Creatine Clearance
Other names: Est Creat Cl
The primary goal of a creatinine clearance test is to measure the estimated glomerular filtration rate (eGFR), providing insight into kidney filtration efficiency. It is instrumental in diagnosing, screening, and tracking the progression of kidney disease.
The test involves measuring creatinine levels in a blood sample and a 24-hour urine collection. Creatinine is a byproduct of the breakdown of creatine, which provides energy to muscles. The kidneys filter creatinine from the blood, and it is excreted in urine. By using a specific formula that considers creatinine levels in both the blood and urine, adjusted for body size, the test estimates the glomerular filtration rate (GFR).
A creatinine clearance test is performed to evaluate kidney function by analyzing both blood and urine samples. Creatinine is a waste product generated by normal muscle activity, which the kidneys filter from the blood and eliminate through urine. This test compares the levels of creatinine in the blood and urine to determine how effectively the kidneys are filtering blood, a key indicator for diagnosing and monitoring kidney health.
This test can help diagnose kidney issues if you have symptoms such as changes in urination, itching, loss of appetite, or swollen feet. It is also useful for identifying kidney problems in individuals with general symptoms like fatigue.
Individuals at higher risk for kidney problems, including those with diabetes, high blood pressure, or a family history of kidney disease, may use this test for early detection. While initial screening often involves a blood test, a creatinine clearance test, including a urine sample, might be necessary if the blood test results are abnormal or less reliable due to personal health factors.
Creatinine clearance tests are also used to monitor kidney function over time, observe disease progression, evaluate the effectiveness of treatments, and detect potential kidney damage from medications or other therapies.
Reference ranges:
- Male: younger than 12 years: 50−90 mL/minute, 12 years and older: 97−137 mL/minute
- Female: younger than 12 years: 50−90 mL/minute, 12 years and older: 88−128 mL/minute
Note: Creatinine clearance reference intervals are based on a body surface area of 1.73 m2.
Additional notes:
Glomerular filtration rate declines about 10% per decade after age 50. Some patients with significant impairment of glomerular filtration rate have only slightly elevated serum creatinine. Creatinine clearance is calculated on the basis of the surface area of the patient. The estimated error of determining creatinine clearance utilizing serum and 24-hour urine collection has been found to be in the range of 10% to 15%. Any test requiring a 24-hour urine collection may also be run on this specimen (eg, protein, quantitative, 24-hour urine).
References:
Swain RR, Briggs SL. Positive interference with the Jaffé reaction by cephalosporin antibiotics. Clin Chem. 1977 Jul; 23(7):1340-1342. PubMed 872385
Levey AS, Perrone RD, Madias NE. Serum creatinine and renal function. Annu Rev Med. 1988; 39:465-490 (review). PubMed 3285786
Klahr S. The modification of diet in renal disease study. N Engl J Med. 1989 Mar 30; 320(13):864-866. PubMed 2494456
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