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Reciprocal serum creatinine concentration and chronic kidney disease

Anthony Bleyer, MD, MS
Section Editors
Gary C Curhan, MD, ScD
Richard H Sterns, MD
Deputy Editor
John P Forman, MD, MSc


Calculation of the creatinine clearance to estimate glomerular filtration rate (GFR) is based upon the fact that creatinine is freely filtered and not reabsorbed. Thus, if creatinine secretion is ignored, all of the filtered creatinine (equal to the product of the GFR and the serum creatinine concentration [SCr]) is equal to all of the excreted creatinine (equal to product of the urine creatinine concentration [UCr] and the urine flow rate). Thus:

 GFR  x  SCr  =  UCr  x  V

 GFR  =  [UCr  x  V]/SCr

If muscle mass remains constant, then creatinine production and therefore creatinine excretion (UCr  x  V) will be relatively constant. Thus, the last equation can be simplified to the GFR being directly proportional to the reciprocal of the serum creatinine concentration. In the clinic, monitoring the reciprocal serum creatinine concentration over time is an effective means of evaluating temporal changes in renal function.

The methods required to use the reciprocal serum creatinine concentration to follow changes in renal function over time will be reviewed here. A graph is also provided to help the clinician in performing this task. A detailed discussion of the use of the serum creatinine concentration and the creatinine clearance to estimate GFR, including drugs that interfere with either creatinine secretion or the assay used to measure the serum creatinine, is presented separately. (See "Assessment of kidney function".)

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Literature review current through: Nov 2017. | This topic last updated: Dec 12, 2017.
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