CREATININE

ESTIMATION
BY
DR.S.RAJAKUMARI M.D BIOCHEMISTRY
Methods
1.Alkaline picrate Method—Jaffe’s Method

2.Lloyd’s Method
 Jaffe ‘s Method
Principle:
Creatinine reacts with alkaline picrate reagent to form reddish
orange coloured complex known as creatinine picrate. This colour is
measured in calorimeter at 490nm blue green filter. The intensity of
the colour is directly proportional to the conentration of creatinine in
the sample.
PROCEDURE-3 large test tube Name as blank, standard, and
test- wait for 10min measure -490 nm (Blue green filter)
Reagent BLANK (B) STANDARD(S) TEST(T)
PICRIC ACID 1ml 1ml 1ml

0.75 NAOH 1ml 1ml 1ml

Serum or plasma 3ml

standard 3ml

Distilled water 3ml

 Calculation
• Creatinine present in 100ml of plasma =
O.D (T)-O.D(B) Concentration of std 100

O.D (S)-O.D(B) Volume of sample

T---B 2
S---B
Result
• Creatinine present in 100 ml of serum/plasma = mg/dl
Normal values
Normal level of creatinine in blood is 0.6-1.2mg/dl in females.
0.7 -1.4 mg /dl in males

Normal excretion of creatinine per day 1.5-2.5gms/24hrs

Clinical interpretation
Increase in blood creatinine
1. Renal diseases
2. congestive heart failure.
3. obstruction of urinary tract
• Creatinine clearance
It is the number of ml of blood which contains the creatinine excreted
in a minute by the kidneys
creatinine clearance =mg creatinine excreted per minute
mg creatinine per ml blood
UV
p
U=concentration of creatinine in urine
V=volume of urine excreted per minute
p= plasma creatinine concentration.
• Normal Range:
clearance in males: 85-125ml/min
clearance in females :80 - 115ml / min

Measuerment of clearance is a test of glomerular filtration rate.

• 56 year old man presented to a family doctor with loss of weight, loss of
appetite, generalised weakness and lethargy of 6 months duration. His
urine output is reduced.
O/E: Pt .is anaemic, emaciated
PR: 110/min, BP: 140 /100 mm Hg

(5 marks)
1. What is your provisional diagnosis?
2.Mention the relevant Blood and Urine investigations in this case.
3 .Mention the normal reference range of the relevant parameters.
• Write the principle and procedure of estimation of Creatinine in
Blood. (5 marks)

• Estimate the amount of Creatinine in the given sample.

(5 marks)

• Discussion. (10 marks)

1. CHRONIC RENAL FAILURE
BLOOD INVESTIGATIONS:
Serum Creatinine
Blood urea
Plasma glucose (fasting & postprandial)
Serum electrolytes
Serum chloride
Serum bicarbonate
Serum total protein
Lipid profile
Blood gas Analysis PH, Pco2,po2
• URINE INVESTIGATIONS:
• Urine Volume
• Urine Specific Gravity
• Urine Protein Creatinine ratio
• Urine Creatinine
• . NORMAL REFERENCE RANGE
• Serum Creatinine - 0.6 - 1.2 mg /dl
• Blood Urea - 15 - 40 mg /dl
• Plasma Glucose (F) - 60 - 100 mg /dl
• (pp) - 90 - 140 mg /dl
• Serum Electrolytes
• Serum Sodium – 136 - 145 mEq /L
• Serum Potassium - 3.5 - 5.5 mEq /L
• Serum Chloride - 96 - 106 mEq /L
• Serum Bicarbonate - 22 - 26 mEq /L
•
Urine volume 1.5 -2 L /day

Urine specific gravity -1.015 1.025

Urine Protein Creatinine ratio <0.2

Urine Creatinine - 1.5 - 2 g/day