From the Guidelines
Low creatinine, albumin, and liver function test results can be caused by several underlying conditions, with malnutrition being a common cause, as insufficient protein intake reduces muscle mass and decreases albumin production, as noted in a study published in Kidney International 1.
Causes of Low Creatinine, Albumin, and Liver Function Test Results
- Malnutrition: insufficient protein intake reduces muscle mass, lowering creatinine, and decreases albumin production
- Liver disease: advanced cirrhosis impairs the liver's ability to synthesize proteins like albumin and process waste products
- Severe kidney disease: decreased muscle mass and impaired filtration can cause low creatinine
- Overhydration: dilutes blood components, artificially lowering these values
- Pregnancy: naturally lowers these levels due to increased blood volume
- Certain medications: including some antibiotics and anti-seizure drugs, can affect liver function tests
- Inflammatory conditions: like inflammatory bowel disease, can reduce albumin through protein loss
- Aging: naturally decreases muscle mass, leading to lower creatinine levels
Importance of Evaluation
If you have abnormally low values, it's essential to consult a healthcare provider for proper evaluation, as these findings often require comprehensive assessment to determine the underlying cause and appropriate treatment, as discussed in the Journal of the American College of Radiology 1.
Recent Findings
A recent study published in the Journal of Hepatology 1 highlights the challenges in addressing liver function in patients with Fontan-type circulation, where most commonly employed scores may reflect liver function poorly in this population.
Key Considerations
- Serum albumin concentration should be monitored on a regular basis, and a stable or rising value is desirable, as recommended by the American Journal of Kidney Diseases 1
- The highest albumin level possible should be the goal for each patient, and this can be obtained by adequate nutrition, prevention and treatment of catabolic illness, and maintenance of Kt/Vurea and creatinine, as noted in the American Journal of Kidney Diseases 1
From the Research
Causes of Low Creatinine, Albumin, and Liver Function Test Results
- Low creatinine levels can be caused by a variety of factors, including low muscle mass, severe malnutrition, or certain liver diseases 2.
- Albumin levels can be low due to liver disease, nephrotic syndrome, or severe malnutrition 3, 4.
- Liver function test results can be low due to various liver diseases or conditions, such as liver cirrhosis or liver failure 5.
Relationship Between Creatinine, Albumin, and Liver Function
- Studies have shown that low albumin levels are associated with an increased risk of chronic kidney disease progression 3.
- Diuretic use can affect creatinine and albumin levels, and should be taken into consideration when interpreting test results 4.
- Urinary sodium excretion and the ratio of urinary sodium to creatinine have been associated with long-term survival in patients with chronic kidney disease 6.
Clinical Application and Interpretation
- Accurate interpretation of creatinine values is critical in assessing kidney function, and understanding the shortcomings of creatinine as a biomarker is essential 2.
- A systematic approach to evaluating and managing abnormal liver test results is recommended to optimize high-value care 5.
- Clinicians should be vigilant in looking for biochemical disturbances related to diuretic use, and should be resourceful in adjusting dose amounts and frequencies as needed 4.