Why Is Creatinine High In Diabetic Ketoacidosis?

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How to Reduce High CREATININE Levels & Increase Low CREATININE Levels | info by Guru Mann

Creatinine Is Falsely Elevated In Diabetic Ketoacidosis Patients: A Comparison Of 4 Jaffe Assays With An Enzymatic Method. Asn Events

Creatinine is Falsely Elevated in Diabetic Ketoacidosis Patients: A Comparison of 4 Jaffe Assays with an Enzymatic Method. ASN Events Creatinine is Falsely Elevated in Diabetic Ketoacidosis Patients: A Comparison of 4 Jaffe Assays with an Enzymatic Method. Azni Abdul-Wahab 1 , Hanh Nguyen 2 , Mervyn Kyi 3 , Wei Ling Chiu 3 , Que Lam Lam 4 , Cherie Chiang 1 3 Pathology/ Endocrinology, Royal Melbourne Hospital, Melbourne Endocrinology, Royal Melbourne Hospital, Melbourne Endocrinology, Austin Hospital , Melbourne Falsely elevatedplasma creatinine due to glucose and ketone interference is well documented inroutine Jaffe assay (1,2). Although Jaffe assays have been recentlystandardised since the introduction of eGFR, the effect of this interference isunknown since the alignment process. Weassessed plasma creatinine in DKA patients using 4 Jaffe assays against anenzymatic method as the gold standard. Samples were collected from DKA patients presenting to the EmergencyDepartment and ten outpatients with normal glucose and bicarbonate.Aliquots were frozen, transported on dry ice, and analysed on 4 Jaffe assays (Architect,Roche, Beckman Coulter and Siemens) and the Vitros Enzymatic assay. Continue reading >>

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  1. Deranged_hypnotist

    Hey all, So I began this Keto diet over 1 month ago and the results have been FANTASTIC! I have lost 35 pounds! (M/6'1 Sw: 245 CW: 210 GW: 180) I have been extremely happy with myself now and its all thanks to you guys. Sadly though yesterday while checking my ketosticks i saw blood in my urine and after a 7 hour ER visit I was told by the doctor that I had passed a kidney stone and gotten a UTI from it as well. I have never had a kidney stone in my life or any major health problems (aside from being overweight). The doctor told me to get off my diet until I can see an urologist to find out why I have a kidney stone. The thing is the next available appointment is not for a long time since I work 2 jobs. So I have done a bit of research and a side effect of being in ketosis is kidney stones (from random online website).
    So my questions to r/keto is 1. How often does this happen? 2. Is this Research Valid Online? 3. Where do I go from here?
    I still want to continue keto for the next 30 more pounds.
    P.S. I do not want this post to discourage anyone from trying keto, EVERYONE'S body is different.

  2. gogge

    Higher protein intake increases the calcium absorption in the gut, and consequently increases the calcium excreted in the urine. Ketosis increases the need to balance blood pH as ketones are acidifying, one way the body likely does this i by increasing calcium leaching from the bones, this also increases urine calcium excretion.
    Increased calcium levels in the urine increases the risk of calcium-oxalate stone formation.
    Excretion of ketones in the urine increases urine acidity, as does the increased excretion of uric acid (can lead to supersaturation, the uric acid can't dissolve and form crystals).
    Increased urine acidity increases the risk of kidney stone formation, lower levels of citrate in the urine also increases the risk of stone formation.
    Paul over at perfecthealthdiet.com has an article on kidney stones and carb restriction, "Dangers of Zero-Carb Diets, IV: Kidney Stones".
    Generally the best way to counter this is to eat more vegetables, most have a negative potential renal acid load (PRAL), which means they'll reduce the acidity of urine (here's a list of foods and their PRAL score). Even calcium rich foods can help as the calcium will bind to oxalate (chelation) in the gut and prevent absoption.
    Increased water intake also helps as it balances the urine pH and prevents supersaturation (through dilution) as you pee more, in general dehydration is a common risk factor for stone formation.
    Another more drastic way to reduce calcium excretion, reduce urine acidity, and increase urine excretion of citrates, is to supplement with potassium citrate. It's been tested in epilepsy studies and resulted in a very high reduction in stone formation incidents (0.9% of patients compared to the 25% Paul mentions in his article):
    Successful empiric administration of Polycitra K at KD onset resulted in a kidney-stone incidence of 0.9% (1 of 106) compared with administration only because of hypercalciuria, 6.7% (13 of 195; P = .02).
    McNally MA, et al. "Empiric use of potassium citrate reduces kidney-stone incidence with the ketogenic diet." Pediatrics. 2009 Aug;124(2):e300-4. Epub 2009 Jul 13.
    You probably need to talk to your doctor about that as potassium is usually limited to ~99 mg for OTC tablets.
    Anecdotaly another thing sometimes used is sodium (or potassium) bicarbonate, as it also reduces urine acidity. I haven't seen any studies on it, but WebMD has some articles on it, "Sodium Bicarbonate (Baking Soda) for Kidney Stones". It's probably a good idea to discuss this with your doctor before starting taking any.

  3. [deleted]

    I had kidney stones about 3 years ago and from what I understand is that there are two different types. Calcium stones and uric acid stones.
    Calcium stones are more often than not a result of not enough fluid intake or an over abundance of calcium in your diet. Were talking multiple Tums a day, a wheel of cheese, gallons of cream - for most people. Others can just be an increase in calcium intake that the body is not used to. Such as going from little to no calcium intake, to hitting well over the suggested daily amount. This could very well be the case with you.
    From what I understand as well, uric acid stones are likely hereditary.
    At the end of the day, no, your keto diet is not the cause of your Kidney stones.
    Personally, I would never wish the pain of a kidney stone onto my worst enemy. So your best course of action is to be sure you're drinking plenty of water. Make sure your pee is always crystal clear. Increase your magnesium intake, either via supplements or more easily, eat an avocado every day. You also have to make sure you supplement your magnesium with calcium. This sounds counterintuitive to what I just stated, but the two work in conjunction with each other ( i dont know the exact science of it). I would suggest chewing on 1 or 2 Tums a day (depending on how much cheese and other dairy products you're already eating).
    Hope this helps!

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What is SERUM ALBUMIN? What does SERUM ALBUMIN mean? SERUM ALBUMIN meaning, definition & explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Serum albumin, often referred to simply as blood albumin, is an albumin (a type of globular protein) found in vertebrate blood. Human serum albumin is encoded by the ALB gene. Other mammalian forms, such as bovine serum albumin, are chemically similar. Serum albumin is produced by the liver, occurs dissolved in blood plasma and is the most abundant blood protein in mammals. Albumin is essential for maintaining the oncotic pressure needed for proper distribution of body fluids between blood vessels and body tissues; without albumin, the high pressure in the blood vessels would force more fluids out into the tissues. It also acts as a plasma carrier by non-specifically binding several hydrophobic steroid hormones and as a transport protein for hemin and fatty acids. Too much or too little circulating serum albumin may be harmful. Albumin in the urine usually denotes the presence of kidney disease. Occasionally albumin appears in the urine of normal persons following long standing (postural

Spurious Serum Creatinine Elevations In Ketoacidosis

Spurious Serum Creatinine Elevations in Ketoacidosis MARK E. MOLITCH, M.D.; ELISE RODMAN, M.D.; CARL A. HIRSCH, M.D.; ELI DUBINSKY, M.D. Article, Author, and Disclosure Information Author, Article, and Disclosure Information Dr. Molitch is a Clinical Associate of the General Clinical Research Centers program, U.S. Public Health Service (grant RR0054-7). Diabetic ketoacidosis is usually accompanied by dehydration resulting in prerenal azotemia, in which the levels of blood urea nitrogen are elevated out of proportion to those of the serum creatinine (1). In contrast, one patient who had been admitted to our hospital in diabetic ketoacidosis a number of times consistently displayed serum creatinine levels repeatedly elevated out of proportion to her blood urea nitrogen levels but had normal renal function between episodes of ketoacidosis. Investigation showed the elevated creatinine levels to be due to the artifactual interference of acetoacetate in the automated measurement of serum creatinine, a fact not widely Continue reading >>

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  1. SparkyHD

    I've had Large Ketones for about 4 days now... straight. I'm drinking a lot of water but I called my endo and she said I didn't need to go to the Er since I wasn't throwing up with ketones. She said to continue drinking water, a cup every two hours. I don't think it's helping :/ I've lost 17 pounds in the last 4 days. How much longer of this hell? Have I mentioned I hate being diabetic. I hate it. No one understands.

  2. IncIncorperated

    You posted about this yesterday. You still need to go to the ER, even more so since nothing is changing.

  3. ensulyn

    I had this happen about a year ago, I had readings of high ketones because I was severely dehydrated from being sick, after I went to the hospital and got checked I was told I just had slight ketone in my kidneys. Lost about 20 lbs. In a few days. I strongly urge you to go to the hospital, you will feel 200x better with an IV to replenish what you need. Do you not understand you could die? People told you yesterday to go and now today. Just go.

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If you want to Reduce Creatinine Level with a home remedy I will share 12 tips to Lower Creatinine Levels Fast & Naturally. ================================================= Buy Organic kidney cleanse tea - https://amzn.to/2smcdTQ ================================================ Amazon link - https://amzn.to/2JQToTK ========================================== 1) Chitosan. add your diet lower creatinine levels fast and without dialysis. 2) Chamomile tea. start to drink 1cup chamomile tea 30 minutes before bedtime to reduce high creatinine and urea level naturally. 3)go vagitarian. eat lots of vegetables. 4) Stinging Nettle. it is a remove toxin from your body and cure urea level naturally. 5) Barley water. Consider an excellent kidney cleanser and natural diuretic, barley is able to make the list of home remedies to reduce high creatinine levels. 6)Dandelion Root. This herb is included in the list of home remedies to reduce high creatinine levels due to its capability in flushing out toxins as well as decreasing the levels of creatinine. 7) Chinese Rhubarb. 8) Cinnamon. 9) sage. Take either 10 fresh leaves or a teaspoon of dried sage into some hot water it Lower Creatinine Levels Fas

Falsely-elevated Serum Creatinine Values In Diabetic Ketoacidosis -- Clinical Implications.

Falsely-elevated serum creatinine values in diabetic ketoacidosis -- clinical implications. Unusual elevations of serum creatinine (S-CR) out proportion to increases in serum urea nitrogen (S-UN) are frequently observed in patients with diabetic ketoacidosis when S-CR is measured by the Jaffe end-point reaction. This has been ascribed to interference from acetoacetate but this is not however observed with kinetic DuPont ACA methodology. Eighteen patients with diabetic ketoacidosis were studied: SCR measurements were done using the end point Technicon SMA 6/60 method (Group a, 10 patients) or the kinetic DuPont ACA method (Group B, 8 patients). The values for S-CR in Group A patients (mean value and S-D were 3.3 +/- 1.1 mg/dl) were significantly different from Group B patients (1.6 +/- 0.24 mg/dl) (P less than 0.01). A significant positive correlation was obtained between the "excess anion gap" and S-CR in Group A patients (r = + 0.81, p less than 0.01). The results from two patients in whom serial measurements of S-UN, S-CR and the anion gap were carried out further demonstrate the analytical interference. The study demonstrates that in diabetic ketoacidosis elevated creatinine va Continue reading >>

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  1. blurfocus

    Your first, best, and cheapest option is not to use them.
    Ketostix do not measure what many people expect that they do.
    Ketostix only measure excess levels of acetoacetate, which is not the type of ketones that correlate with nutritional ketosis.
    Ketostix may show negative ketones when your blood ketones are high and then may show positive ketones when your blood ketones are low.
    Misinterpretation of what they show is one of the most common unnecessary causes of keto anxiety and wasted time. You can be perfectly successful on a ketogenic or low-carb diet without ever measuring ketones.
    Many people are already overwhelmed with learning about keto diets. Adding another layer of unnecessary complexity doesn't help the matter. Often, people are most successful on keto when they treat it as a lifestyle and not a diet. Obsessively measuring ketones can be at odds with attempting to live a keto lifestyle.
    If you decide to use Ketostix anyway, please be kind to those who answer questions here by not submitting a question that begins with I know that Ketostix are unreliable, but ...
    If you consume few enough carbohydrates and avoid excessive intake of protein, you can trust that your liver will be producing ketones within a single day. That is how human metabolism works.
    If you consume too many carbs, you will be kicked out of ketosis temporarily. However, if you once again restrict carbs, you will go right back into ketosis within 24 hours. This is because the liver can store only 100 grams of glycogen. If you restrict carbs, the liver will run out of glycogen within a day and begin burning fat instead. The liver produces ketones as a side effect of burning fat.
    As an example of how Ketostix can be misleading, it is possible to eat a high-carbohydrate meal followed by a positive Ketostix result. You may think that you cheated the system, but you didn't. It takes time for excess ketones to appear in urine. Ketostix are showing you what happened in the past before you cheated.
    If you have the time and really want to know why Ketostix will not tell you much, read pages 164 and 165 of The Art and Science of Low Carbohydrate Living by Volek and Phinney. This is the section headed by Ketones: To Measure or Not.
    If you do not have this book, read this summary:
    Ketostix were designed to help diabetics avoid ketoacidosis which is a dangerous condition involving very high blood sugar and very high serum ketones. If you have near normal blood sugar and serum ketone levels consistent with nutritional ketosis, you don't need to worry about this.
    Ketostix only measure excess levels of acetoacetate, which is not the type of ketones that correlate with nutritional ketosis.
    The ketones that correlate with nutritional ketosis are known as beta-hydroxybutyrate. This type can be measured only with a blood ketone meter.
    There is a built-in time lag. Ketostix are measuring what has happened in the past since it takes a while for the kidneys to produce urine.
    Exercise can influence how many excess ketones are excreted.
    You can be in nutritional ketosis even when Ketostix show no excess acetoacetate. In the keto-adapted state, very little acetoacetate ketones will be excreted in urine even though blood ketones may be high.
    Note that it takes a period of four to six weeks of being in ketosis every day in order to become keto-adapted. Someone who is keto-adapted has adapted to using fat as the primary fuel for muscles and various organs. The keto-adapted brain uses ketones in place of glucose for most of its energy needs. When keto-adapted, most acetoacetate is not excreted. Instead, muscles convert it to beta-hydroxybutyrate and return it to the blood for use by the brain.
    If after all of this, you still want to use Ketostix because you bought them and cannot bring yourself to throw them away or because they are comforting in some way, here is how they may be useful.
    When you are first starting a low-carb or keto diet and transitioning into ketosis from a moderate to high-carb diet, Ketostix will confirm that your body has in fact done what biology says that it must do. It will show that your liver has begun producing ketones.
    Once you are a few days into the diet, you can give them away to a keto newbie or toss them. Note that Ketostix will eventually expire, especially if you keep them in a moist environment like a bathroom.
    If you have a medical condition that makes monitoring blood ketone levels necessary or if you are a numbers geek with spending money, you may be interested in purchasing a ketone blood meter and test strips for measuring beta hydroxybutyrate in your blood. The test strips cost somewhere between $2 and $5 per strip.
    There are a few meters to choose from.
    Precision Xtra - https://www.abbottdiabetescare.com/products/patient/pxtra-overview.html
    Nova Max Plus - http://www.novacares.com/nova-max-plus/
    CardioChek Home - http://www.healthchecksystems.com/CardioChek.cfm#home
    Most use one of the first two listed (Precision Xtra or Nova Max Plus). Some say that the Precision Xtra is the more accurate of the two. I've found that readings from these two track fairly closely with each other. The Nova Max Plus has cheaper test strips.
    To detect nutritional ketosis, look for a reading between 0.5 and 5.0 mmol / liter. Some experts recommend aiming for a level of 1.0 to 5.0 mmol / liter.
    Another option is the Ketonix Sport breath meter. This meter measures acetate in the breath. It does not require test strips.
    Acetate forms when acetoacetate spontaneously breaks down to acetate. According to Volek and Phinney (page 165 of The Art and Science of Low Carbohydrate Living), it should be linearly correlated with blood ketones. In practice, it is not as accurate as the blood meters in part because it is difficult to breathe in the same way every time you test.
    Ketonix Sport (order direct from Sweden) - https://www.ketonix.com/index.php/product/sport
    Again, remember that you can be perfectly successful on a ketogenic or low-carb diet without ever measuring ketones whether in urine, blood, or breath.
    In the final analysis, ketone concentrations are what they are. Chasing ketone concentrations often becomes as unnecessary and distracting as Ketostix. Unless you are treating epilepsy, cancer, or other medical condition, the concentration of ketones do not matter too much. You can achieve weight loss and a sense of well-being even with lower levels of ketones.
    Focus on how you feel, not on the number. Use ketone meters for interest and experimentation, but don't let the results stress you out.
    tl;dr never, unless you have read and understood this post, yet still want to use them anyway
    [If anyone has any suggestions for improving this post or correcting misinformation, let me know. I'll correct this and re-post it once in a while]

  2. anbeav

    tl;dr never
    If you want to do it for experimentation, go for it but please spare the rest of us the unnecessary ketosis anxiety
    edits: In addition to false negatives, ketostix commonly show false positives as in when people eat a high carb meal and think they cheated biology. Also I might remove the bit about using ketostix to monitor keto-adaptation, just asking for more posts about the issue. Also I might emphasize that people seem to already be overwhelmed with keto when starting and adding another layer of unnecessary complexity doesn't help the matter. People always talk about lifestyle, live a lifestyle and IMO living a lifestyle certainly shouldn't have to include measuring. Lastly, ketone concentrations are what they are. If you want to measure with a blood or breath meter, they are what they are and chasing ketone concentrations often becomes as unnecessary as ketostix. Unless someone has a medical condition for which a particular concentration is required for management, focus on how you feel not the number. Use the meter for interest and experimentation, but don't let it stress you out.

  3. blurfocus

    Thanks. I have incorporated your feedback.

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