Advertisement

Springer Nature is making Coronavirus research free. View research | View latest news | Sign up for updates

Creatinine for estimation of glomerular filtration rate

  • 70 Accesses

  • 29 Citations

Abstract

The aim of this study was to evaluate the plasma creatinine concentration (PCr) and creatinine clearance (C Cr) for estimation of glomerular filtration rate (GFR). Inulin clearance (C in) was used as the reference standard for GFR. Thirty-nine concurrentC in andC Cr studies provided data for comparingC in with the measuredC Cr and with the calculatedC Cr (calc-C Cr). (Calc-C Cr=k·L/PCr, where L=height in centimeters and k is the proportionality constant.) Thirty-one children 5.3–20.8 years of age, withC in ranging from 2.8 to 138.8 ml/min per 1.73 m2, participated in these studies at The Children's Mercy Hosptial. The measuredC Cr was 16.7±10.3 ml/min per 1.73 m2 (P<0.001) greater than theC in, and the calc-C Cr overestimatedC in by a mean of 31.6±20.8 ml/min per 1.73 m2 (P<0.001). Although there is good correlation betweenC in andC Cr (r=0.96), andC in and calc-C Cr (r=0.90), the 95% confidence intervals are quite broad. Hence, theC Cr and the calc-C Cr, derived using Schwartz values for k, consistently overestimate GFR. However, if the k value in the equation GFR=k·L/PCr is derived from k=C in/L, rather than from k=C Cr·PCr/L, a more accurate estimate of GFR may be obtained.

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Smith HW (1951) The kidney. Structure and function in health and disease. Oxford University Press, New York, pp 39–62

  2. 2.

    Wesson LG (1969) Physiology of the human kidney. Grune and Stratton, New York, pp 632–655

  3. 3.

    Duarte CG, Elveback LR, Liedtke RR (1980) Glomerular filtration rate and renal plasma flow. In: Duarte CG (ed) Renal function tests. Little Brown, Boston, pp 29–47

  4. 4.

    Duarte CG, Elveback LR, Liedtke RR (1980) Creatinine. In: Duarte CG (ed) Renal function tests. Little Brown, Boston, pp 1–28

  5. 5.

    Shemesh O, Golbetz H, Kriss JP, Myers BD (1985) Limitations of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 28: 830–838

  6. 6.

    Ross EA, Wilkinson A, Hawkins RA, Danovitch GM (1987) The plasma creatinine concentration is not an accurate reflection of the glomerular filtration rate in stable renal transplant patients receiving cyclosporine. Am J Kidney Dis 10: 113–117

  7. 7.

    Levey AS, Perrone RD, Madias NE (1988) Serum creatinine and renal function. Annu Rev Med 39: 465–490

  8. 8.

    Hellerstein S, Hunter JL, Warady BA (1988) Creatinine excretion rates for evaluation of kidney function in children. Pediatr Nephrol 2: 419–424

  9. 9.

    Bleiler RE, Schedl HP (1962) Creatinine excretion: variability and relationship to diet and body size. J Lab Clin Med 59: 945–955

  10. 10.

    Arant BS Jr, Edelmann CM Jr, Spitzer A (1972) The congruence of creatinine and inulin clearances in children: use of the Technicon Auto Analyzer. J Pediatr 81: 559–561

  11. 11.

    Schwartz GJ, Brion LP, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 34: 571–590

  12. 12.

    White RP, Samson FE Jr (1954) Determinations of inulin in plasma and urine by use of anthrone. J Lab Clin Med 43: 475–478

  13. 13.

    Brown D (1982) Creatinine Analyzer 2 operating manual. Beckman Instruments, Brea, California

  14. 14.

    Mak RHK, Dahhan JA, Azzopardi D, Bosque M, Chantler C, Haycock GB (1983) Measurement of glomerular filtration rate in children after renal transplantation. Kidney Int 23: 410–413

  15. 15.

    Hagstam KE, Nordenfelt I, Svensson TL, Svensson SE (1974) Comparison of different methods for determination of glomerular filtration rate in renal disease. Scan J Clin Lab Invest 34: 31–36

  16. 16.

    Counahan R, Chantler C, Ghazali S, Kirkwood B, Rose F, Barratt TM (1976) Estimation of glomerular filtration rate from plasma creatinine concentration in children. Arch Dis Child 51: 875–878

  17. 17.

    Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58: 259–263

  18. 18.

    Schwartz GJ, Feld LG, Langford DJ (1984) A simple estimate of glomerular filtration rate in full-term infants during the first year of life. J Pediatr 104: 849–854

  19. 19.

    Schwartz GJ, Gauthier B (1985) A simple estimate of glomerular filtration rate in adolescent boys. J Pediatr 106: 522–526

  20. 20.

    Brion LP, Fleischman AR, McCarton C, Schwartz GJ (1986) A simple estimate of glomerular filtration rate in low birth weight infants during the first year of life: noninvasive assessment of body composition and growth. J Pediatr 109: 698–707

  21. 21.

    Brion LP, Boeck MA, Gauthier B, Nussbaum MP, Schwartz GJ (1989) Estimation of glomerular filtration rate in anorectic adolescents. Pediatr Nephrol 3: 16–21

  22. 22.

    Morris MC, Allanby CW, Toseland P, Haycock GB, Chantler C (1982) Evaluation of a height/plasma creatinine formula in the measurement of glomerular filtration rate. Arch Dis Child 57: 611–615

  23. 23.

    Davies JG, Taylor CM, White RHR, Marshall T (1982) Clinical limitations of the estimation of glomerular filtration rate from height/plasma creatinine ratio: a comparison with simultaneous Cr edetic acid slope clearance. Arch Dis Child 57: 607–610

  24. 24.

    Chantler C, Barratt TM (1972) Estimation of glomerular filtration rate from plasma clearance of 51-chromium edetic acid. Arch Dis Child 47: 613–617

Download references

Author information

Correspondence to Stanley Hellerstein.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hellerstein, S., Alon, U. & Warady, B.A. Creatinine for estimation of glomerular filtration rate. Pediatr Nephrol 6, 507–511 (1992). https://doi.org/10.1007/BF00866485

Download citation

Key words

  • Glomerular filtration rate
  • Inulin clearance
  • Creatinine clearance
  • Plasma creatinine
  • Calculated creatinine clearance