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→Serum creatinine: Cleanup; we don't use direct hyperlinks within articles - change in testing noted |
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Diagnostic serum creatinine studies are used to determine renal function.<ref name="Lewis_2016" /> The reference interval is 0.6–1.3 mg/dL (53–115 μmol/L).<ref name="Lewis_2016" /> Measuring serum creatinine is a simple test, and it is the most commonly used indicator of renal function.<ref name=ClinChem89>{{cite book| vauthors = Taylor EH |title=Clinical Chemistry|year=1989|publisher=Wiley |isbn=0-471-85342-9 |oclc=19065010 |pages=4, 58–62}}</ref>
A rise in blood creatinine concentration is a late marker, observed only with marked damage to functioning [[nephron]]s. Therefore, this test is unsuitable for detecting early-stage [[kidney disease]]. A better estimation of kidney function is given by calculating the estimated glomerular filtration rate (eGFR). eGFR can be accurately calculated without a 24-hour urine collection using serum creatinine concentration and some or all of the following variables: sex, age, weight
A concern as of late 2010 relates to the adoption of a new analytical methodology, and a possible impact this may have in clinical medicine. Most clinical laboratories now align their creatinine measurements against a new standardized [[isotope dilution mass spectrometry]] (IDMS) method to measure serum creatinine. IDMS appears to give lower values than older methods when the serum creatinine values are relatively low, for example 0.7 mg/dL. The IDMS method would result in a comparative overestimation of the corresponding calculated GFR in some patients with normal renal function. A few medicines are dosed even in normal renal function on that derived GFR. The dose, unless further modified, could now be higher than desired, potentially causing increased drug-related toxicity. To counter the effect of changing to IDMS, new FDA guidelines have suggested limiting doses to specified maxima with carboplatin, a chemotherapy drug.<ref>{{cite web|url=https://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm228974.htm|archive-url=https://web.archive.org/web/20111119090611/https://www.fda.gov/AboutFDA/CentersOffices/CDER/ucm228974.htm|archive-date=2011-11-19|title=Carboplatin dosing|website=[[Food and Drug Administration]]|department=Center for Drug Evaluation and Research|url-status=dead}}</ref>
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