NAME: KHAW WERN TING MATRIC NU: 99575 TITLES: THE DIFFERENCES BETWEEN SERUM CREATININE AND CREATININE

CLEARANCE

Differences
Definition

Serum Creatinine
Serum creatinine is a substance formed from the metabolism of creatine that found in the blood . A laboratory test for the creatinine level in the blood may be used as a measurement of kidney function.

Creatinine clearance
Creatinine clearance is the rate at which ingested creatinine is filtered through the renal glomeruli. Creatinine clearance test is a measure of renal function based on the rate.

Units

Serum creatinine is often measured as milligram/desiliters (mg/dl).

Creatinine clearance is often measured as milliliters/minute (mL/min).

Tests comparison

The serum creatinine level shows how well your kidneys are working. A high creatinine level may mean your kidneys are not working properly. The amount of creatinine in the blood depends partly on the amount of muscle tissue you have; men generally have higher creatinine levels than women.

A creatinine clearance test measures how well creatinine is removed from your blood by your kidneys. A creatinine clearance test gives better information than a blood creatinine test on how well your kidneys are working.

In principle, the renal clearance of creatinine is the urine creatinine excretion divided by the area under the plasma creatinine concentrationtime curve over the period of time in which the urine was sampled. In practice, creatinine clearance is usually measured by determining the urine creatinine excretion and sampling a single plasma creatinine value. It is then assumed that the

The blood sample is taken from a vein in your arm, may feel a quick sting or pinch.

plasma creatinine was constant over the time of the urine collection. There is no pain while collecting a 24-hour urine sample.

Measurement

Serum creatinine cannot be predicted can directly measure from the blood directly.

Creatinine clearance can be predicted from serum creatinine level by using formula or get from the collected 24-hour urine sample.

Reference values

Adult males: 0.8 - 1.4 mg/dl: values are slightly higher in males due to larger muscle mass

Reference range in our laboratory of an "uncorrected" creatinine clearance for: adult male:90-139 mL/minute. adult female is 80-125 mL/minute. Many medications must be adjusted for renal impairment when the CrCl falls below 50 mL/min.

Adult females: 0.6 - 1.1 mg/dl: creatinine clearance is increased in pregnancy, resulting in lower serum levels

Children: 0.2 - 1.0 mg/dl: slight increases with age because values are proportional to body mass

A panic value for creatinine is 10 mg/dl in nondialysis patients.

Problems

serum creatinine is very insensitive to even substantial declines in glomerular filtration rate.

Creatinine clearance often overestimates actual glomerular filtration rate by 10-20% because of active secretion in the peritubular capillaries.
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Failure to consider variation in creatinine production due to differences in muscle mass frequently leads to misinterpretation of serum creatinine levels.

Differences in steady-state creatinine production due to differences in muscle mass that affect serum creatinine should not affect creatinine clearance but the

The extrarenal degradation of creatinine has been attributed to its

conversion to carbon dioxide and methylamine by bacteria in the intestine. The increase in extrarenal creatinine degradation with declining renal function can be expected to cause plasma creatinine to underestimate declines in glomerular filtration rate. There is probably more variation in what laboratories report as the upper limit of normal for serum creatinine than for any other standard chemistry value. A number of normal plasma constituents can interfere with creatinine measurement. For example, glucose, fructose, pyruvate, acetoacetate, uric acid, ascorbic acid, and plasma proteins can all cause the Jaffe colorimetric assay to yield falsely high creatinine values. Popularity It is the most widely used indirect measure of glomerular filtration rate. -

reliability of creatinine clearance is greatly diminished by variability in tubular secretion of creatinine and by the inability of most patients to accurately collect timed urine samples. Tubular secretion of creatinine gives a creatinine clearance rate that overestimates the true glomerular filtration rate. Prolonged storage of the urine can introduce error in the creatinine clearance determination by perturbing urine creatinine levels. High temperature and low urine pH enhance the conversion of creatine to creatinine in urine.

Creatinine clearance attain its popularity by the accurately estimating GFR by determining the urine creatinine excretion and sampling a single plasma creatinine value.

Advantages

convenience and low cost

Glomerular filtration rate measured by more accurate techniques but more inconvenient and high cost.

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