
In clinical practice, blood urea level is taken as an indicator of renal function. The normal urea level in plasma is from 20 to 40 mg/dl. Blood urea level is increased where renal function is inadequate. Urea level in blood may be theoretically increased when protein intake is very high. However in usual conditions, this will be only within the upper limit of the normal values. Urinary excretion of urea is 15 to 30 g/day (6-15g nitrogen/day). This corresponds to the breakdown of 40 to 80 g of proteins per day. Urea constitutes 80% of urinary organic solids.(Van De , 2002)
2.6.4.2 Creatinine
Creatinine is synthesized in the liver from three amino acids namely, arginine, glycine, and methionine. Creatinine is liberated into the blood and is taken up by the muscle when required. In skeletal muscle, it is phosphorylated to form Creatinine phosphate, which is an important energy store for ATP synthesis. Creatinine is formed in the body from Creatinine phosphate. Creatinine is not converted directly to creatinine. The rate of creatinine excretion is constant from day to day.
Creatinine is a waste product, formed from Creatinine phosphate. This conversion is spontaneous, non-enzymatic, and is dependent on total muscle mass of the body. It is not affected by diet, age or exercise. Women and children excrete less creatinine than men, because of their smaller muscle mass. 98% of Creatinine pool is in muscle. About 1.6% is converted to creatinine per day which is rapidly excreted. Since the production is continuous, the blood level will not fluctuate much, making creatinine an ideal substance for clearance test. Creatinine excretion is constant in a particular person. Hence the urine creatinine is sometimes used to check whether the 24hours urine sample does actually contain total urine volume or not. This is important when urine is collected from children and mentally retarded persons. (Human Anatomy, 2002)