This is an old, but still relevant message from the original Igan.org.
Before that french canadian turd pierre ripped off the site after it
ran out of funding.
FOLLOWING MESSAGE IS FROM DR. RON HOGG, MEDICAL CITY DALLAS HOSPITAL
I would like to provide some basic information about kidney function
may be helpful for newcomers to this list.
I will begin by responding to 3 questions about the substance called
CREATININE. What is it? Why is it important? What level of serum
creatinine leads a nephrologist to recommend dialysis? These are
issues for all patients with kidney disease - whether they have IgA
Nephropathy or not.
What is creatinine?
Creatinine is a substance that is derived from the metabolism of
our muscles. You are probably familiar with creatine if you have
sons since this is the substance being promoted by some members of the
pharmaceutical industry (and occasional high school football coaches!)
bulking up muscles. The creatinine that is produced by muscle activity
be measured in the blood as serum creatinine (serum is the liquid part
blood that is left after the blood is allowed to clot in a test tube).
you might guess, the serum creatinine level in normal individuals is
dependent on how much creatinine is produced, which in turn is
how big your muscles are! The normal level for a small child is in the
of 0.3 to 0.6 mg per 100 cc of serum, for a woman 0.6 to 1.0 mg per
for a 250 pound lineman it could be up to 1.5 mg per 100 cc.
Why is measuring serum creatinine important?
The reason this is important is because serum creatinine is a good
kidney function. Creatinine is mainly removed from the body by the 1
million microscopic filters in the kidney we call glomeruli. Measuring
creatinine level in the blood gives your doctor a way of estimating
the filters are working; this is called the glomerular filtration rate
(GFR). The GFR measurement is sometimes obtained with a more accurate
known as a GLOFIL TEST (which we will discuss in a later issue), but
serum creatinine is often sufficient to give the information that is
for routine purposes.
When is the serum creatinine high enough to need dialysis?
The level of serum creatinine that necessitates consideration of
will vary between patients - as you might expect from the fact that
normal blood levels vary according to age and muscle mass. A rule of
is that when the serum creatinine level reaches ten times normal, the
is functioning at approximately 10% of the normal rate. At this point
patients will start dialysis - whereas others may not start for quite
time. The decision when to start is an individual one that will be
determined by the patient and the doctor based on many factors,
the patient's age, medical diagnosis, level of disability induced by
kidney failure, etc.
One final note about creatinine:
Creatinine itself is probably not very harmful when the level is high.
was studied 30 years by some Italian nephrologists who infused
into normal dogs and found that this caused very little harm. Serum
creatinine levels are mainly useful in telling us how well the kidneys
I would also like to let you know that the video on IgA Nephropathy
1998 Dallas Seminar is still available. This gives a fairly
review of some issues raised over the past few days. It is available
from the National Kidney Foundation of North Texas. You may obtain
copy by calling (800) 247-8843, or by sending an e-mail to
A number of the "old-timers" on this list (no offense, Russ!) attended
seminar and/or have reviewed the video. It is intended to give you
information about the disease and enable you to be more aware of the
different approaches to treatment that have been proposed.
Finally, I am pleased to inform you that we have completed enrollment
North American IgA Nephropathy Study. Follow-up of all patients will
completed in 2002. The results will be listed here when they are
I hope that some of this information is helpful.
Ron Hogg, M.D.