Creatinine Estimated Glomerular Filtration Rate 24 Hour Urine

Glomerular filtration rate (GFR) is the sum of filtration rates in all functioning nephrons and so an estimation of the GFR provides a measure of functioning nephrons of the kidney. A decrease in GFR implies either progressive renal disease, or a reversible process causing decreased nephron function (eg, severe dehydration). Creatinine is derived from the metabolism of creatine from skeletal muscle and dietary meat intake, and is released into the circulation at a relatively constant rate. Thus, the serum creatinine concentration is usually stable. Creatinine is freely filtered by glomeruli and not reabsorbed or metabolized by renal tubules. However, approximately 15% of excreted urine creatinine is derived from proximal tubular secretion. Decreased creatinine clearance indicates decreased glomerular filtration rate (GFR). This can be due to conditions such as progressive renal disease, or result from adverse effect on renal hemodynamics that are often reversible, including drug effects or decreases in effective renal perfusion (eg, volume depletion, heart failure). Increased creatinine clearance is often referred to as hyperfiltration and is most commonly seen during pregnancy or in patients with diabetes mellitus, before diabetic nephropathy has occurred. It may also occur with large dietary protein intake.

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