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.
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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
- Glomerular filtration rate
- Inulin clearance
- Creatinine clearance
- Plasma creatinine
- Calculated creatinine clearance