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Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

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In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...
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[Elevated serum creatinine without discernible kidney disease].

G Schley1, N Höfliger, M Vogt

  • 1Medizinische Klinik, Zuger Kantonsspital.

Deutsche Medizinische Wochenschrift (1946)
|March 19, 2009
PubMed
Summary

Sarcosinemia can cause falsely elevated creatinine levels detected by dry chemical enzyme tests. If sarcosinemia is suspected, confirm serum creatinine with an alternative laboratory method.

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Area of Science:

  • Biochemistry
  • Clinical Chemistry
  • Metabolic Disorders

Background:

  • Elevated serum creatinine is a common indicator of kidney dysfunction.
  • Dry chemical enzyme assays are widely used for routine laboratory testing.

Observation:

  • A patient presented with incidentally elevated serum creatinine (2.7 mg/dl) on dry chemical testing.
  • Subsequent tests revealed normal creatinine, but elevated plasma and urine sarcosine levels.
  • Kidney function tests and imaging were unremarkable.

Findings:

  • The elevated serum sarcosine levels interfered with the dry chemical creatinine assay, leading to a false positive result.
  • Sarcosinemia, an inborn error of amino acid metabolism, was diagnosed.

Implications:

  • Dry chemical enzyme assays may yield inaccurate creatinine results in patients with sarcosinemia.
  • Alternative laboratory methods are recommended for creatinine measurement when sarcosinemia is suspected.
  • This highlights the importance of considering metabolic disorders in unexplained laboratory abnormalities.