Which of the following statements about creatinine clearance test is true:
Correct Answer: Creatinine clearance may overestimate the actual GFR as renal function declines
Description: Answer is B (Creatinine clearance may overestimate the actual GFR as renal function declines) Creatinine clearance may overestimate the GFR as renal function declines, since secretion of creatinine from tubular cells is increased as renal function declines (when GFR decreases). Creatinine is an endogenous metabolite that is freely. filtered by the glomerulus but is also actively secreted by the proximal tubular cells into the renal tubules in very small amounts. In the steady state such 'Secretion' of creatinine into the tubules is minimal, however as GFR falls creatinine secretion is increased. Creatinine clearance thus over estimates the actual GFR especially in conditions with mild to moderate reductions in GFR. Inulin is still considered the 'Gold standard' test for assessing GFR. Inulin clearance is more accurate than creatinine clearance as Inulin is not secreted by tubular cells.
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