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Clinical Chemistry 54: 559-566, 2008. First published January 17, 2008; 10.1373/clinchem.2007.099648
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(Clinical Chemistry. 2008;54:559-566.)
© 2008 American Association for Clinical Chemistry, Inc.

General Clinical Chemistry

Reference Intervals for Serum Creatinine Concentrations: Assessment of Available Data for Global Application

Ferruccio Ceriotti1,a, James C. Boyd2, Gerhard Klein3, Joseph Henny4, Josep Queraltó5, Veli Kairisto6, Mauro Panteghini7 on behalf of the IFCC Committee on Reference Intervals and Decision Limits (C-RIDL)

1 Diagnostica e Ricerca San Raffaele S.p.A. Milano, Italy;2 University of Virginia Health System, Department of Pathology, Charlottesville, VA;3 Roche Diagnostics, Mannheim, Germany;4 Laboratoire de Biologie Clinique, Centre de Médicine Préventive, Vandoeuvre-lès-Nancy, France;5 Servei de Bioquímica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;6 Turku University Hospital, Laboratory Department, Turku, Finland;7 Department of Clinical Sciences, ‘Luigi Sacco,’ University of Milan, Milan, Italy.

aAddress correspondence to this author at: Diagnostica e Ricerca San Raffaele S.p.A. Via Olgettina 60, 20132 Milano, Italy. Fax +39 02 26432640; e-mail ceriotti.ferruccio{at}hsr.it.

Background: Reference intervals for serum creatinine remain relevant despite the current emphasis on the use of the estimated glomerular filtration rate for assessing renal function. Many studies on creatinine reference values have been published in the last 20 years. Using criteria derived from published IFCC documents, we sought to identify universally applicable reference intervals for creatinine via a systematic review of the literature.

Methods: Studies were selected for inclusion in the systematic review only if the following criteria were met: (a) reference individuals were selected using an "a priori" selection scheme, (b) preanalytical conditions were adequately described; (c) traceability of the produced results to the isotope dilution–mass spectrometry (IDMS) reference method was demonstrated experimentally, and (d) the collected data received adequate statistical treatment.

Results: Of 37 reports dealing specifically with serum creatinine reference values, only 1 report with pediatric data and 5 reports with adult data met these criteria. The primary reason for exclusion of most papers was an inadequate demonstration of measurement traceability. Based on the data of the selected studies, we have collated recommended reference intervals for white adults and children.

Conclusion: Laboratories using methods producing traceable results to IDMS can apply the selected reference intervals for serum creatinine in evaluating white individuals.




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 Ann Clin BiochemHome page
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Reference intervals: the way forward
Ann Clin Biochem, January 1, 2009; 46(1): 8 - 17.
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