Creatinine, Serum

Creatinine, Serum

CPT Test code: 82565

Test Includes: Creatinine, serum; eGFR calculation
Specimen: Serum (preferred) or plasma
Volume: 1 mL
Minimum Volume: 0.5 mL
Container: Gel-barrier tube, red-top tube, green-top (heparin) tube, or lavender-top (EDTA) tube
Collection: Separate serum or plasma from cells within 45 minutes of collection.
Storage Instructions: Maintain specimen at room temperature.1
Causes for Rejection: Hemolysis; improper labeling
Reference Interval:
Age Female*




*LabCorp internal studies.
Age/sex regardless 0.57-1.00 0.76-1.27
<2 mo 0.44-1.19 0.44-1.19
2-11 mo 0.17-1.18 0.17-1.18
1 y to <3 y 0.19-0.42 0.19-0.42
3 y to <5 y 0.26-0.51 0.26-0.51
5 y to <7 y 0.30-0.59 0.30-0.59
7 y to <9 y 0.37-0.62 0.37-0.62
9 y to <11 y 0.39-0.70 0.39-0.70
11 y to <13 y 0.42-0.75 0.42-0.75
13 y to <15 y 0.49-0.90 0.49-0.90
≥15 y 0.57-1.00 0.76-1.27
Use: A renal function test used in eGFR calculation.2

High creatinine: Renal diseases and insufficiency with decreased glomerular filtration, urinary tract obstruction, reduced renal blood flow including congestive heart failure, shock, and dehydration; rhabdomyolysis can cause elevated serum creatinine.

Low creatinine: Small stature, debilitation, decreased muscle mass; some complex cases of severe hepatic disease can cause low serum creatinine levels. In advanced liver disease, low creatinine may result from decreased hepatic production of creatinine and inadequate dietary protein as well as reduced muscle mass.3

Limitations: With reduced renal blood flow, creatinine rises less quickly than urea nitrogen. Concentration of creatinine only becomes abnormal when about half or more of the nephrons have stopped functioning in chronic progressive renal disease. Antibiotics containing cephalosporin lead to significant false-positive values if samples are drawn within four hours of a dose.4 With severe renal disease, creatinine is not reliable in the presence of cefoxitin therapy. There is less interference reported from the cephalosporins cephalothin, cephaloridine, cephadrine sodium, and cephaloglycin dihydrate. Lipemia, hemolysis, and bilirubin may interfere.5,6
Footnotes: 1. LabCorp Internal Studies.

2. Levey AS, Stevens LA, Schmid CH; CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration), “A New Equation to Estimate Glomerular Filtration Rate,” Ann Intern Med, 2009, 150(9):604-12.PubMed 19414839

3. Takabatake T, Ohta H, Ishida Y, et al, “Low Serum Creatinine Levels in Severe Hepatic Disease,” Arch Intern Med, 1988, 148(6):1313-5.PubMed 3377614

4. Durham SR, Bignell AH, Wise R, “Interference of Cefoxitin in the Creatinine Estimation and its Clinical Relevance,” J Clin Pathol, 1979, 32(11):1148-51.PubMed 512029

5. Bowers LD, Wong ET, “Kinetic Serum Creatinine Assays. II: A Critical Evaluation and Review,” Clin Chem, 1980, 26(5):555-61.PubMed 7020989

6. Soldin SJ, Henderson L, Hill JG, “The Effect of Bilirubin and Ketones on Reaction Rate Methods for the Measurement of Creatinine,” Clin Biochem, 1978, 11(3):82-6.PubMed 688598