What to Do When Creatinine Levels Reach 400: Understanding Kidney Function and Treatment Options

When serum creatinine levels rise to 400 μmol/L, it often signals a significant decline in kidney function and may indicate advanced kidney damage. At this stage, the body struggles to filter waste and toxins effectively, leading to a buildup that can impact overall health. Medical experts estimate that a creatinine level of 400 μmol/L typically corresponds to only about 10% to 15% of normal kidney function. This means the kidneys are operating at a fraction of their capacity, making prompt medical evaluation essential.

Seek Immediate Medical Evaluation

If your creatinine level has reached 400 μmol/L, it's crucial to consult a nephrologist—a kidney specialist—as soon as possible. A thorough assessment will help determine whether the condition is acute (sudden onset) or chronic (long-term). This distinction is vital because acute kidney injury may be reversible with timely treatment, while chronic kidney disease often requires long-term management strategies.

Diagnostic Tools: The Role of Kidney Ultrasound

One of the first diagnostic steps usually recommended is a renal ultrasound. This imaging test allows doctors to evaluate the size, shape, and structure of the kidneys. If the ultrasound shows that both kidneys are significantly smaller than normal, it strongly suggests chronic kidney disease. In such cases, the likelihood of fully restoring kidney function is low, and the focus shifts toward managing symptoms and preparing for kidney replacement therapies.

Exploring Treatment Options: Dialysis and Beyond

When kidney function drops below 15%, dialysis often becomes necessary to sustain life. There are two main types of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis uses a machine to filter blood outside the body, typically performed in a clinic several times a week. Peritoneal dialysis, on the other hand, uses the lining of the abdomen to filter waste and excess fluid and can often be done at home.

In addition to dialysis, patients may also be evaluated for kidney transplantation, which offers the best long-term outcome for eligible individuals. Lifestyle modifications—such as following a kidney-friendly diet, controlling blood pressure, and managing underlying conditions like diabetes—are also critical components of care.