Extraordinary Creatinine Level: A Case Report

Creatinine, an amino acid derived from creatine, has been traditionally used to assess kidney function. However, its levels are significantly affected by nutritional status, muscle mass, age, and sex of an individual. The effect of creatinine levels on human physiology is not completely understood, and no correlation has been established between high creatinine levels and physiological equilibrium. We describe a case of a 27-year-old Hispanic male who presented with extremely elevated serum creatinine level (>37 mg/dL) with minimal symptoms of uremia and relatively fair functional status, eventually requiring hemodialysis. To our knowledge, based on a thorough review of the literature using PubMed, Medline, and Google Scholar, only four other cases have been reported with a creatinine level higher than that of our patient. A brief discussion on the utility of serum creatinine levels to assess mortality is provided using examples from similar case reports.