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Creatine phosphate is a high energy compound used by muscle and brain tissues, and during phosphorylation through the action of creatinine kinase, it is converted to creatinine, which is a metabolic end product that is excreted primarily through the kidney.

Serum levels of creatinine are a good indicator of renal health and elevated levels (hypercreatininemia) above the normal range of 0.5 - 1.6 mg/dL reflect underlying renal pathology.

Diseases associated with elevated creatinine include:

In many dogs with acute renal injury, azotemia (elevated BUN and creatinine) is a common concurrent finding on hematological examination[7].

In patients with elevated serum creatinine levels, an estimate of glomerular filtration rate is conducted by evaluating urine protein:creatinine ratio[8] or urine corticoid:creatinine ratio.

In dogs with uroabdomen, diagnostic peritoneal lavage and abdominocentesis usually shows a creatinine level > 2:1 with serum creatinine[9].


  1. Zatelli A et al (2012) Effect of dietary supplements in reducing probability of death for uremic crises in dogs affected by chronic kidney disease (masked RCCT). Scientific World Journal 2012:219082
  2. Pointer E et al (2013) Starvation and the clinicopathologic abnormalities associated with starved dogs: a review of 152 cases. J Am Anim Hosp Assoc 49(2):101-107
  3. Mitani S et al (2012) Association between the Intrarenal Renin-Angiotensin System and Renal Injury in Chronic Kidney Disease of Dogs and Cats. J Vet Med Sci Sep 14
  4. Wolf J et al (2012) Lowered N-terminal pro-B-type natriuretic peptide levels in response to treatment predict survival in dogs with symptomatic mitral valve disease. J Vet Cardiol 14(3):399-408
  5. Lake-Bakaar GA et al (2012) Aortic thrombosis in dogs: 31 cases (2000-2010). J Am Vet Med Assoc 241(7):910-915
  6. Ishii T et al (2013) Background data for hematological and blood chemical examinations in juvenile beagles. Exp Anim 62(1):1-7
  7. Harison E et al (2012) Acute azotemia as a predictor of mortality in dogs and cats. J Vet Intern Med 26(5):1093-1098
  8. Rossi G et al (2012) Evaluation of factors that affect analytic variability of urine protein-to-creatinine ratio determination in dogs. Am J Vet Res 73(6):779-788
  9. Connally HE (2003) Cytology and fluid analysis of the acute abdomen. Clin Tech Small Anim Pract 18(1):39-44