Clinical Case 71: Answers and Summary

WHAT IS THE HIGHEST SERUM CREATININE THAT YOU HAVE ENCOUNTERED?

15-20mg/dl	11 (18%)
21-30mg/dl	16 (27%)
31-40mg/dl	12 (20%)
41-50mg/dl	8 (13%)
>50mg/dl	12 (20%)

Only two references I could find reporting high creatinine levels. 

One is Dr Topf's blog PB fluids reference of crt level in 34-37 range. But the highest reported in the literature is 61mg/dl. The poll above shows that 20% of you have seen such high creatinine levels. Disease states that cause such high creatinine likely are to be Rhabdomyolysis and obstruction. But the case reported above was hypertension. Cast nephropathy might be another form of obstructive disease where such high creatinines might be noted.