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▣ Creatinine [CREE-AT-tin-neen] is a waste product produced by muscles from the breakdown of a chemical called creatine phosphate from muscle (see below). Creatinine is released at a constant rate by the body (depending on muscle mass). Creatinine is removed from the body by the kidneys, which filter almost all of it from the blood and release it into the urine.
▣ The amount of creatinine you produce depends on your body size and your muscle mass. For this reason, creatinine levels are usually slightly higher in men than in women and children (because men usually have more muscle).
▣ A creatinine test measures the amount of creatinine in the blood and/or urine. Since almost all creatinine is filtered from the blood by the kidneys and released into the urine, blood levels of creatinine are usually a good indicator of how well the kidneys are working.
▣ In a person with normal muscles, a high creatinine level would indicate potential kidney problems. In patients with IBM, the muscles are shrinking and creatinine levels will decline. Those with higher than usual muscle mass (for example bodybuilders) or those taking creatine supplements may show higher than normal creatinine levels (mistakenly suggesting kidney problems).
▣ Creatine [CREE-a-teen] is part of the cycle of chemicals that produces energy needed to contract muscles.
▣ Many elite athletes and weight-lifters use nutritional supplements of creatine (usually taken as creatine monohydrate). Studies have shown the benefits of dietary creatine supplementation, which is thought to cause an increase of creatine phosphate levels in certain types of skeletal muscle fibers.
⬛ Creatine phosphate
▣ Creatine phosphate (also known as phosphocreatine) is a slightly different form of creatine that is stored in muscle and used to provide instant energy when muscles need to respond quickly.
⬛ Creatine kinase (CK)
▣ Creatine kinase (CK) is an enzyme found in the heart, brain, skeletal muscle, and other tissues. A CK test measures the amount of creatine kinase in the blood. Increased amounts of CK are released into the blood when there is muscle damage.
▣ The small amount of CK that is normally in the blood comes primarily from skeletal muscles. Any condition that causes muscle damage and/or interferes with muscle energy production or muscle use can cause an increase in CK. For example, strenuous exercise and inflammation of muscles, called myositis, can increase CK as can muscle diseases (myopathies) such as muscular dystrophy (and IBM).
▣ Elevated CK levels affect enzymes in the liver that are normally used to test liver function. A normal CK level with elevated ALT and AST liver enzymes would suggest a liver problem; a high CK with high ALT and AST levels suggest muscle problems (with normal kidney function).
▣ Creatine kinase is an enzyme. Enzymes are chemicals that are used to speed up chemical reactions. Creatine kinase is found primarily in tissues which require a lot of energy. Muscle cells must use a large amount of energy to carry out their functions and contain large amounts of creatine kinase.
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