Creatinine Clearance 24 hrs

Kidney

Report in 24Hrs

At Home

No Fasting Required

Details

Kidney function estimation (urine+serum).

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Creatinine Clearance 24 hrs - Comprehensive Medical Test Guide

Why is it done?
- Test Description: Measures the amount of creatinine filtered from the blood by the kidneys over a 24-hour period. This test estimates glomerular filtration rate (GFR), which reflects how well the kidneys are functioning.
- Primary Indications: Assess kidney function and detect renal disease progression; evaluate patients with elevated serum creatinine; monitor kidney function in patients with diabetes, hypertension, or chronic kidney disease; determine medication dosing for drugs eliminated by kidneys; evaluate proteinuria or hematuria; assess transplant kidney function
- Typical Timing: Routinely ordered during initial evaluation of kidney function; performed at regular intervals (every 6-12 months) for chronic kidney disease monitoring; before starting nephrotoxic medications; annually in patients with diabetes or hypertension
Normal Range
- Reference Values: Male: 90-140 mL/min (or 0.75-1.17 mL/s) Female: 80-125 mL/min (or 0.67-1.04 mL/s) Values vary with age, body surface area, and muscle mass
- Units of Measurement: mL/min/1.73m² (milliliters per minute per 1.73 square meters of body surface area) or mL/s
- Age-Related Considerations: Creatinine clearance decreases with age (approximately 1 mL/min per year after age 40); elderly patients may have normal serum creatinine but reduced creatinine clearance; expected decline is approximately 0.75 mL/min/year in healthy individuals
- Interpretation Guide: Normal: ≥90 mL/min indicates adequate kidney function Borderline: 60-89 mL/min suggests mild decrease in kidney function Low: <60 mL/min indicates significant kidney impairment Critically Low: <15 mL/min suggests advanced renal failure
Interpretation
- Normal Results (≥90 mL/min): Kidney function is adequate for age and sex; no evidence of significant renal disease; patient can typically tolerate normal medication dosing
- Mildly Decreased (60-89 mL/min): Stage 2 Chronic Kidney Disease; mild decline in kidney function; investigate underlying cause; monitor with serial measurements; may need medication dose adjustment for renally-eliminated drugs
- Moderately Decreased (45-59 mL/min): Stage 3a Chronic Kidney Disease; moderate loss of kidney function; requires investigation and management; medication dosing adjustments needed; increased risk for cardiovascular disease and bone disease
- Severely Decreased (30-44 mL/min): Stage 3b Chronic Kidney Disease; significant kidney dysfunction; close monitoring required; referral to nephrologist recommended; careful medication selection and dosing; evaluate for complications
- Very Severely Decreased (15-29 mL/min): Stage 4 Chronic Kidney Disease; severe loss of kidney function; regular nephrologist visits essential; prepare for renal replacement therapy; manage mineral bone disorder and anemia
- Kidney Failure (<15 mL/min): Stage 5 Chronic Kidney Disease; end-stage renal disease (ESRD); urgent dialysis or transplant evaluation needed; significant metabolic complications
- Factors Affecting Readings: Incomplete urine collection; pregnancy (increases GFR); dehydration; intense exercise; high protein diet; muscle mass variations; certain medications (ACE inhibitors, NSAIDs); body composition and obesity; recent illness or surgery
- Clinical Significance: More accurate than serum creatinine alone for assessing kidney function; accounts for variations in age, sex, and body composition; essential for determining appropriate medication dosing; helps stage severity of chronic kidney disease; predicts progression of renal disease
Associated Organs
- Primary Organ System: Kidneys (renal system); glomeruli specifically responsible for filtering blood and removing waste
- Commonly Associated Diseases and Conditions: Type 1 and Type 2 Diabetes Mellitus; Chronic hypertension; Chronic glomerulonephritis; Polycystic kidney disease; Lupus nephritis; IgA nephropathy; Nephrotic syndrome; Nephritic syndrome; Pyelonephritis; Acute tubular necrosis; Interstitial nephritis; Diabetic nephropathy; Drug-induced kidney disease; Obstructive nephropathy
- Related Organ System Involvement: Cardiovascular: Hypertension, heart disease, atherosclerosis; Skeletal: Mineral bone disorder, renal osteodystrophy; Hematopoietic: Anemia from erythropoietin deficiency; Nervous: Uremic encephalopathy; Metabolic: Acid-base imbalances, electrolyte disorders
- Potential Complications of Abnormal Results: Uremia and uremic toxins; Fluid overload and edema; Uncontrolled hypertension; Electrolyte abnormalities (hyperkalemia, hypocalcemia); Secondary hyperparathyroidism; Renal anemia; Accelerated atherosclerosis; Progressive cardiovascular disease; Bone disease and fracture risk; Progression to end-stage renal disease requiring dialysis or transplantation
Follow-up Tests
- Recommended Based on Abnormal Results: Serum creatinine level; Blood urea nitrogen (BUN); Electrolyte panel (sodium, potassium, chloride, CO2); Phosphorus and calcium levels; Parathyroid hormone (PTH); Complete blood count (CBC); Urinalysis with microscopy; Urine protein quantification; Renal ultrasound or imaging; Renal biopsy (if etiology unclear)
- Monitoring Frequency for Chronic Kidney Disease: Stage 2 (GFR 60-89): Annual testing; Stage 3a (GFR 45-59): Every 6-12 months; Stage 3b (GFR 30-44): Every 3-6 months; Stage 4 (GFR 15-29): Monthly or more frequent; Stage 5 (GFR <15): Regular monitoring during dialysis or transplantation
- Complementary Tests for Complete Assessment: Cystatin C (alternative GFR marker); Estimated GFR (eGFR) calculations; Albumin-to-creatinine ratio; Blood glucose monitoring; Lipid panel; Blood pressure monitoring; Abdominal imaging for kidney size and structure; Bone density screening
- Additional Testing Considerations: Serologic testing (ANA, ANCA) if autoimmune disease suspected; Imaging studies for obstructive pathology; Genetic testing for hereditary kidney diseases; Renal artery duplex or CT angiography if renal artery stenosis suspected; Immunology panel for kidney transplant candidates
Fasting Required?
- Fasting Requirement: NO - Fasting is NOT required for 24-hour creatinine clearance testing
- Patient Preparation Instructions: Maintain normal fluid intake; Avoid excessive fluid consumption or dehydration on collection day; Continue all regular medications unless specifically instructed otherwise by physician; Document any current medications being taken; Maintain normal diet and activity level; Avoid strenuous exercise during the collection period
- Medications to Continue: All regular medications should be continued as prescribed; Do not discontinue or modify doses without physician approval; Inform provider of all medications including over-the-counter drugs and supplements
- 24-Hour Urine Collection Procedure: Void first morning urine into toilet (discard); Begin collection from next void; Collect all urine for 24 hours in provided container; End collection with first morning void next day; Keep container at room temperature or refrigerated as instructed; Record exact start and end times; Measure total urine volume if not collected in marked container; Bring specimen to laboratory as directed
- Additional Requirements: Serum creatinine blood sample collected during collection period; Height and weight needed for body surface area calculation; Accurate timing of collection period is critical; Record any incomplete collection for provider notification; Notify lab if collection was interrupted; Provide information on current health status or recent illness

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