Clinical significance of serum creatinine determination

Serum creatinine concentration is mainly dependent on glomerular filtration function. But serum creatinine and creatinine clearance rate is not exactly the same, creatinine clearance rate is more sensitive than serum creatinine. In the early stage of renal dysfunction (compensatory period), creatinine clearance decreased and serum creatinine was normal. When the glomerular filtration rate dropped to normal more than 50%, serum creatinine began to rise rapidly, so when the serum creatinine was significantly higher than normal, often that renal function has been seriously damaged. As creatinine clearance rate is also affected by glomerular enrichment function, in the case of impaired renal function, serum creatinine is the most reliable indicator of glomerular function.

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 Normal male serum creatinine was 53-106gmol / L (0.6-1.2rug / d1) and 44.2-97.2gmol / L (0.5-1.1rug / d1) for women. Due to the amount of endogenous creatinine and the amount of muscle is related to the general every 20g muscle daily produce 1rug creatinine, so the muscles are particularly developed, the blood creatinine can be as high as 130gmol / L; and particularly thin people, the blood creatinine can only 26.5gmol / L, if the patient serum creatinine more than 132gmol / L, the glomerular may have been seriously damaged. In addition to weight loss, the normal pregnancy due to increased glomerular filtration rate and fetal assimilation, serum creatinine is often lower than normal


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Normal creatinine only trace by the secretion of renal tubules, but also a trace of dispersion into the intestine. But uremic patients with renal tubular secretion increased, the amount of diffuse into the intestine can also reach 16% to 60% of the total. Uremic patients with upper digestive tract Streptococcus and enterococci can produce creatinine cleavage enzyme pyrophortic creatinine, so some uremic patients blood, urine creatinine concentration and endogenous creatinine clearance rate will fluctuate.

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