Creatinine 201 indicates that renal function is impaired and the disease is severe, the next step should be to clarify the acute and chronic renal insufficiency. If it is chronic renal insufficiency, then this creatinine is the decompensated stage of chronic renal insufficiency, and the cause of renal disease may be chronic glomerulonephritis, chronic interstitial nephritis, obstructive nephropathy, diabetic nephropathy, hypertensive nephropathy and so on. Clear diagnosis of the disease, active treatment of the primary pathology, with the preservation of kidney detoxification and other treatments, can achieve good results. In case of acute renal insufficiency, the possible causes include infection, hypovolemia, urinary tract obstruction, drug allergy and other conditions. The cause should also be clarified and active treatment of the original disease should be given.