Calculation of creatinine clearance, a measure of renal function, when used in conjunction with serum creatinine
Enzymatic Colorimetric Assay
Creatinine, Urine
Urine
24-Hour volume (in milliliters) is required.
Question ID | Description | Answers |
---|---|---|
TM10 | Collection Duration | |
VL8 | Urine Volume |
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Collection Container/Tube: 24-hour graduated urine container with no metal cap or glued insert
Submission Container/Tube: Plastic tube or a clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 4 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. Refrigerate specimen within 4 hours of completion of 24-hour collection.
Additional Information:
1. This test does not require the use of a chemical preservative; if a chemical preservative is used, it must be added to the specimen within 4 hours of completion of 24-hour collection.
2. See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.
Note: The addition of preservative or application of temperature controls must occur within 4 hours of completion of the collection.
| OK |
Refrigerate | Preferred |
Frozen | OK |
50% Acetic Acid | OK |
Boric Acid | OK |
Diazolidinyl Urea | OK |
6M Hydrochloric Acid | OK |
6M Nitric Acid | No |
Sodium Carbonate | OK |
Thymol | OK |
Toluene | No |
1 mL
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 30 days | |
Frozen | 30 days | ||
Ambient | 14 days |
Calculation of creatinine clearance, a measure of renal function, when used in conjunction with serum creatinine
Creatinine is formed from the metabolism of creatine and phosphocreatine, both of which are principally found in muscle. Thus the amount of creatinine produced is, in large part, dependent upon the individual's muscle mass and tends not to fluctuate much from day-to-day.
Creatinine is not protein bound and is freely filtered by glomeruli. All of the filtered creatinine is excreted in the urine. Renal tubular secretion of creatinine also contributes to a small proportion of excreted creatinine. Although most excreted creatinine is derived from an individual's muscle, dietary protein intake, particularly of cooked meat, can contribute to urinary creatinine levels.
The renal clearance of creatinine provides an estimate of glomerular filtration rate.
Reference values mg per 24 hours:
Males > or =18 years: 930-2955 mg/24 hours
Females > or =18 years: 603-1783 mg/24 hours
Reference values have not been established for patients who are less than 18 years of age.
For SI unit Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html
Twenty-four-hour urinary creatinine determinations are principally used for the calculation of creatinine clearance.
Decreased creatinine clearance indicates decreased glomerular filtration rate. This can be due to conditions such as progressive renal disease or result from adverse effects on renal hemodynamics, which are often reversible, including certain drug usage or from decreases in effective renal perfusion (eg, volume depletion or heart failure).
Increased creatinine clearance is often referred to as "hyperfiltration" and is most commonly seen during pregnancy or in patients with diabetes mellitus before diabetic nephropathy has occurred. It also may occur with large dietary protein intake.
The reliability of 24-hour urinary creatinine determinations is, as for all timed urine collections, very dependent on accurately collected 24-hour specimens.
Intra-individual variability in creatinine excretion may be due to differences in muscle mass or amount of ingested meat.
Acute changes in glomerular filtration rate, before a steady state has developed, will alter the amount of urinary creatinine excreted.
1. Delaney MP, Lamb EJ: Kidney disease. In: Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1256-1323
2. Lamb EJ, Jones GRD: Kidney function tests. In: Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap32
3. Kasiske BL, Keane WF: Laboratory assessment of renal disease: clearance, urinalysis, and renal biopsy. In: Brenner BM, ed. The kidney. 6th ed. WB Saunders; 2000:1129-1170
The enzymatic method is based on the determination of sarcosine from creatinine with the aid of creatininase, creatinase, and sarcosine oxidase. The liberated hydrogen peroxide is measured via a modified Trinder reaction using a colorimetric indicator. Optimization of the buffer system and the colorimetric indicator enables the creatinine concentration to be quantified both precisely and specifically.(Package insert: Creatinine plus ver 2. Roche Diagnostics; V15.0 03/2019)
Monday through Sunday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
82570
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
CTU | Creatinine, 24 HR, U | 65634-8 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
NCTU_ | Creatinine Concentration | 20624-3 |
CRE_A | Creatinine, 24 HR, U | 2162-6 |
TM10 | Collection Duration | 13362-9 |
VL8 | Urine Volume | 3167-4 |