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Taif University

College of Medicine
Biochemistry Practical for 2nd MBBS
Name: -----------------------------------

ID: -------------------

Determination of Creatinine
Sample: -------------------------------------Wave length: -----------------------------------------Absorbance of the unknown sample: ---------------------------Absorbance of the standard: -----------------------------------Calculation

1. What the creatinine test is used for.

2. State the reference ranges of creatinine.

3.What are the cases in that may change creatinine level.

3. What are the factors that may affect the creatinine test result.

Clinical Significance of Creatinine

Structure of creatinine

Metabolism of creatinine
Creatine phosphate is used in skeletal muscle contraction. Creatinine is a breakdown
product of creatine. People with greater muscle mass produce a correspondingly greater
amount of creatine and have higher levels of serum creatinine than smaller people or
people with less muscle mass. Because creatinine is excreted by the kidneys, its level in
the blood is considered an indicator of kidney health. When the kidneys are functioning
normally, the blood creatinine level is relatively constant day to day, though minor
increases can occur after a high-protein meal.

Causes of Abnormal Creatinine


Increased blood creatinine is usually a sign of problems with kidney function. The
creatinine level is also raised with injury to muscle and during increased breakdown of
muscle tissue. Increases in muscle mass will also raise the level of serum creatinine.
Conversely, decreased muscle mass will decrease blood creatinine.

Kidney Damage and Creatinine


Any disease that affects the filtration process of the kidneys (glomerulus) will tend to
raise serum creatinine levels over time. Doubling of serum creatinine levels is indicative
of a 50 percent reduction in the filtration rate of the kidneys. Diseases linked to increased
creatinine levels include glomerulonephritis, pyelonephritis, diabetic nephropathy and
conditions such as shock and congestive heart failure that reduce blood flow through the
kidneys.

Muscle Damage and Creatinine


Muscle damage releases a protein called myoglobin into the bloodstream. Large amounts
of myoglobin are toxic to the kidneys so the serum creatinine levels rise.

Creatinine clearance test


this test seems more useful to measure the efficiency of glomerulus function. An
estimation of glomerulus filtration rate (GFR) can be calculated from the concentration
of creatinine in urine sample collected in 24 hours and from sample of plasma collected
within this period as shown in the following equation:
UV
GFR

=
P

U: Urinary creatinine concentration.


V: Volume of urine/24hour.
P: Plasma creatinine concentration.
Recently most of the laboratories have started to use the ratio between plasma urea and
plasma creatinine as an indicator test beside the creatinine clearance test to measure the
efficiency of glomerulus function.

Defects in creatinine clearance test


1. The kidney actively secretes creatinine substance so the creatinine concentration in
urine is higher than the true value therefore the creatinine clearance test overestimates the
glomerular filtration rate (GFR).
2. Creatinine concentration in plasma is affected by diet (meat)
3.Exercise also increases the concentration of the creatinine so it is recommended to do
this test under rest condition.
4. There are numbers of cases in which creatinine concentration is found decreased in
plasma, these include: starvation, after surgery, corticosteroids therapy, during pregnancy