Low Creatinine In Children: Causes, Symptoms, Diagnosis, And Treatment

Knowing the exact cause of low creatinine levels is vital to finding suitable treatment.

Medically reviewed by Dr. Neema Shrestha, MD Dr. Neema Shrestha Dr. Neema ShresthaMD MomJunction on FacebookFollow MomJunction on LinkedinFollow MomJunction on Instagram Specialty: Neonatology and PediatricsExperience: 5 years
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Creatinine test

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Renal disease, neuromuscular disorders, and urinary tract obstructions can cause low creatinine in children. However, creatinine levels may vary depending on a person’s age, gender, and health status. Usually, men have higher creatinine levels than women, and children have lower levels than adults (1) (2).

Creatinine is a waste product produced in the body during muscle metabolism. It is transported in the blood to the kidneys and eliminated from the body. Urine tests and blood tests help determine the amount of creatinine in the body.

Read this post to know the causes, symptoms, diagnosis, and treatment of low creatinine in children.

In This Article

Key Pointers

  • Impaired renal function can cause a drop in serum (blood) and urine creatinine levels.
  • Fatigue, loss of muscle strength, poor development, lethargy, tooth decay, etc., are signs of low creatinine levels in children.
  • Urinalysis and creatinine blood tests can diagnose its levels at an early stage.
  • Even if there are no symptoms at first, high serum creatinine levels can indicate renal issues.

Importance Of Monitoring Creatinine Levels

Monitoring creatinine levels is crucial for assessing a child’s kidney function and overall health. Regular testing helps in the early detection of potential health issues, allowing for timely intervention and management. Regular testing may also help monitor the renal development of the child and help healthcare providers determine treatment efficiency in case the child has kidney dysfunction (22) (23).

Causes Of Low Creatinine Level In Children

The normal blood creatinine level in children between three and 18 years is 0.5 to 1.0 milligrams per deciliter (mg/dL), and for children below three years, it is 0.3 to 0.7 mg/dL

(1).

Sometimes, the serum creatinine (blood creatinine) level drops below normal due to the following causes (1) (3) (4) (5):

  • Low muscle mass (occurs due to malnutrition, inadequate physical activity, neuromuscular diseases, etc.)
  • Liver failure
  • Insufficient protein in the diet (generally due to a strict vegetarian diet)
  • Excessive weight loss in kids
  • Impaired renal functioniA condition when the kidneys are unable to eliminate waste and maintain fluid balance

Furthermore, the creatinine clearance (urine creatinine) level may drop due to the following causes (6):

  • Kidney disease
Kidney disease can cause low creatinine in children

Image: iStock

  • Blocked urinary tract
  • Heart failure
  • Dehydration.

Symptoms Of Low Creatinine Level In Children

Low creatinine levels in children do not cause specific symptoms

. The symptoms are an outcome of the underlying condition, which are as follows (7) (8) (9):

  • Poor posture, fatigue, and loss of muscle strength for low muscle mass
  • Liver enlargement, itching, fatigue, and jaundice for chronic liver disease
  • Being underweight or overweight, poor growth, lethargy, and tooth decay from poor nutrition
Being overweight is a symptom of low creatinine in child

Image: IStock

Diagnosis Of Low Creatinine Level In Children

Under typical conditions, it is advisable to assess creatinine levels on an annual basis (10). Two types of tests help diagnose the creatinine levels in children:

  1. Serum creatinine level: The blood creatinine level is measured through a blood test. If the level is lower than normal, it may indicate problems with the muscles, nerves leading to the muscles, liver, or nutrition (11).
  2. Creatinine clearance: This test indicates how well the kidneys remove creatinine from the blood and accurately detects kidney function issues. Creatinine clearance involves testing a blood and urine sample collected over 24 hours. The time of urine collection is an important factor for accurate diagnosis.

Children are advised to do the following before the test (6) (12):

  • Refrain from eating overnight
  • Avoid meat for 24 hours
  • Drink plenty of fluid for urine collection
Drink plenty of fluid for urine collection

Image: IStock

Since low creatinine levels generally indicate muscle loss, further assessments such as a muscle biopsyiA minor surgical procedure where a sample of tissue from a specific muscle is removed to diagnose muscle-related conditions , blood tests, and an electromyogramiA device for capturing the electrical activity of skeletal muscles can determine the reason (13).

Treatment Of Low Creatinine In Children

Your child’s healthcare provider may advise treatments based on the causes.

  • If a child has liver problems, medications, lifestyle changes, and surgery help treat the condition (14).
  • In case of loss in muscle mass, medications, physical therapy, surgery, support of a walker and walking machines, and nutritional counseling are suggested (13). Physical activity is recommended for increasing the body’s serum creatinine level (15).
  • If the creatinine level is low due to malnutrition, having a balanced diet by adding fruits and vegetables, meat, fish, eggs, starchy food, and dairy products will help control the condition (16).
A balanced diet can help treat low creatinine in child

Image: Shutterstock

  • Creatine supplements may be given; however, such supplements have not yet been determined safe for children under 18 years. A study in 2012 found that 62 out of 1103 middle and high school students in the US used creatine supplements, but as their safety is still questionable, intake may lead to further problems (17).

High Creatinine Levels: Causes And Symptoms

High levels of creatinine in the body can be determined with a blood test. The causes of high creatinine levels in children are (1) (4)

  • Chronic kidney disease
  • Muscle disease
  • Blocked urinary system
  • Diabetes
  • Dehydration
  • Excess protein in the diet
  • Overactive thyroid
  • Congestive heart failure (the heart works harder than normal to pump blood)
  • Pediatric medicines

protip_icon Quick fact
High creatinine may also occur due to shock in children (1).

High levels of serum creatinine may indicate kidney disease in children without noticeable symptoms in the beginning. However, as the disease progresses, it produces these symptoms (4) (12):
Children may be fatigued due to high serum creatinine

Image: IStock

  • Dehydration
  • Less urine
  • Dark urine
  • Swollen feet, face, and eyes
  • Loss of appetite
  • Nausea
  • Itching
protip_icon Be watchful
Painful urination, mild to moderate fever, and fatigue are other symptoms of high creatinine levels in children (4).

Frequently Asked Questions

1. What level of creatinine indicates kidney failure in a child?

Normal creatinine levels for each child can vary depending on their body size. So, the creatinine levels indicating renal failure can also vary in children. Pediatric nephrology specialists (kidney specialists) assess the creatinine levels with child size to establish the diagnosis. For example, if the normal creatinine level for a child with a specific size is 0.5, the child’s kidneys are in 100 percent working condition. Kidney function can be half for the same child if the creatinine level rises to one. If the creatine is between one and two, kidney function would be only 25% (18).

2. Does drinking water help creatinine levels?

Drinking enough water can reduce creatinine levels. But, this will not improve kidney function. That means drinking water only gives you low creatinine levels on tests and does not make a difference in existing kidney problems such as kidney damage or kidney injury. Excess water intake can also be harmful as low water intake (19).

3. How often should a child’s creatinine levels be monitored?

There is no ideal time to monitor creatinine levels. However, you may do your child’s blood and urine test routinely every year. In this way, it is believed that any early signs of illness may be effectively diagnosed.

4. Can low creatinine levels be a hereditary condition in children?

Child specialist Dr. Mubina Agboatwala opines, “Low creatinine levels can be hereditary in a rare condition known as CCDS, which is associated with delayed mental development, seizures, hypotonia, and other symptoms. However, this condition is very rare in children.”

Low creatinine in children may occur due to several reasons. It is not considered a disease on its own but usually indicates an underlying health condition such as thyroid, diabetes, low muscle mass, or issues related to kidney health. Therefore, parents should immediately consult their child’s pediatrician if they notice symptoms related to these conditions. The treatment process for low creatinine levels will be based on the diagnosis. It is advised that children should follow the treatment procedure diligently to speed up their recovery.

Infographic: More About Creatine Supplements

The use of creatine supplements in children has not been thoroughly studied. However, these supplements are promising in providing benefits to children with low creatinine levels and improving athletic performance. The infographic below summarizes the benefits and safety of such supplements.

more about creatine supplements for kids (infographic)

Illustration: Momjunction Design Team

Illustration: Low Creatinine In Children: Causes Symptoms Diagnosis And Treatment

Low Creatinine In Children: Causes, Symptoms, Diagnosis, And Treatment_illustration

Image: Dall·E/MomJunction Design Team


References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Creatinine (Blood).
    https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=creatinine_serum
  2. Urine Test: Creatinine.
    https://kidshealth.org/en/parents/test-creatinine.html
  3. Should we pay more attention to low creatinine levels?
    https://www.elsevier.es/en-revista-endocrinologia-diabetes-nutricion-english-ed–413-articulo-should-we-pay-more-attention-S2530018020300962
  4. Here’s How To Check If Your Kidneys Are Working Fine.
    https://www.narayanahealth.org/blog/heres-how-to-check-if-your-kidneys-are-working-fine/
  5. Marlies Ostermann et al.;(2016); The two sides of creatinine: both as bad as each other?
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958791/
  6. Creatinine and Creatinine Clearance.
    https://www.mottchildren.org/health-library/hw4322#hw4325
  7. Low muscle tone.
    https://www.rch.org.au/kidsinfo/fact_sheets/Low_muscle_tone/
  8. Liver Disease.
    https://www.stlouischildrens.org/conditions-treatments/liver-disease
  9. Nutrition – school-age to adolescence.
    https://www.rch.org.au/kidsinfo/fact_sheets/Nutrition_older_children/
  10. Restless Legs Syndrome in Pediatric Patients With Nephrotic Syndrome.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784599/
  11. Anemia in Chronic Kidney Disease.
    https://www.niddk.nih.gov/health-information/kidney-disease/anemia
  12. Creatinine and eGFR – Measuring Kidney Function; United States Department of Veterans Affairs
    https://www.va.gov/EKIDNEYCLINIC/rooms/laboratory/pdfs/creatinine-and-egfr.pdf
  13. Creatinine blood test.
    https://www.ucsfbenioffchildrens.org/medical-tests/creatinine-blood-test%5C%5C
  14. Creatinine Clearance Test.
    https://my.clevelandclinic.org/health/diagnostics/16380-creatinine-clearance-test
  15. Muscular Dystrophy.
    https://kidshealth.org/en/parents/muscular-dystrophy.html
  16. Liver Failure in Children.
    https://www.nationwidechildrens.org/conditions/liver-failure-in-children
  17. Alessandra Calábria Baxmann et al.; (2008); Influence of Muscle Mass and Physical Activity on Serum and Urinary Creatinine and Serum Cystatin C.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2390952/
  18. Malnutrition.
    https://www.nhs.uk/conditions/malnutrition/
  19. Robert Cooper et al.; (2012); Creatine supplementation with specific view to exercise/sports performance: an update.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3407788/
  20. How Kidneys Work.
    https://www.childrenscolorado.org/doctors-and-departments/departments/kidney/how-kidneys-work/
  21. My serum creatinine level is 1.17. Will drinking more water lower it?.
    https://www.kidney.org/blog/ask-doctor/my-serum-creatinine-level-117-will-drinking-more-water-lower-it
  22. Guidance for clinicians managing children at risk of, or with, acute kidney injury.
    https://www.thinkkidneys.nhs.uk/aki/wp-content/uploads/sites/2/2016/05/Guidance-for-paediatric-patients-FINAL-1017.pdf
  23. Creatinine Test.
    https://medlineplus.gov/lab-tests/creatinine-test/

 

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Dr. Neema Shrestha
Dr. Neema ShresthaMD
Dr. Neema Shrestha is a pediatrician with a special interest in the field of neonatology. She has an overall experience of five years working in the field. Currently working in Kathmandu, Nepal, she completed her MBBS from Kasturba Medical College, Manipal in 2008, Diploma in Child Health from D.

Read full bio of Dr. Neema Shrestha
  • Dr. Mubina Agboatwalla
    Dr. Mubina AgboatwallaMBBS, DCH, MCPS Dr. Mubina Agboatwalla is the head of the department of pediatrics in Karachi Liaquat Hospital, Pakistan. She has over 20 years of experience in the field of pediatrics and 50 research papers published in international journals including Lancet and JAMA. Dr. Agboatwalla is also a public health specialist specializing in preventive health including nutrition, breastfeeding and infectious diseases especially diarrhea, polio and tuberculosis. She has affiliations with the Center of Disease Control Atlanta (CDC), UNICEF, and WHO.
    Dr. Mubina Agboatwalla is the head of the department of pediatrics in Karachi Liaquat Hospital, Pakistan. She has over 20 years of experience in the field of pediatrics and 50 research papers published in international journals including Lancet and JAMA. Dr. Agboatwalla is also a public health specialist specializing in preventive health including nutrition, breastfeeding and infectious diseases especially diarrhea, polio and tuberculosis. She has affiliations with the Center of Disease Control Atlanta (CDC), UNICEF, and WHO.
Pragya Bhargavi
Pragya BhargaviMSc, BEd
Pragya Bhargavi has been in the field of content research, writing and editing for over six years. Her passion for academics and science has enabled her to write creative as well as research-based articles. She has completed her Masters in Microbiology from Bangalore University and obtained a Bachelor’s degree in Education (BEd) from Acharya Nagarjuna University, Guntur.

Read full bio of Pragya Bhargavi
Dr. Ritika Shah
Dr. Ritika ShahBDS, CLC
Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College.

Read full bio of Dr. Ritika Shah
Dr. Joyani Das
Dr. Joyani DasM.Pharm, PhD
Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

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