Elevated Serum Creatine Kinase Level in Diabetic Patients with Nephrotic Syndrome: A Role of Fluid Retention

Excerpt

Elevation of serum levels of the MM isoenzyme of creatine kinase usually reflects the destruction of skeletal muscles. However, creatine kinase levels can increase without muscle destruction, and in diabetes mellitus, the elevation of this enzyme level has been noted in patients with ketoacidosis (1, 2). We treated a patient with diabetes and the nephrotic syndrome in whom the serum level of the MM isoenzyme of creatine kinase was extremely high despite no evidence of coexisting muscle disease. In this patient, the creatine kinase level decreased to normal after hemodialysis therapy was begun, and we suspected that fluid retention had