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

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

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...

Serum Studies: Renal Function Tests

Serum Studies: Renal Function Tests

Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...

Renal Clearance

Renal Clearance

The glomerular filtration rate (GFR) is a critical marker of kidney function, reflecting the efficiency of filtration by the glomeruli. Renal clearance of specific substances, such as inulin or creatinine, is commonly used to measure GFR.
Renal clearance refers to the volume of plasma cleared of a specific substance, such as creatinine, per unit of time. To measure clearance, urine samples are collected over a 24-hour period during each bladder voiding, followed by a single blood sample at the...

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...

Factors Affecting Renal Clearance: Renal Impairment

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...

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Updated: Jun 9, 2026

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice

Published on: August 9, 2013

Creatinine.

Shigehiko Uchino¹

¹Department of Anesthesiology, Intensive Care Unit, Jikei University School of Medicine, Tokyo, Japan. s.uchino@jikei.ac.jp

Current Opinion in Critical Care

|August 26, 2010

Summary

This summary is machine-generated.

Creatinine remains a dominant renal biomarker despite new options like neutrophil gelatinase-associated lipocalin and cystatin C showing promise in diagnosing acute kidney injury. Further research is needed to confirm their superiority and impact on patient outcomes.

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Assessment of Kidney Function in Mouse Models of Glomerular Disease

Assessment of Kidney Function in Mouse Models of Glomerular Disease

Published on: June 30, 2018

Area of Science:

Nephrology
Biomarker Discovery
Clinical Diagnostics

Background:

Creatinine is a long-established biomarker for kidney function.
Its utility is limited in modifying patient outcomes.
New biomarkers offer potential advancements in kidney disease assessment.

Purpose of the Study:

To review the historical and current role of creatinine as a renal biomarker.
To evaluate emerging kidney biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C.
To compare the development of renal biomarkers with those in other diseases, like troponins and procalcitonin.

Main Methods:

Literature review and synthesis of existing clinical studies.
Comparative analysis of creatinine versus novel renal biomarkers (NGAL, cystatin C).
Exploration of biomarker applications in diagnosis, severity classification, and outcome prediction.

Main Results:

New renal biomarkers (NGAL, cystatin C) demonstrate faster and more accurate diagnosis of acute kidney injury (AKI).
These novel biomarkers show a stronger correlation with AKI severity and better outcome prediction than creatinine.
Creatinine is effective for diagnosis, severity, and prediction but not outcome modification.

Conclusions:

While NGAL and cystatin C show significant promise, further interventional studies are required to establish their superiority over creatinine.
Demonstrating improved patient outcomes, particularly mortality reduction, is crucial for widespread adoption of new biomarkers.
Creatinine is likely to remain the standard in clinical practice due to historical data, familiarity, and ongoing use, pending sufficient evidence for alternatives.