Creatinine

What is normal creatinine level? Answer: Improve

Creatinine Normals

The typical reference ranges are 0.5 to 1.0 mg/dL (about 45-90 mol/l) for women and 0.7 to 1.2 mg/dL (60-110 mol/l) for men. While a baseline serum creatinine of 2.0 mg/dL (150 mol/l) may indicate normal kidney function in a male body builder, a serum creatinine of 0.7 mg/dL (60 mol/l) can indicate significant renal disease in a frail old woman.

Creatinine (from the Greek , flesh, pronounced, kr-'a-t-nn, -n 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). Creatinine starts to decompose above 295 C. In chemical terms, creatinine is a spontaneously formed cyclic derivative of creatine. Creatinine is chiefly filtered out of the blood by the kidneys (glomerular filtration and proximal tubular secretion). There is little-to-no tubular reabsorption of creatinine. If the filtering of the kidney is deficient, creatinine blood levels rise. Therefore, creatinine levels in blood and urine may be used to calculate the creatinine clearance (CrCl), which reflects the glomerular filtration rate (GFR).

The GFR is clinically important because it is a measurement of renal function. However, in cases of severe renal dysfunction, the creatinine clearance rate will be "overestimated" because active secretion of creatinine from the proximal tubule will account for a larger fraction of the total creatinine cleared[clarification needed]. Ketoacids, cimetidine and trimethoprim reduce creatinine tubular secretion and therefore increase the accuracy of the GFR estimate, particularly in severe renal dysfunction. (In the absence of secretion, creatinine behaves like inulin.) A more complete estimation of renal function can be made when interpreting the blood (plasma) concentration of creatinine along with that of urea. BUN-to-creatinine ratio (the ratio of blood urea nitrogen to creatinine) can indicate other problems besides those intrinsic to the kidney; for example, a urea level raised out of proportion to the creatinine may indicate a pre-renal problem such as volume depletion.

Diagnostic use
[edit] Serum creatinine
Measuring serum creatinine is a simple test and it is the most commonly used indicator of renal function. A rise in blood creatinine level is observed only with marked damage to functioning nephrons. Therefore, this test is not suitable for detecting early-stage kidney disease. A better estimation of kidney function is given by the creatinine clearance (CrCl) test. Creatinine clearance can be accurately calculated using serum creatinine concentration and some or all of the following variables: sex, age, weight, and race, as suggested by the American Diabetes Association without a 24-hour urine collection.[2] Some laboratories will calculate the CrCl if written on the pathology request form, and the necessary age, sex, and weight are included in the patient information. A current concern in late 2010 relates to the adoption of a new analytical methodology, and a possible impact this may have in clinical medicine. All clinical laboratories in the US will soon use a new standardized Isotope Dilution Mass Spectrometry (IDMS) method to measure serum creatinine. IDMS appears to give lower values compared to older methods when the serum creatinine values are relatively low, for example 0.7 mg/dL. The IDMS method would result in a comparative overestimation of the corresponding calculated Glomerular Filtration Rate (GFR) in some patients with normal renal function. A few medicines are dosed even in normal renal function on that derived GFR. The dose, unless further modified, could now be higher than desired, potentially causing increased drug-related toxicity. To counter the effect of changing to IDMS, new FDA guidelines have suggested limiting doses to specified maximums with carboplatin, a chemotherapy drug.[3] A recent Japanese study suggests that a lower-serum creatinine level is associated with an increased risk for the development of type 2 diabetes in Japanese men.[4]

[edit] Urine creatinine

Creatinine concentration is also checked during standard urine drug tests. Normal creatinine levels indicate that the test sample is undiluted, whereas low amounts of creatinine in the urine either indicate either a manipulated test or low individual baseline creatinine levels. Test samples that are considered manipulated due to low creatinine aren't tested and the test is sometimes considered failed. It should be noted[citation needed] that diluted samples may not always be due to a conscious effort of subversion and diluted samples cannot be proved to be intentional, but are only assumed to be. Random urine creatinine levels have no standard reference ranges. They are usually used with other tests to reference levels of other substances measured in the urine. Diuretics, such as coffee and tea, cause more frequent urination, thus potently decreasing creatinine levels. A decrease in muscle mass will also cause a lower reading of creatinine, as will pregnancy.

[edit] Interpretation
In the United States, creatinine is typically reported in mg/dL, whereas, in Canada and a few European countries, mol/litre may be used. 1 mg/dL of creatinine is 88.4 mol/L. The typical human reference ranges for serum creatinine are 0.5 to 1.0 mg/dL (about 45-90 mol/L) for women and 0.7 to 1.2 mg/dL (60-110 mol/L) for men. While a baseline (medicine) serum creatinine of 2.0 mg/dL (150 mol/L) may indicate normal kidney function in a male body builder, a serum creatinine of 1.2 mg/dL (110 mol/L) can indicate significant renal disease in an elderly female.[citation needed] for male reference range are 60-120 mol/L and for female it is 50110 mol/L

BLOOD TEST REFERENCE RANGE CHART Test 17 Hydroxyprogesterone (Men) 17 Hydroxyprogesterone (Women) Follicular phase 25-hydroxyvitamin D (25(OH)D) Acetoacetate Acidity (pH) Alcohol Reference Range (conventional units*) 0.06-3.0 mg/L

0.2-1.0 mg/L

8-80 ng/mL

<3 mg/dL 7.35 - 7.45 0 mg/dL (more than 0.1 mg/dL normally indicates intoxication) (ethanol) 15 - 50 g of nitrogen/dL 53 - 123 units/L 0.4 - 1.5 mg/dL 18 - 23 mEq/L (carbon dioxide content) Direct: up to 0.4 mg/dL Total: up to 1.0 mg/dL 8.5 - 9.1% of total body weight 8.2 - 10.6 mg/dL (normally slightly higher in children) 35 - 45 mm Hg Less than 5% of total hemoglobin 500 - 1500 cells/L

Ammonia Amylase Ascorbic Acid Bicarbonate Bilirubin

Blood Volume Calcium Carbon Dioxide Pressure Carbon Monoxide CD4 Cell Count

Ceruloplasmin Chloride Complete Blood Cell Count (CBC)

15 - 60 mg/dL 98 - 106 mEq/L Tests include: hemoglobin, hematocrit, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular volume, platelet count, white Blood cell count Please click each to view an individual test value. Total: 70 - 150 g/dL Male: 38 - 174 units/L Female: 96 - 140 units/L 5% MB or less 0.6 - 1.2 mg/dL Test includes: calcium, chloride, magnesium, potassium, sodium Please click each to view an individual test value. Male: 1 - 13 mm/hr Female: 1 - 20 mm/hr Tested after fasting: 70 - 110 mg/dL Male: 45 - 62% Female: 37 - 48% Male: 13 - 18 gm/dL Female: 12 - 16 gm/dL 60 - 160 g/dL (normally higher in males) 250 - 460 g/dL Venous: 4.5 - 19.8 mg/dL Arterial: 4.5 - 14.4 mg/dL 50 - 150 units/L

Copper Creatine Kinase (CK or CPK)

Creatine Kinase Isoenzymes Creatinine Electrolytes

Erythrocyte Sedimentation Rate (ESR or Sed-Rate) Glucose Hematocrit

Hemoglobin

Iron Iron-binding Capacity Lactate (lactic acid)

Lactic Dehydrogenase

Lead Lipase Zinc B-Zn Lipids: Cholesterol Triglycerides

40 g/dL or less (normally much lower in children) 10 - 150 units/L 70 - 102 mol/L

Less than 225 mg/dL (for age 40-49 yr; increases with age) 10 - 29 years 30 - 39 years 40 - 49 years 50 - 59 years 60 - 69 years > 70 years

53 - 104 mg/dL

55 - 115 mg/dL

66 - 139 mg/dL

75 - 163 mg/dL

78 - 158 mg/dL

83 - 141 mg/dL

Liver Function Tests

Tests include bilirubin (total), phosphatase (alkaline), protein (total and albumin), transaminases (alanine and aspartate), prothrombin (PTT) Please click each to view an individual test value. 1.9 - 2.7 mEq/L 27 - 32 pg/cell

Magnesium Mean Corpuscular Hemoglobin (MCH) Mean Corpuscular Hemoglobin Concentration (MCHC)

32 - 36% hemoglobin/cell

Mean Corpuscular Volume (MCV) Osmolality Oxygen Pressure Oxygen Saturation (arterial) Phosphatase, Prostatic Phosphatase

76 - 100 cu m

280 - 296 mOsm/kg water 83 - 100 mm Hg 96 - 100% 0 - 3 units/dL (Bodansky units) (acid) 50 - 160 units/L (normally higher in infants and adolescents) (alkaline) 3.0 - 4.5 mg/dL (inorganic) 150,000 - 350,000/mL 3.5 - 5.4 mEq/L 0 - 4 ng/mL (likely higher with age)

Phosphorus Platelet Count Potassium Prostate-Specific Antigen (PSA) Proteins: Total Albumin Globulin

6.0 - 8.4 gm/dL 3.5 - 5.0 gm/dL 2.3 - 3.5 gm/dL

Prothrombin (PTT) Pyruvic Acid Red Blood Cell Count (RBC)

25 - 41 sec 0.3 - 0.9 mg/dL 4.2 - 6.9 million/L/cu mm

Sodium

133 - 146 mEq/L

Thyroid-Stimulating Hormone (TSH) Transaminase: Alanine (ALT) Aspartate (AST)

0.5 - 6.0 units/mL

1 - 21 units/L 7 - 27 units/L

Urea Nitrogen (BUN) BUN/Creatinine Ratio Uric Acid

7 - 18 mg/dL 5 - 35 Male Female 2.1 to 8.5 mg/dL (likely higher with age) 2.0 to 7.0 mg/dL (likely higher with age)

Vitamin A WBC (leukocyte count and white Blood cell count) White Blood Cell Count (WBC)

30 - 65 g/dL 4.3-10.8 10 /mm

3 3

4,300 - 10,800 cells/L/cu mm