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The page below is a sample from the LabCE course Chronic Kidney Disease. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Creatinine Clearance

The assessment of kidney function using renal clearance of creatinine was originally reported in the early 20th century (Rehberg, 1926) with a method for estimating GFR using endogenous creatinine in 1940 (Steinitz, 1940). Using the concentration of creatinine in urine and serum as well as the volume of urine collected over a known timeframe, an estimate of GFR can be determined.
For the most accurate estimates of creatinine clearance, urine collections over 24 hours are typically employed; however, ensuring complete urinary collection is fraught with difficulty, limiting the accuracy of these studies. Moreover, plasma clearance of biomarkers is not best estimated using a single timepoint - as such, GFR estimates by creatinine clearance may be falsely increased.