Biomarkers · Renal & Purine

Serum Creatinine

Both low and high values go with higher risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 25% higher risk of death. Risk rises at both ends: not comparable

Serum Creatinine and risk of death

Published curve higher than the NHANES fitNHANES fit higher

Risk of death from our NHANES fit, relative to its reference value. The dotted vertical line marks the NHANES median.

Risk of death per SD (NHANES)1.25×95% CI 1.22–1.28 · 43,817 adults, 5,903 deaths

Value of the measurement+0.022gain in concordance within age bands; rank 16 of 56 · all tests

Across studies, risk per SD1.25×NHANES 1.25 [1.22–1.28] · CRELES 1.27 [1.16–1.39]

Serum Creatinine across cohorts

11.11.25HR per SD (95% CI)

NHANES · United States, 20–8443,817 people · 5,903 deaths1.25 1.22–1.28

CRELES · Costa Rica, 60+2,501 people · 478 deaths1.27 1.16–1.39

Risk-of-death ratio per standard deviation, adjusted for age and sex, within each cohort. Cohorts differ in age range, assay, measurement protocol and follow-up, and one SD is a different amount in each, so the comparison is of direction and rough size per SD, not per unit. Vertical line: no association.

Serum Creatinine by age and sex

Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.

The percentiles as a table

Each row is one sex and age band: the values below which 5%, 25%, 50%, 75% and 95% of people fall (mg/dL), from the survey named in the row. Not a reference range or a target.
Sex	Age	5th	25th	Median	75th	95th	n	Cycle / source
All	20-39	0.57	0.70	0.83	0.94	1.16	1,431	NHANES 2017-2018
All	40-59	0.57	0.70	0.83	0.99	1.21	1,548	NHANES 2017-2018
All	60+	0.60	0.77	0.92	1.07	1.39	1,890	NHANES 2017-2018
All	all	0.57	0.72	0.85	1.00	1.25	4,869	NHANES 2017-2018
Men	20-39	0.74	0.85	0.93	1.04	1.22	684	NHANES 2017-2018
Men	40-59	0.71	0.85	0.96	1.07	1.29	723	NHANES 2017-2018
Men	60+	0.73	0.89	1.01	1.16	1.53	958	NHANES 2017-2018
Men	all	0.73	0.86	0.96	1.09	1.35	2,365	NHANES 2017-2018
Women	20-39	0.52	0.63	0.70	0.79	0.93	747	NHANES 2017-2018
Women	40-59	0.53	0.64	0.72	0.81	0.98	825	NHANES 2017-2018
Women	60+	0.57	0.70	0.82	0.96	1.28	932	NHANES 2017-2018
Women	all	0.54	0.65	0.74	0.84	1.08	2,504	NHANES 2017-2018

What studies found when this marker was changed

They describe what happened in those study groups, not a recommendation. See all catalogued interventions.

Measured changes in Serum Creatinine, study by study

3 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Study results in the groups studied, not predictions for a person.

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Intervention	Reported effect	Evidence	Source
clinical	Hypertonic saline solution co-administered with intravenous furosemide in acute decompensated heart failure	Serum creatinine -0.46 mg/dL (95% CI -0.51 to -0.41) vs furosemide alone	meta-analysis	Liu C, Peng Z, Gao X, et al. Crit Care Med. 2021.
lifestyle	Increased fluid intake (2-3 L/night during daytime fasting)	Drinking 2 to 3 L fluid overnight kept serum creatinine significantly lower than controls during Ramadan fasting (P <.05; effect size not reported)	RCT	Tarabeih M, et al. Increasing Overnight Fluid Intake and Kidney Function During…
pharmacologic	SGLT2 inhibitors (e.g. Empagliflozin)	Empagliflozin slowed chronic annual eGFR decline by 64% (95% CI 59-69) and cut risk of a >=50% serum creatinine rise by 20% vs placebo	meta-analysis	Herrington WG, et al. Effects of empagliflozin on conventional and exploratory…
pharmacologic	SGLT2 inhibitor empagliflozin in type 2 diabetes at high cardiovascular risk	Doubling of serum creatinine in 1.5% vs 2.6% with placebo, a relative risk reduction of 44%	RCT	Wanner C, et al. Empagliflozin and Progression of Kidney Disease in Type 2…
pharmacologic	Angiotensin receptor blocker (losartan) for intraglomerular pressure control	Losartan reduced the risk of doubling of serum creatinine by 25 percent vs placebo (P=0.006)	RCT	Brenner BM, et al. N Engl J Med. 2001;345:861-869.
pharmacologic	ACE inhibitor or ARB therapy vs symptomatic treatment in IgA nephropathy	Serum creatinine -9.37 µmol/L (95% CI -71.95 to -6.80) vs symptomatic treatment	meta-analysis	Tunnicliffe DJ, Reid S, Craig JC, et al. Cochrane Database Syst Rev. 2024.

Things that worsen it

Each row is one study: what was changed, the effect it reported on this marker, and the source.
Type	Condition or exposure	Reported effect	Evidence	Source
clinical	Dehydration and volume depletion (daytime fluid abstinence)	Fasting-related dehydration raised serum creatinine and urea vs hydrated group; highest during Ramadan (P <.05; effect size not reported)	RCT	Tarabeih M, et al. Increasing Overnight Fluid Intake and Kidney Function During…
clinical	Venovenous ultrafiltration vs stepped pharmacologic diuretic therapy in acute decompensated heart failure with worsening renal function	Serum creatinine +0.23 mg/dL at 96 h with ultrafiltration vs -0.04 mg/dL with pharmacologic therapy	RCT	Bart BA, Goldsmith SR, Lee KL, et al. N Engl J Med. 2012.
pharmacologic	High-dose chronic NSAID use (Ibuprofen / Naproxen / Meloxicam)	NSAID inhibition of renal prostaglandins can cause acute renal dysfunction, especially with reduced renal perfusion (effect size not reported)	review	Whelton A. Nephrotoxicity of nonsteroidal anti-inflammatory drugs: physiologic…

What else moves this marker

They describe those study groups, not an individual, and an association is not a cause.

Diseases and conditions

Each row is one study: what it compared and the change it reported in this marker.
What	Effect on the marker	Comparison · population	Source
↓ Amyotrophic lateral sclerosis · ALS patients vs controls	SMD -0.78 (95% CI -0.97 to -0.6)	ALS patients vs controls · Patients with ALS and controls in 5 of the included studies	meta analysis · PMID 32564621

Sources

NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.

Map Serum Creatinine against another biomarker.

Map Serum Creatinine against another marker