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HelpTest Code CRCL Creatinine Clearance, Serum and 24-Hour Urine
Reporting Name
Creatinine ClearancePerforming Laboratory
Mayo Clinic Laboratories in Rochester
Useful For
Estimation of glomerular filtration rate
Method Name
Enzymatic Colorimetric Assay
Necessary Information
1. 24-Hour volume is required.
2. Patient's height in centimeters and weight in kilograms are required.
Specimen Required
Both serum and urine are required. Serum must be collected no earlier than 72 hours before start of urine collection and no later than 72 hours after urine collection is completed.
Specimen Type: Serum
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Centrifuge and aliquot serum into plastic vial.
2. Label specimen as serum.
Specimen Type: Urine
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Specimen Volume: 5 mL
Collection Instructions:
1. Collect urine for 24 hours.
2. Refrigerate specimen within 4 hours of completion of 24-hour collection.
3. Label specimen as urine.
Additional Information: For multiple collections see Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens
Specimen Type
SerumUrine
Specimen Minimum Volume
Serum: 0.5 mL
Urine: 1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | ||
| Frozen | |||
| Urine | Refrigerated (preferred) | ||
| Ambient | |||
| Frozen | |||
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
Reference Values
CREATININE CLEARANCE
Males:
0-18 years: Not established
19-75 years: 77-160 mL/min/body surface area (BSA)
≥76 years: Not established
Females:
0-17 years: Not established
18-29 years: 78-161 mL/min/BSA
30-39 years: 72-154 mL/min/BSA
40-49 years: 67-146 mL/min/BSA
50-59 years: 62-139 mL/min/BSA
60-72 years: 56-131 mL/min/BSA
≥73 years: Not established
CREATININE, URINE:
Reported in units of mg/dL
CREATININE, SERUM
Males:
0-11 months: 0.17-0.42 mg/dL
1-5 years: 0.19-0.49 mg/dL
6-10 years: 0.26-0.61 mg/dL
11-14 years: 0.35-0.86 mg/dL
≥15 years: 0.74-1.35 mg/dL
Females:
0-11 months: 0.17-0.42 mg/dL
1-5 years: 0.19-0.49 mg/dL
6-10 years: 0.26-0.61 mg/dL
11-15 years: 0.35-0.86 mg/dL
≥16 years: 0.59-1.04 mg/dL
Estimated glomerular filtration rate (eGFR)
≥18 years old: ≥60 mL/min/BSA
eGFR calculated using the 2021 CKD-EPI creatinine equation
Note: eGFR results will not be calculated for patients younger than 18 years old.
Interpretation
Decreased creatinine clearance indicates decreased glomerular filtration rate (GFR). This can be due to conditions such as progressive kidney disease or result from adverse effect on renal hemodynamics that are often reversible, including drug effects or decreases in effective renal perfusion (eg, volume depletion, heart failure).
Increased creatinine clearance is often referred to as hyperfiltration and is most commonly seen during pregnancy or in patients with early diabetes mellitus, before diabetic nephropathy has occurred. It may also occur with large dietary protein intake.
A major limitation of creatinine clearance is that its accuracy worsens in relation to the amount of tubular creatinine secretion. Often as GFR declines, the contribution of urine creatinine from tubular secretion increases, further increasing the discrepancy between true GFR and measured creatinine clearance.
Estimated GFR:
According to the Kidney Disease: Improving Global Outcomes (KDIGO) CKD work group, chronic kidney disease (CKD) is defined as the abnormalities of kidney structure of function, present for more than 3 months, with implications for health.(1,2) CKD should be classified by cause, GFR category, and albuminuria category.(1,2)
KDIGO guidelines provide the following GFR categories(1,2):
|
Stage |
Terms |
GFR mL/min/1.73 m(2) |
|
G1* |
Normal or high |
90 |
|
G2* |
Mildly decreased |
60 to 89 |
|
G3a |
Mildly to moderately decreased |
45 to 59 |
|
G3b |
Moderately to severely decreased |
30-44 |
|
G4 |
Severely decreased |
15-29 |
|
G5 |
Kidney failure |
<15 |
*In the absence of evidence of kidney damage, neither G1 nor G2 fulfill criteria for CKD.
Urinary albumin excretion can also be used to further subdivide CKD stages.
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 to 2 daysTest Classification
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.CPT Code Information
82575
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CRCL | Creatinine Clearance | 58446-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CRTSA | Creatinine, S | 2160-0 |
| EGFR1 | Estimated GFR (eGFR) | 98979-8 |
| CRE_U | Creatinine, U | 20624-3 |
| TM54 | Collection Duration (h) | 13362-9 |
| VL52 | Volume (mL) | 3167-4 |
| CRCL1 | Creatinine Clearance | 12195-4 |
Forms
If not ordering electronically, complete, print, and send a Renal Diagnostics Test Request (T830) with the specimen.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CRTS1 | Creatinine with eGFR, S | Yes | Yes |
| CRCU | Creatinine, U | No | Yes |