Description

 


Overviwe:

Sometimes it is assumed that a normal serum creatinine level is associated with a normal creatinine clearance. It may be necessary to directly measure the creatinine clearance in trauma patients with a normal serum creatinine.

 

Reasons for measuring creatinine clearance in a trauma patient with a normal serum creatinine:

(1) detection of high creatinine clearance > 120 mL per min per 1.73 square m

(2) detection of low creatinine clearance

 

A patient with a high creatinine clearance will show poor response to medications cleared by the kidneys associated with low serum levels. Similarly a patient with a low creatinine clearance will show accumulation of a renally cleared drug.

 

Patients at risk for high creatinine clearance with creatinine in the normal reference range:

(1) young males (tend to have a larger muscle mass)

(2) polytrauma or burns

(3) high urine output

 

Patients at risk for low creatinine clearance with creatinine in the normal reference range:

(1) elderly adult with low muscle mass

(2) low urine output

 

In these patients a simple estimate of creatinine clearance based on the serum creatinine value may be misleading.

 


To read more or access our algorithms and calculators, please log in or register.