The creatinine test measures urine levels of creatinine, the chief metabolite of creatine. Produced in amounts proportional to total body muscle mass, creatinine is removed from the plasma primarily by glomerular filtration and is excreted in the urine. Because the body doesn't recycle it, creatinine has a relatively high, constant clearance rate, making it an efficient indicator of renal function. However, the creatinine clearance test, which measures both urine and plasma creatinine clearance, is a more precise index than this test. A standard method for determining urine creatinine levels is based on Jaffe's reaction, in which creatinine treated with an alkaline picrate solution yields a bright orange-red complex.
Procedure and posttest care
Normally, urine creatinine levels range from less than 0.8 to 1.8 g/24 hours in males and from 0.6 to 1.6 g/24 hours in females.
Decreased urine creatinine levels may result from impaired renal perfusion (associated with shock, for example) or from renal disease due to urinary tract obstruction. Chronic bilateral pyelonephritis, acute or chronic glomerulonephritis, and polycystic kidney disease may also depress creatinine levels. Increased levels generally have little diagnostic significance.
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