Which of the following is most indicative of renal failure?
a. Elevated blood-urea-nitrogen c. Peripheral edema
b. Congestive heart failure d. Elevated creatinine
D
Creatinine is used as a measure of the glomerular filtration rate (GFR) because it is a waste product produced at a fairly constant rate by the muscles, is freely filtered by the glomerulus, and is minimally resorbed or secreted by the tubules. Therefore, most of the creatinine produced by the body is excreted by the kidneys, making the creatinine clearance a good screening and follow-up test for estimating the GFR. A creatinine clearance less than 100 mL/min reflects a GFR of less than 100 mL/min and is a signal of decreased kidney function. A creatinine clearance (and GFR) less than 20 mL/min results in symptoms of kidney failure.
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