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Discussion

creatinine is always 2 point something

I have this patient in acute renal failure. I was looking at her labs in the chart and the creatinine never goes above 2 point something....is that normal?? I mean I understand that its a high creatinine but I just feel that if the kidneys rested it would return . I feel like its wrong what some renal docs do. They have alot of pts (the certain docs I am talkin about) and I don't feel they are thorough. I feel its all about money. She's making good amt of urine. I feel like this is wrong. While I'm still a new nurse I can't help but be ticked off. I don't care if a doc does other things wrong but I this to me is just wrong...if indeed they are doing it on purpose. What do yall think? maybe i don't know enough about this? I just feel like a 24 hr creatinine clearance should be ordered to make sure......

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Just because a pt is urinating doesn't mean anything...some pts may urinate the fluid but may not clean the blood as needed. Just like any specialty a pt=money but believe me that there are plenty of people in kidney failure where a nephrologist does not need to make it up. Plus there are good neph MD and bad ones.

:twocents:

Our nephrologist doesnt freak at that level. Usually he will order a 24hr urine creatinine level and go from there. Many times he will d/c them as a "kick start" and bring them back only when things go downhill. After a few weeks d/c'd again as once again a "kick start". Only thing is the other Nep that covers for him is much more agressive and will order tx then the reg nep comes back and takes them off lol. Talk about consistency in care??? Many pts urinate just as well as I do. I still have dialysis nurses with the attitude that if they are on dialysis then it is absolutely necessary to pull of fluid in turn dehydrating them then they feel like a truck hit them. Sometimes and many times it's the kidneys just dont filter toxins not that they dont pee :) As the previous poster there are some good nephs out there and some bad or just differences in how they approach renal failure. Fortunately I work with one who looks at the patient as a whole and not just the lab paper it's written on.

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