To help detect and evaluate kidney dysfunction or decreased blood flow to the kidneys
Creatinine Clearance
Your doctor will request this test if he/she thinks that you may have a problem affecting how your kidneys work, such as a blockage within the kidney, damage to the kidneys, dehydration or fluid loss, or another disease, such as congestive heart failure. Creatinine clearance may also be measured before you are given certain drugs which rely on good kidney function in order to allow the drugs to be removed from the body. Another way of measuring how well your kidneys are working, commonly used across the UK, includes the “estimated glomerular function rate“ (eGFR) which is calculated from a single blood sample taken from a vein in your arm. This is an ‘estimation’ as there is no direct or simple way of measuring kidney function.
Two samples are needed, both a urine sample (all the urine is collected over a 24-hour period) and a blood sample taken from a vein in your arm.
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How is it used?
The creatinine clearance test is used to help evaluate the rate and efficiency of kidney filtration. It is used to help detect kidney dysfunction resulting from either kidney disease or decreased blood flow to the kidneys
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When is it requested?
The test may be requested if you suffer from kidney disease or a condition known to stop kidneys working such as congestive heart failure, or diabetes. It may also be requested before starting some drugs, which rely on well working kidneys to prevent toxic (poisonous) side effects.
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What does the test result mean?
An example of a normal creatinine clearance is 100 mL/minute. You may find it useful to consider your results in percentage terms. For example if your creatinine clearance is 50, then you have lost about 50% of your kidney function. This may be a permanent or temporary loss. A low creatinine clearance may indicate a drop in the amount of blood filtered by the kidney either due to disease within the kidney cells or to less blood getting to the kidneys. Congestive heart failure, diabetes, dehydration, shock (meaning losing a lot of fluid from the body for example if someone was to bleed after an accident or operation), blockage within the kidney, or acute or chronic kidney failure are among the possible causes.
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Are there other ways to estimate or determine the Glomerular Filtration Rate (GFR) of my kidneys?
Yes. The GFR can be estimated using the result of a blood creatinine test and a calculation. (See the article on eGFR).
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Is there anything else I should know?
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What should I do if I forget to save one urine sample during the collection?
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Is this test extremely accurate?
There are other, more involved tests that have higher accuracy. However, these are more complex for the patient and doctor and involve injecting a radioactive tracer in the patient. For most purposes, the accuracy of creatinine clearance is good enough. The estimated GFR produces very similar information, and does not require a urine collection. Creatinine clearance measurement is now rarely done except for some drug dose decisions (particularly for some chemotherapy) and in children (where eGFR calculations cannot be so accurate but usually only prior to giving specific drugs).
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Can I perform this test at home?
No. The test requires analysis in an accredited laboratory and calculations by skilled personnel.