Creatinine 5.0 mg/dL (442 µmol/L): Is It High?

A serum creatinine of 5.0 mg/dL is 442 µmol/L. It is about 3.8 times the upper limit for men (0.7 to 1.3 mg/dL), and about 4.5 times the upper limit for women (0.6 to 1.1 mg/dL). At age 50 it gives a CKD-EPI 2021 eGFR of 13 (G5) for a man and 10 (G5) for a woman. Every adult result in the eGFR table below is under 30, so the trend and the setting matter more than fine differences in age.

5.0 mg/dL in µmol/L and mmol/L

Multiply by 88.4: 5.0 × 88.4 = 442 µmol/L, or 0.442 mmol/L. Going back, 442 ÷ 88.4 = 5.0 mg/dL, and any result from 438 to 446 µmol/L rounds to 5.0 mg/dL. The creatinine unit converter handles other results.

eGFR at a Creatinine of 5.0 mg/dL by Age and Sex

With the race-free CKD-EPI 2021 equation, 5.0 mg/dL (442 µmol/L) gives:

For a man, the eGFR is below 30 at every adult age and drops below 15 from about age 37. For a woman, the eGFR is below 15 at every adult age. An eGFR below 60 for more than three months meets the KDIGO definition of chronic kidney disease.

What these results mean: eGFR 15.

Older Equations on Earlier Reports

Some laboratories still report CKD-EPI 2009 or MDRD, so an older result may not match. For a 60-year-old at 5.0 mg/dL the three equations agree to the nearest whole number:

See MDRD vs CKD-EPI for why the numbers differ.

Creatinine Clearance at 5.0 mg/dL: Four Example Patients

Drug doses are usually checked against Cockcroft-Gault creatinine clearance, which also uses weight. Our dosing-weight rule uses actual weight below ideal body weight (IBW), IBW up to 30% above it, and adjusted body weight (AjBW) beyond that.

At 5.0 mg/dL, CrCl runs from 6.6 mL/min (woman, 82) to 21.2 mL/min (man, 55). 4 of 4 are below 30 mL/min, where 22 drugs in our renal dosing registry have a cutoff, and 4 are below 50, where 16 do. The formula assumes a stable creatinine.

Which Dosing Lines 5.0 mg/dL Crosses

In our registry, 9 drugs change at 60, 16 drugs change at 50, 22 drugs change at 30, and 8 drugs change at 15 mL/min of creatinine clearance. The list shows where each example adult stands at 5.0 mg/dL, using the same Cockcroft-Gault engine and weights as the table above:

• Man aged 40, 80 kg: 20.3 mL/min, below 60, 50 and 30. Reaches 15 mL/min at about 6.76 mg/dL.
• Woman aged 65, 62 kg: 9.7 mL/min, below 60, 50, 30 and 15. Already below the lowest line.
• Woman aged 82, 48 kg: 6.6 mL/min, below 60, 50, 30 and 15. Already below the lowest line.
• Man aged 55, 118 kg: 21.2 mL/min, below 60, 50 and 30. Reaches 15 mL/min at about 7.05 mg/dL.

Between 3.0 and 5.0 mg/dL, the man aged 40 drops below 30, and the woman aged 65 drops below 15, and the man aged 55 drops below 30. The next line any of them meets is 15 mL/min, for the man aged 40, at about 6.76 mg/dL. At 15 mL/min, 8 drugs in our registry change, including dabigatran, edoxaban and gabapentin.

In the eGFR table, 12 of 12 results are below 60, the same as at 3.0 mg/dL, and 12 are below 30. Below an eGFR of 30, KDIGO advises sharing care with a kidney specialist.

Is 5.0 mg/dL High for You?

5.0 mg/dL is well above the usual range; all 12 table results are below 60, spanning categories G4 to G5. A new result at this level should be reviewed promptly. For someone with known, stable advanced kidney disease it may be an expected value their kidney team already follows.

Even at 5.0 mg/dL, clinicians check for causes that are not about filtration. Dehydration, intense exercise, creatine supplements and drugs that block tubular secretion, such as trimethoprim, can raise creatinine without changing filtration. See causes of high creatinine.

When a Result of 5.0 mg/dL Needs Prompt Attention

If 5.0 mg/dL is your usual (baseline) value, a rise to 5.3 mg/dL within 48 hours, or to 7.5 mg/dL within 7 days, meets the KDIGO creatinine criteria for acute kidney injury and should be assessed promptly. So should much less urine, swelling, confusion or breathlessness.

• Compare the result with earlier ones: stable and rising mean different things.
• Ask whether a kidney specialist is involved: 12 of the 12 eGFR results above are below 30.
• Ask for your eGFR and, if you take regular medicines, your creatinine clearance.
• Mention recent illness, new medicines, supplements or contrast scans.

There is no quick "flush": how to lower creatinine covers what helps, with your clinician.

Nearby Creatinine Results

• Lower result: Creatinine 3.0 mg/dL (265 µmol/L)

Or browse all creatinine results.