Blood creatinine 400μmol/L may be caused by acute renal failure or chronic renal failure, dynamic monitoring of blood creatinine is needed to clarify whether it is acute renal failure or chronic renal failure, and the treatment program includes removing the cause of the disease, symptomatic supportive treatment, or alternative treatment such as hemodialysis.
1. Acute renal failure: the etiology should be clearly defined, including dehydration, insufficient intake, post-renal obstruction, nephrotoxic drugs, nephrotic syndrome, nephritis syndrome, etc. The treatment includes correcting the intake, relieving the obstruction, stopping nephrotoxic drugs, immunosuppressant drugs (such as tacrolimus, etc.), and treating the primary pathology; the combination of pulmonary edema, hyperkalemia, cardiac failure and other indications for dialysis can be considered to be performed on hemodialysis and other treatment options.
2. Chronic renal failure: the cause may be nephrotic syndrome, nephritis syndrome, or secondary to diabetes mellitus, hypertension, systemic diseases and other factors. Treatment should be the first treatment of the primary disease, such as immunosuppressive therapy, control of blood pressure and blood sugar, etc., combined with heart failure, pulmonary edema and other indications for dialysis can be considered in advance into the renal replacement therapy.
If the combination of renal anemia, metabolic acidosis, secondary hyperparathyroidism and other complications, the anemia can be corrected by supplementation of recombinant human erythropoietin, the metabolic acidosis can be corrected by sodium bicarbonate, lowering phosphorus and calcium.
It is recommended that patients with elevated creatinine go to a regular hospital in a timely manner to seek medical attention, after clarifying the cause of the disease, and take symptomatic treatment under the guidance of the doctor. The above drugs should be used in accordance with the doctor’s instructions, do not self-medication.