagnosis.

Which doctor to contact

Creatinine is one of the few substances whose concentration is practically not affected by food, exercise and circadian rhythms. It is produced a lot during the breakdown of muscle tissue, increases in serum levels and in violation of the urinary system. Accordingly, creatininemia is an important diagnostic sign especially in cases of renal insufficiency. Most often, a nephrologist directs a nephrologist to study the level of creatinine in the blood.

The study of creatinine levels by biochemical blood analysis is also used in their practice by doctors of other specialties: urologist, traumatologist, surgeon, endocrinologist, cardiologist, rheumatologist.

Determining the level of creatinine (Crea) in the blood serum is an important diagnostic examination. It allows specialists to confirm or refute a preliminary diagnosis. This method is mainly used to diagnose kidney diseases, but the analysis can also indicate a violation of other organs. Creatinine in the blood is elevated causes, and what methods of treatment exist to normalize the level of this substance.

The energy of life

Creatinine - what is it? In order for our muscles to contract so that we can carry on a normal active life they need protein. The main supplier of muscle energy is a substance called creatine. This is a compound synthesized in the liver from several types of protein molecules. When creatine enters the muscles, it is broken down. Energy is absorbed by muscle tissue, and the remaining product is excreted from the body by the kidneys.

This substance is no longer needed by our body, it is a residual compound that is toxic. At healthy person the content of creatinine in the blood is a constant value, because it is produced and excreted continuously. However, in some diseases, creatinine in the blood is increased, and if the cause of the failure is not eliminated, intoxication is possible.

Norms for healthy people

Today, experts determine creatinine in a biochemical blood test, depending on the age, complexion and gender of the patient. So the averages are:

When calculating the norm for each individual patient, the doctor must take into account many factors that can affect the fact that criatinine in the blood is elevated and these reasons may be different. Remember, elevated creatinine is not always a pathology! So, for example, for a large child, the indicators can be significantly higher than for a thin peer, and for an elderly person, they will be lower than for a young one.

What does the decrease in the indicator in pregnant women mean? Also, when carrying a child, creatinine (Crea) in the blood may decrease, this is justified by an increase in the volume of blood in the woman's body. This deviation usually resolves on its own by the third trimester. But if this did not happen, this may mean the presence of a pathological cause in the blood of a decrease in creatinine.

Increased performance in healthy people

High creatinine - what does it mean? Every person's creatinine level can increase throughout life. but high level does not always indicate the development of the disease. Elevated levels of creatinine in the blood can be with physical exertion.

So, if you have never played sports and suddenly decided to enroll in a gym, your creatinine level will increase noticeably.

With increased creatinine in the blood, your diet may be unbalanced. If you like meat and fish and do not include fruits and vegetables in your diet, this can increase the level of a protein breakdown product in your blood. However, these causes of increased creatinine do not give a critical protein indicator, which means it is not dangerous for your health. Therapy to reduce creatinine in these situations is reduced to a review of the diet and exercise. Experts advise to eat according to the principles of a healthy diet.

Pathological excess of indicators

It is possible to speak about the pathological process only in the case when the increase in creatinine in the blood occurs two or more times. At the same time, other indicators of the biochemical study of plasma also do not meet the standards. Why is a highly elevated level of a protein breakdown product dangerous? First of all, if blood creatinine is elevated, doctors may suspect kidney disease. In renal failure, the substance is not excreted from the body in full and it accumulates in the plasma. However, other pathologies can be the reasons for the increase in creatinine in the blood.

What does it mean increased rate in blood:

• Kidney diseases. With these diseases, the kidneys cannot cope with their function and harmful substances that must be excreted in the urine remain in the blood. If the blood test shows a critical value, the patient may be prescribed dialysis.
• Heart failure. With this disease, the heart cannot actively pump blood, which affects the removal of the decay product from the body. Also, when the cells of the heart muscle are destroyed, creatinine is released, which also contributes to its increase in the blood.
• endocrine disorders. The increased production of hormones provokes the destruction of muscle tissue, and as a result, an increase in the level of creatinine in the blood occurs. In this case, the patient is given specific analysis blood for hormones and, based on its results, a treatment plan is developed. The danger of these disorders lies in the long asymptomatic course of the disease.
• Oncological diseases. Malignant tumors and metastases can destroy muscle tissue. In some forms of cancer, the liver or kidneys are severely affected. All these types of malignant diseases lead to the fact that the analysis will show elevated creatinine in blood.
• Severe muscle injury. With extensive muscle injuries, creatinine is released from damaged cells. Most often, the level in the blood test normalizes after the injury heals.
• Kidney removal. After nephrectomy, one of the paired organs takes over the entire burden of blood purification. If the remaining kidney is completely healthy, after nephrectomy, the indicators may not go beyond allowable rate, but usually slightly higher.

When is an analysis ordered?

Endogenous creatinine clearance is indicated for all inpatients and pregnant women, biochemistry is prescribed primarily for people with suspected renal failure.

Signs that creatinine in the blood is elevated resemble the symptoms of intoxication.

Also specific symptoms that require research in the analysis of the level of creatinine, also called - (Crea), are:

• Pain in the muscles.
• Decreased amount of urination.
• Edema of the lower extremities.
• General weakness, from which a person feels bad all the time.
• Fast fatiguability.
• Paleness of the skin.

With increased creatinine, the doctor must first of all exclude the influence of third-party factors - what is it? If you accept any medications tell your doctor about it. If this indicator is increased due to the presence of a disease, treatment should be prescribed immediately. You also need to report if you took alcohol or ate fatty foods before donating blood. Why? Simply because not following the rules for testing can increase the level of creatinine and you will get a false result.

How to reduce the indicator of the substance? To treat this deviation, it is necessary to eliminate the cause of the increase in creatinine. The level of the substance does not rise on its own. If you have an increased level of creatinine in the blood, you need to do additional examinations and only after making an accurate diagnosis, start treatment.

In particular, if urea is also elevated with increased creatinine, then there are clearly problems with the kidneys. Only the attending physician should decipher the analysis, because it is he who knows all the features of your body and will be able to correctly interpret the results.

What to do if the analysis is bad? If you are told that you have found a deviation from the norm in the analysis, this means that something in your body has gone wrong. If the indicator is slightly increased, most likely, the whole thing is in your lifestyle, but when the indicators exceed the norm by two or more times, you need to look for the cause in hidden diseases. A biochemical blood test is an excellent method for assessing general condition patient. Remember, only a doctor can diagnose real reasons deviations in the analysis and prescribe adequate treatment.

In contact with

Creatinine is a chemical substance that is formed in the muscles of a person during physical exertion as a result of the breakdown chemical compounds(creatine - creatine phosphate reaction), which are a source of energy for the contraction of muscle fibers.

From the muscle fibers, creatinine enters the bloodstream and, after purification of the blood serum by the kidneys, is completely excreted from the body in the urine. An increase in creatinine in the blood is called hypercreatinemia and indicates a violation of the excretory or musculoskeletal systems organism.

To determine the rate of products of the creatine phosphate reaction, the first study is biochemical analysis blood for creatinine, which is carried out with suspicion of renal failure.

Cretitin norm by age (table)

The norm of creatinine in the blood differs depending on gender, age and the amount of muscle mass in each person. At the same time, the concentration of creatinine is stable and depends little on external factors. physical factors(for example, from food).

Among women normal level creatinine in the blood is almost two times lower than in men, due to fewer muscles.

To assess the work of the kidneys, a set of tests called creatinine clearance (or Reberg's test, glomerular filtration rate) is used.

Clearance in medicine is the speed and quality of blood purification by the kidneys from the decay products of human vital activity. Creatinine clearance determines the amount of purified blood in 1 minute. Thus, there is an assessment of the functioning of the kidneys and the degree of violation of the cleansing processes.

To calculate creatinine clearance, it is necessary to take a blood and urine test. In this case, urine is taken several times over 2-5 hours, depending on the method of examination. There are special formulas for evaluating the cleansing work of the kidneys using creatinine in both body fluids.

A clearance study is prescribed with an increase in creatinine, with suspicion of systemic lupus erythematosus, glomerulosclerosis, nephropathy, and renal failure.

Causes of increased creatinine in the blood

Among the reasons for the increase in creatinine, the main categories can be distinguished: a violation of chemical processes in the muscles (destruction of proteins), as well as malfunctions of the excretory system.

A significant increase in creatinine in the blood can occur with such diseases:

• renal failure in the acute or chronic stage;
• tumors of the liver and kidneys;
• autoimmune diseases;
• blockage of the urinary tract;
• diseases of the thyroid gland, when there is an increased breakdown or growth of muscle tissue (hyperthyroidism, acromegaly, gigantism);
• adrenal hypofunction;
• oncological neoplasms;
• internal bleeding;
• dehydration.

If creatinine is significantly higher than normal, then this may also indicate an increase in other blood parameters (bilirubin, uric acid, red blood cells, protein, etc.) that are higher than normal due to pathology of the liver and kidneys.

There is the concept of a false increase in creatinine, which is used in cases where the causes of the increase are associated with physiological processes in organism. These reasons include:

• a significant amount of muscle mass;
• physical exercise;
• use of creatine supplements;
• use medications to reduce pressure (Capoten, Zofenopril, Benazepril, Lisinopril);
• long-term use of drugs that have a toxic effect on the kidneys (non-steroidal anti-inflammatory drugs, antibiotics, immunosuppressants, immunoglobulins).

In cases where high creatinine is due to prolonged use drugs that have a toxic effect on the kidneys, it is necessary to review the treatment and change drugs. If you do not take action and continue treatment with nephrotoxic drugs that increase the amount of creatinine in the blood, then after a while, kidney failure may occur.

Symptoms

As a rule, a significant increase in creatinine indicates a violation of the kidneys and may be accompanied by the following symptoms:

• drawing pains in the lower back;
• the occurrence of edema;
• violation of urine excretion;
• high blood pressure;
• convulsions;
• muscle pain during movement and at rest;
• constant fatigue;
• nausea and loss of appetite;
• memory impairment;
• apathy.

Since an increase in the level of creatinine indicates a violation in the work of the kidneys, for complete diagnosis excretory system are carried out additional analysis blood and urine:

• excretion of albumin in the urine;
• the level of uric acid in the blood;
• the rate of catecholamines in daily urine;
• urea clearance.

How to lower creatinine levels

Decrease in creatinine level consists of drug therapy and therapeutic diet, the action of which is aimed at improving the functioning of the excretory system.

Most often, elevated blood creatinine normalizes with the use of drug therapy with the following drugs:

• enterosorbents - drugs that are used to cleanse the body of waste products, as well as toxic substances (Enterosgel, Smecta, Polysorb, Lignin);
• drugs that improve the excretion of protein breakdown products - creatinine, uric acid, urea (Ketosteril, Chitosan, Lespefan);
• diuretics - activate the work of the kidneys and contribute to the removal of fluid from the body (Indapamide, Trifas, Diuver, Furosemide);
• blood pressure lowering agents (for hypertensive patients with elevated creatinine) (Hydrosaluretil, Hypothiazide).

Diet

Therapeutic nutrition with an increase in creatinine in the blood consists in the exclusion from the diet of foods that lead to a load on the kidneys:

• purine compounds - during the digestion of proteins of animal origin (purines are included), an additional concentration of creatinine, uric acid, urea, etc. occurs, which must be removed from the body;
• phosphates (salts of phosphorus) - vital important connections, but in excess they lead to a decrease in the level of calcium in the body (they are present in meat, fish, canned food, in products with preservatives in the composition).

In order to reduce creatinine in the body (in the blood and in the urine), therapeutic is used, as well as table 7a and 7b, which are prescribed at different stages of acute and chronic nephritis.

To improve the excretory ability of the kidneys, the diet consists mainly of vegetable carbohydrates with a minimum amount of protein. With a high content of creatinine in the blood, the main diet should consist of the following products:

• vegetables (except potatoes), greens, moderately sweet fruits, berries;
• dried fruits, nuts, honey;
• lean dairy products(cottage cheese, sour cream, fermented baked milk, kefir);
• cereal porridges and soups on vegetable broth;
• pasta from durum wheat;
• diet salt-free bread;
• vegetable oil.

In limited quantities, you can use:

• dietary meat (chicken, turkey, rabbit) 2 times a week;
• lean fish;
• potato;
• boiled eggs - 3 pieces per week;
• lean fish.

If creatinine significantly exceeds the norm, the above products are completely excluded from the diet.

With an increase in creatinine, the following foods are prohibited:

• fatty meats (pork, duck, goose);
• fatty fish;
• smoked and fried foods;
• spicy seasonings and sauces;
• a lot of salt;
• sweet pastries;
• strong tea and coffee;
• milk.

In the process of cooking, preference is given to boiling, stewing, baking, as well as steaming food.

Folk remedies

Traditional medicine recipes that are used if creatinine in the blood is elevated are aimed at improving kidney function. As a rule, infusions and decoctions of herbs with diuretic and anti-inflammatory properties are used.

nettle tea. Nettle leaves are known in traditional medicine as a means of purifying the blood, and can also reduce the concentration of creatinine and stimulate the urinary system.

To prepare one serving of tea, you need 3 teaspoons of dried nettle leaves and a glass of boiling water. Tea insist 7-10 minutes and add half a teaspoon of honey for taste.

Dried nettle leaf tea is consumed 2-3 times a day for a month.

Chamomile infusion. Chamomile helps to eliminate toxic substances from the body, reduces the content of creatinine in the blood.

To prepare the infusion, mix two teaspoons of dried chamomile flowers and 200 ml of boiling water and cover with a lid for 5-7 minutes. Next, the infusion of chamomile should be filtered and consumed as a tea several times a day.

Treatment with infusion of chamomile is carried out for no more than 3 weeks. After a ten-day break, the course can be repeated.

Cinnamon. The use of cinnamon improves kidney function, namely, it activates the filtration and throughput capacity of the excretory organs, which reduces urea, uric acid and blood creatinine. It is necessary to add cinnamon to your diet every day, but do not consume more than 1 teaspoon per day.

Eleutherococcus or Siberian ginseng. Eleutherococcus is able to stop the increase in the amount of creatinine, as it enhances the processes of blood circulation and blood circulation in the kidneys, stimulates the work of the nervous and hormonal systems.

You can use dragees, tablets, capsules with eleutherococcus or tincture of the plant for alcohol. Dry extract of the plant (in tablets, etc.) must be taken three times a day for a month. Eleutherococcus tincture should be consumed depending on age from 15 to 30 drops 2 times a day before meals. The course of treatment is 25-30 days.