Received on ,
Accepted on ,

General Clinical Chemistry

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

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
⁸ Diagnostica e Ricerca San Raffaele S.p.A. Milano, Italy, and University of Virginia Health System, Department of Pathology, Charlottesville, VA, and Roche Diagnostics, Mannheim, Germany, and Laboratoire de Biologie Clinique, Centre de Médicine Préventive, Vandoeuvre-lès-Nancy, France, and Servei de Bioquímica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, and Department of Clinical Sciences, 'Luigi Sacco,' University of Milan, Milan, Italy

^* To whom correspondence should be addressed. 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 report 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.