• Creatinine Clearance

• Calculated measurement of the rate at which creatinine is removed from

the plasma by the kidneys

• Measurement of glomerular filtration ( renal function )

• A good test of glomerular filtration because

• Creatinine is an endogenous substance ( not affected by diet )

• Creatinine is filtered by the glomerulus, but not secreted or
re-absorbed by the renal tubules

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24 Hour Urine collection
Container.

The volume can be measured

directly off the container.

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 • Creatinine Clearance specimens

• 24 hour urine specimen

• Plasma / serum creatinine collected during the urine collection

• 24 Hour Creatinine Clearance Formula

 UV  1.73 
  
• CREATININE CLEARANCE =  P  A 

U = Creatinine concentration of the 24 hour urine ( mg / dl )

V = 24 hour urine volume ( mls ) per minute - V / 1440 = mls / minute
P = Plasma creatinine concentration ( mg / dl )

A = Correction factor accounts for differences in body surface area

obtained from a height – weight chart

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 Example of a 24 Hour Creatinine Clearance calculation

24 hour urine volume = 1000 mls

24 hour urine creatinine = 20.0 mg / dl
Plasma creatinine = 5.0 mg / dl

Patients height / weight = 6’00 / 190 lbs ( see pg. 680 )

Creat Cl 
 UV   1.73    20.0   1000
1440   1.73  
   
  
P A   
5.0  2.05 

Creat Cl = 2 ml / min …. Very poor clearance !!!

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• Procedure for 24 Hour Urine Collection

• Have the patient empty his / her bladder ( discard this urine ).

• Note the time . For the next 24 hours, have the patient collect and save all
urine in an appropriate container.

• At the end of the 24 hour period have the patient void one last time into
the urine container. This completes the collection.

• If possible, keep the urine specimen refrigerated.

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• Reference range

• 97 - 137 ml / min ( male)

• 88 - 128 ml / min (female)

• Let’s remember 90 - 130 ml / min