The serum creatinine may be low for a number of reasons, some of which may be significant for the patient.
Cause
Reason
Implication
protein malnutrition
low skeletal muscle mass
increased mortality in the ICU
advanced age
low skeletal muscle mass
muscle weakness
pregnancy
physiologic hemodilution
a creatinine in the normal range may be abnormal
artifactual dilution
collection from a line infusing fluids
other analytes also low
pathologic hemodilution
fluid overload
renal loss in diabetes or other nephropathies
glomerular hyperfiltration or tubular secretion
where:
• A low serum creatinine is a better indicator for malnutrition than body weight. Fat or fluid retention can result in a normal body weight despite low muscle mass.
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