Creatine Kinase (CK)
Creatine kinase (CK) is an enzyme that mainly exists in the heart and skeletal muscle, with small amounts in the brain. The cells in the skeletal muscles, heart muscles or brain release creatine kinase into the blood when they’re damaged.
An enzyme is a protein that acts as a catalyst to bring about a specific biochemical reaction.
The small amount of CK that’s normally in the blood mainly comes from your skeletal muscles (the muscles that are attached to the bones and tendons).
Any disease, injury or event that causes muscle damage and/or interferes with muscle energy production or use increases levels of CK in the blood. For example, intense exercise can increase CK levels. Muscle diseases such as myopathies or such as muscular dystrophy (MD) can also increase CK levels in the body.
Following are the three types of CK enzymes:
- CK-MM: Found mostly in the skeletal muscles.
- CK-MB: Found mostly in the heart muscle.
- CK-BB: Found mostly in the brain tissue.
Creatine kinase is also known as CK, total CK, creatine phosphokinase, CPK.
Creatine Kinase (CK) Test
The creatinine blood test measures the level of creatinine in the blood. The result of this blood test is useful, as it is an important marker of how well the kidneys are working.
Creatinine is the waste product of creatine, which the muscles use to make energy. Typically, creatinine travels in the blood to the kidneys, where it leaves the body in the urine. High levels in the blood might indicate that the kidneys are not working correctly.
The creatinine blood test helps doctors diagnose kidney disease. A poorly functioning kidney cannot filter creatinine as well as it usually does, which causes levels in the blood to rise.
Preparation of Creatine Kinase (CK) Test
A doctor or healthcare professional will carry out the blood test.
Before the test, they might ask questions related to:
- Current medications
- Diet
- Physical activity
- Supplements
It is best to discuss any medical conditions and any family history of kidney disease at the time of the blood test.
There is no need to avoid food or drink before the blood test.
The blood test involves collecting blood from a vein in the arm or hand. The doctor then sends the sample to a lab for analysis.
Creatine Kinase (CK) Normal Levels
The kidneys are responsible for keeping the level of creatinine in the blood within a normal range.
Medical professionals define the typical reference ranges for serum creatinine in micromoles per liter (μmol/L) and milligrams per deciliter (mg/dL).
Below are average reference ranges for adult males and females.
| Average creatinine levels (μmol/L) | Average creatinine levels (mg/dL) | |
|---|---|---|
| Adult male | 60–110 | 0.7–1.2 |
| Adult female | 45–90 | 0.5–1.0 |
Causes of High Levels of Creatine Kinase (CK)
Following some of the causes of having high creatinine levels are:
Chronic Kidney Disease (CKD)
When kidneys are damaged, they have trouble removing creatinine from the blood, and levels rise.
Doctors use the creatinine blood test result to calculate glomerular filtration rate (GFR), which is a more specific measure that can indicate chronic kidney disease (CKD).
A GFR level of 60 or over is considered to be normal, while a GFR of less than 60 may indicate kidney disease. A GFR level of 15 or less indicates kidney failure.
Kidney Obstruction
A blockage in urine flow, such as an enlarged prostate or kidney stones, could cause kidney obstruction.
This blockage can create a backup of urine into the kidney and impair the kidney’s ability to function correctly. The medical term for this condition is called hydronephrosis.
If obstructions affect both kidneys, this can raise a patient’s blood creatinine levels.
Increased Consumption of Protein
What a person eats higher levels of proteins it can have an effect on creatinine levels.
For example, proteins and cooked meat contain creatinine, so eating more than the recommended amount of meat or other proteins for a person’s activity levels can cause high creatinine levels after eating.
However, long-term studies have shown that high protein diets do not significantly impact blood creatinine levels over a 2-year period.
Intense Exercise
Creatine is present in the muscles and helps them produce energy. Both dehydration and muscle breakdown from exercise may cause an increase in blood creatinine levels.
Certain Medications
Antibiotics, such as trimethoprim, and H2 blockers, such as cimetidine, can cause a temporary increase in measured serum creatinine levels.
A 2020 study found that even low levels of trimethoprim can increase blood serum levels in patients following a kidney transplant.
Causes of Low Levels of Creatine Kinase (CK)
Creatinine levels may be lower than normal for the following reasons:
Low Muscle Mass
Because the breakdown of muscle produces creatinine, low muscle mass can result in low levels of creatinine.
Older adults are more at risk, as muscle mass declines with age. Malnutrition can also cause low muscle mass and low creatinine levels.
Chronic conditions, such as myasthenia gravis or muscular dystrophy (MD), may result in low creatinine levels.
Extreme Weight Loss
Weight loss can result in the reduction of muscle mass, leading to low levels of creatinine.
Creatine Kinase (CK) Levels in Pregnancy
During pregnancy, blood flow to the kidneys is higher. This increases a person’s GFR and the rate of creatinine excretion. Due to this, pregnant women typically have lower levels of blood creatinine.
A 2020 review found that the mean blood creatinine level in pregnant people is 77–84% of that in nonpregnant people. A person’s creatinine levels will also change across trimesters.
| Trimester | Mean creatinine level | Upper limit of creatinine level |
|---|---|---|
| First | 56 μmol/L (0.63 mg/dL) | 76 μmol/L (0.86 mg/dL) |
| Second | 52 μmol/L (0.59 mg/dL) | 72 μmol/L (0.81 mg/dL) |
| Third | 54 μmol/L (0.61 mg/dL) | 77 μmol/L (0.87 mg/dL) |
Significance of Low or High Creatine Kinase (CK) Levels
Low creatinine levels mean something is affecting creatine production in the body. This will often result from an individual having low muscle mass or body weight.
However, low creatinine levels may also indicate an individual has chronic kidney disease (CKD), reduced kidney function, or malnutrition.
Low levels of the waste product creatinine in the body could be a sign that the liver or muscles are not working as well as they should. More often, low creatinine levels are a sign of losing muscle mass as people age, or it is a temporary condition during pregnancy or periods of illness, or due to malnutrition.
likely to be used alongside other tests to look at overall kidney health.
Causes of Low Creatinine Levels
There are four key causes of low creatinine:
- Diet
- Low muscle mass
- Liver disease
- Pregnancy or illness
Diet
Although creatine is made naturally in the body, a small amount comes from food, so low levels of creatinine could relate to diet.
Creatine is mostly found in meat, so those who follow a vegetarian or low-protein diet are likely to have lower levels than people who eat meat.
A prolonged period of not eating, or having an illness that prevents someone from eating, could be another cause of low levels of creatinine.
Low Muscle Mass
Levels of creatinine are often linked with muscle mass or the amount of muscle in the body, which can decrease with age or illness.
Low levels may indicate that muscles are less strong or are deteriorating, for example with a disease such as muscular dystrophy (MD).
Older adults often lose some muscle mass with age, and this is not usually a serious medical concern.
Liver Disease
Creatine is made in the liver, and an unhealthy liver that is not working properly will not be able to make the normal amount of creatine.
For chronic liver disease, there can be a 50 percent reduction in the production of creatine. This means that there will be lower levels of creatinine in the blood, which can be checked with a simple blood test called a serum creatinine test.
Pregnancy
Pregnancy is often a cause of low creatinine levels, which should return to normal after a woman has given birth.
High creatinine levels may also indicate severe kidney problems, such as infection or failure.
However, this will not always be the case. Antibiotics, diet, and dehydration from exercise can all impact creatine production. In these instances, creatinine levels may return to normal shortly after a person addresses the underlying cause.
Causes of High Creatinine Levels
High creatinine levels may indicate one of several underlying health conditions requiring medical treatment. Following treatment of the underlying cause, creatinine levels should return to normal.
Creatinine is a waste product of the muscles. In a healthy body, the kidneys filter creatinine from the blood and excrete it through the urine. High levels of creatinine can indicate kidney issues.
High creatinine levels usually indicate that the kidneys are not working as they should. Possible causes of this dysfunction include:
- A kidney infection infection
- Kidney failure
- Glomerulonephritis which is inflammation of the kidney structures that filter the blood
- Kidney Stones that block urinary tract
Outside of kidney function, several other factors can temporarily raise creatinine levels above normal. These include dehydration and consuming large amounts of protein, either through food sources or nutritional supplements.
High intensity exercise can also increase certain blood biomarkers, including creatinine.
An individual undergoing a creatinine test should let the doctor know if they are taking any medications, fasting, or adhering to a protein-rich diet.
Certain medicines can cause a temporary increase in serum creatinine levels or damage the kidneys.
Some health conditions can also damage these organs, leading to increased creatinine levels. These conditions include:
Treating Low or High Creatine Kinase (CK) Results
Dietary choices and physical activity play an essential role in regulating blood creatinine levels. It is advisable to keep protein consumption within the recommended range for age and activity level.
Creatinine levels outside of normal ranges may indicate an underlying disease. If a doctor can diagnose what may be causing abnormal creatinine levels, they can suggest suitable treatment options.
If levels persist at an abnormally high or low level, people may need to see a kidney specialist. Early treatment of rising or falling creatinine levels is essential to prevent more significant kidney disease.
Summary
Adult males’ average creatinine level range is 60–110 μmol/L, while it is 45–90 μmol/L for females.
Creatinine is the waste product of creatine, which the body uses for energy. Doctors can use creatinine level tests to check for abnormalities in kidney function.
Dehydration, exercise, physical changes in pregnancy, and kidney failure can all impact creatinine levels.
A patient will typically undergo creatinine level tests in a medical setting, meaning doctors will usually be able to quickly interpret results and plan the next steps.
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