Creatinine Clearance Calculator

Medically reviewed by Dr. Benjamin Gibson, PAHM, PharmD, Certified Functional Specialist Dr. Benjamin Gibson Dr. Benjamin GibsonPAHM, PharmD, Certified Functional Specialist linkedin_icon
Written by , Senior Health & Wellness Writer Payal Karnik Senior Health & Wellness Writer Experience: 2.5 years
Edited by , Senior Editor Arshiya Syeda Senior Editor Experience: 7 years
Fact-checked by , Senior Health & Wellness Writer Sindhu Koganti Senior Health & Wellness Writer Experience: 6 years
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Creatinine clearance is the measure of the rate at which blood plasma is purged of creatinine per unit of time. Calculators for CrCl are available to estimate this value, offering a specific approach for its determination. This method is known for its speed and cost-effectiveness in assessing renal function. By evaluating the creatinine levels in both blood and urine, both CrCl and GFR can be determined (1).

Gender

System

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Inception And Use Of Creatinine Clearance Calculator Or CrCl

The Cockcroft and Gault formula (CG) was developed in 1973. It was developed from data sampling using 249 men with CCr of creatinine clearance from around 30 to 130 mL/m2. Calculations derived from this tool are estimates of creatinine clearance from the liver. Medical practitioners know how to estimate creatinine clearance using this tool (1), (2).

Creatinine Calculator Is A Tool That Helps

This formula used for producing results in the CrCl calculator is not recommended for use for real-time diagnosis as it has not been expressed as per the standardized creatinine values. Still, it is provided on various websites for research purposes only. It is not for the purposes of drug dosing calculation or for GFR estimation. The most effective ways of determining drug dosage is by the use of the CKD-EPI Creatinine Equation and the MDRD Study Equation. These equations showcased much more precise and accurate results compared to the Cockcroft and Gault formula (CG) (1), (3).

The Online Tools That Facilitate Us To Estimate Our Kidney Condition

While using the Cockcroft-Gault equation, certain corrections are needed, and experienced medical practitioners use the tool and are aware of the tweaking parameters. The online tool requires gender, age, weight, and serum creatinine (mg/dl). The formula used in online tools typically presents creatinine clearance level overestimated (10% to 30%).

The Process Of Calculation

Assumptions: For using the Adult Creatinine Clearance (CrCl) Calculator the following conditions are pre-requisite:

The patient is > 18 years of age

To be considered: The renal function is stable which means acute renal failure is excluded

Formulas Used:

Adult Males = [(140 – age in years) x (weight in kg)] ÷ 72 x serum Cr

Adult Females = 0.85 x [((140 – age in years) x (weight in kg)) ÷ 72 x serum Cr]

Creatinine Clearance Percentage Differs From GFR

MDRD or Modification of Diet in Renal Disease Study equation for the estimated GFR or Glomerular Filtration Rate is a suitable substitute for measured or estimated creatinine clearance. This is an index for adjustment of the drug doses in patients with major kidney injury or chronic kidney disease (1), (2). There remain doubts and other propositions that justify the injudicious use of the estimated Glomerular Filtration Rate as CCr may result in dosage errors and toxicity. And this is specifically in the case of drugs with narrow therapeutic indices.

The following list showcases normal creatinine clearance (1):

mg/dLmL/min
Men0.6 to 1.2107 to 139
Women0.5 to 1.187 to 107
Teenager0.5 to 1.0
Children0.3 to 0.7

*mg= milligrams

*dc=deciliter

Indications Of Kidney Failure Based On Conditions And Creatinine Clearance

Creatinine is considered to be a reliable factor indicating kidney functioning. High creatinine levels in a kidney are a sign of kidney disease or impaired kidney functioning. Creatinine level in blood rises due to poor creatinine clearance from the kidney. The use of a creatinine clearance calculator helps to check the kidney’s performance. If creatinine levels reach 2.0 or more in the case of babies and equal or more than 5.0 in the case of adults, it is an indication of kidney failure or severe kidney impairment. Certain symptoms of kidney failure are hypovolemia (low blood volume), dehydration, and abnormal blood inflow and outflow from the kidneys due to obstruction of the renal artery or vein (1).

What food should be avoided if creatinine is high?

  • Protein-rich food is advisable to be included in every meal. Some of the foods rich in protein are fish, meat, poultry, and pork. If you have diabetes and rarely eat meat, this will temporarily increase your creatinine levels. If you eat it consistently, the body will not raise the creatinine levels (4).
  • Avoiding phosphorus and potassium is a good idea (5).
  • Peanut butter, seeds, dried beans, nuts, and lentils are high in protein (6). Avoidance of these foods is essential as they are also high in phosphorus and potassium.
  • Use of lesser salt and intake of fewer salty foods is required as this reduces blood pressure and helps to arrest weight gain during sessions of dialysis (7).
  • It is wise to use spices, herbs, and low-salt flavor enhancers instead of using salt. Avoid high-fiber food and whole grains such as wheat bread or brown bread, brown rice, and bran cereal to limit phosphorus intake.
  • Limit your intake of milk, cheese, and yogurt as the phosphorus content in these foods is quite high.
  • Opting for berries and apples over oranges and yellow bananas is great because they will raise your blood glucose levels less. If you must eat a banana, eat a green one since it is less ripe. Instead of potatoes and asparagus, go for cabbage and broccoli (8).

Frequently Asked Questions

How do you calculate creatinine clearance in a 24-hour urine collection?

The doctor will advise blood and urine tests to estimate creatinine clearance in a 24-hour period (1).

What is low creatinine clearance?

Low creatinine clearance indicates a decline in normal kidney functioning resulting in higher amounts of serum creatinine (1).

What is the difference between CrCl and GFR?

Creatinine clearance (CrCl) is used to measure the amount of creatinine excreted by the kidneys with a 24-hour urine collection. GFR is an overall measure used to determine the glomerular filtration rate (which indicates how well your kidney filters (glomeruli) are functioning) (1).

Are GFR and CrCl interchangeable?

While CrCI may give an estimation of GFR, both are different and should not be used interchangeably (1).

References

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    1. Creatinine Clearance
      https://www.ncbi.nlm.nih.gov/books/NBK544228/
    2. Estimating Glomerular Filtration Rate: Cockcroft–Gault and Modification of Diet in Renal Disease Formulas Compared to Renal Inulin Clearance
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2676189/
    3. A New Equation to Estimate Glomerular Filtration Rate
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763564/
    4. Effect of a Cooked Meat Meal on Serum Creatinine and Estimated Glomerular Filtration Rate in Diabetes-Related Kidney Disease
      https://diabetesjournals.org/care/article/37/2/483/29467/Effect-of-a-Cooked-Meat-Meal-on-Serum-Creatinine
    5. Acute Kidney Injury
      https://www.ncbi.nlm.nih.gov/books/NBK441896/
    6. Composition of Nuts and Their Potential Health Benefits—An Overview
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10000569/
    7. Sodium Intake and Hypertension Sodium Intake and Hypertension
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770596/
    8. A glycemic diet improves the understanding of glycemic control in diabetes patients during their follow-up
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072118/

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