Clinically, creatinine clearance is a useful measure for estimating the glomerular filtration rate (GFR) of the kidneys. In renal physiology, creatinine clearance (C Cr) is the volume of blood plasma that is cleared of creatinine per unit time. In general, creatinine clearance is the removal of creatinine from the body. List of terms related to Creatinine clearanceĮditor-In-Chief: C. Risk calculators and risk factors for Creatinine clearanceĬauses & Risk Factors for Creatinine clearanceĭiagnostic studies for Creatinine clearance Patient resources on Creatinine clearanceĭiscussion groups on Creatinine clearanceĭirections to Hospitals Treating Creatinine clearance US National Guidelines Clearinghouse on Creatinine clearanceīe alerted to news on Creatinine clearance Ongoing Trials on Creatinine clearance at Clinical Ĭlinical Trials on Creatinine clearance at Google Powerpoint slides on Creatinine clearanceĬochrane Collaboration on Creatinine clearance Most cited articles on Creatinine clearanceĪrticles on Creatinine clearance in N Eng J Med, Lancet, BMJ Most recent articles on Creatinine clearance g., albumin, α‐amylase).WikiDoc Resources for Creatinine clearance In addition to the diagnosis and treatment of renal disease, the monitoring of renal dialysis, creatinine measurements are used for the calculation of the fractional excretion of other urine analytes (e. In children, the Bedside Schwartz formula should be used. While the first equation was derived from data obtained with the conventional Jaffé method, a newer version of the second is usable for IDMS-traceable creatinine methods. Among the various approaches suggested, two have found wide recognition: that of Cockroft and Gault and that based on the results of the MDRD trial. However, since this test is prone to error due to the inconvenient collection of timed urine, mathematical attempts to estimate GFR based only on the creatinine concentration in serum or plasma have been made. For this test a precisely timed urine collection (usually 24 hours) and a blood sample are needed. A considerably more sensitive test and better estimation of glomerular filtration rate (GFR) is given by the creatinine clearance test based on creatinine’s concentration in urine and serum or plasma, and urine flow rate. Since a rise in blood creatinine is observed only with marked damage of the nephrons, it is not suited to detect early stage kidney disease. Current guidelines define chronic kidney disease as kidney damage or glomerular filtration rate (GFR) less than 60 mL/min per 1.73 m 2 for three months or more, regardless of cause. malignancy, nephrolithiasis and prostatism, both the plasma creatinine and urea levels will be increased in these situations the rise is disproportionately greater for BUN dueto the increased back diffusion of urea.Ĭhronic kidney disease is a worldwide problem that carries a substantial risk for cardiovascular morbidity and death. In post renal conditions where obstruction to the flow of urine is present e.g. An increase in serum BUN without concomitant increase of serum creatinine is key to identifying prerenal azotemia. However, the serum level is not sensitive to early renal damage and responds more slowly than blood urea nitrogen (BUN) to haemodialysis during treatment of renal failure.Both serum creatinine and BUN are used to differentiate prerenal and postrenal (obstructive) azotemia. Measurements of creatinine are used in the diagnosis and treatment of renal disease and prove useful in the evaluation of kidney glomerular function and in monitoring renal dialysis. The assay of creatinine in serum or plasma is the most commonly used test to assess renal function. A serum creatinine level that would usually be considered normal does not rule out the presence of impaired renal function. It is sometimes low in subjects with relatively small muscle mass, cachectic patients, amputees, and in older persons. Serum creatinine varies with the subject’s age, body weight, and sex. Thus, creatinine production is proportional to muscle mass and varies little from day to day. A small but significant amount is also actively secreted. It is freely filtered by the glomeruli and, under normal conditions, is not reabsorbed by the tubules to any appreciable extent. Creatinine is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass).
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