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Creatinine is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). blood levels rise. Therefore, creatinine levels in blood and urine may be used to calculate the creatinine clearance (CrCl), which correlates with the glomerular filtration rate (GFR). Blood creatinine levels may also be used alone to calculate the estimated GFR (eGFR).
The GFR is clinically important because it is a measurement of renal function. However, in cases of severe renal dysfunction, the CrCl rate will overestimate the GFR because hypersecretion of creatinine by the proximal tubules will account for a larger fraction of the total creatinine cleared. Ketoacids, cimetidine, and trimethoprim reduce creatinine tubular secretion and, therefore, increase the accuracy of the GFR estimate, in particular in severe renal dysfunction. (In the absence of secretion, creatinine behaves like inulin.)
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Creatinine itself is produced via a biological system involving creatine, phosphocreatine (also known as creatine phosphate), and adenosine triphosphate (ATP, the body's immediate energy supply).Creatine is synthesized primarily in the liver from the methylation of glycocyamine (guanidino acetate, synthesized in the kidney from the amino acids arginine and glycine) by S-adenosyl methionine. It is then transported through blood to the other organs, muscle, and brain where, through phosphorylation, it becomes the high-energy compound phosphocreatine. During the reaction, creatine and phosphocreatine are catalysed by creatine kinase, and a spontaneous conversion to creatinine may occur.
An alternate estimation of renal function can be made when interpreting the blood (plasma) concentration of creatinine along with that of urea. BUN-to-creatinine ratio (the ratio of blood urea nitrogen to creatinine) can indicate other problems besides those intrinsic to the kidney; for example, a urea level raised out of proportion to the creatinine may indicate a prerenal problem such as volume depletion. Each day, 1-2% of muscle creatine is converted to creatinine. Men tend to have higher levels of creatinine than women because, in general, they have a greater mass of skeletal muscle. Increased dietary intake of creatine or eating a lot of meat can increase daily creatinine excretion.
Measuring serum creatinine is a simple test, and it is the most commonly used indicator of renal function. A rise in blood creatinine level is observed only with marked damage to functioning nephrons. Therefore, this test is unsuitable for detecting early-stage kidney disease. A better estimation of kidney function is given by calculating the estimated glomerular filtration rate (eGFR). eGFR can be accurately calculated using serum creatinine concentration and some or all of the following variables: sex, age, weight, and race, as suggested by the American Diabetes Association without a 24-hour urine collection. Many laboratories will automatically calculate eGFR when a creatinine test is requested.
The U.S. market for urinary stone management devices (defined in this report as including lithotripsy systems and stone access, dilation, and retrieval devices) is expected to continue stable, moderate growth over the next 5 years due to positive demographic trends and corresponding increases in urinary stone cases, continued adoption of more cost-effective minimally invasive stone removal techniques and next-generation lithotripsy and medical device technologies. Valued at more than $423.4 million in 2011, the market is expected to increase at a compound annual rate of 3.4%, with sales reaching more than $500 million in 2016, reflecting an increase of approximately $77.0 million.
November 30-02, 2015, Atlanta, USA
October 03-05, 2016 Miami, USA
3. Congress on Rare Diseases Orphan Drugs
May 12-13, 2016 Chicago, USA
May 16-18, 2016 San Antonio, USA
June 30-July 01, 2016, South Africa
August 25-27, 2016 Philadelphia, USA
November 30-02, 2015, USA
October 03-05, 2016 Miami, USA
9. World Antibiotics conference
September 14-16, 2015, Nevada, USA
10. 2nd Antibiotics Congress
October 03-05, 2016 London, UK
11. 4th Immunology Conference
September 28-30, 2015 Houston, Texas, USA
12. 2nd Parasitology Conference
August 01-03, 2016 Manchester, UK
13. 7th Vaccines Vaccination Summit
September 28-30, 2015 Dubai, UAE
14. 12th Vaccines Vaccination Summit
October 20-22, 2016
November 02-04, 2015, Hyderabad, India
November 30-02, 2015 San Francisco, USA
17. 11th Vaccines Vaccination conference
September 12-14, 2016 Seattle, USA
18. 6th Cell Stem Cell Research
February 29-02, 2016 Philadelphia, USA
19. 6th Virology Conference
March 10-12, 2016 Madrid, Spain.
March 29-30, 2016 Valencia, Spain
21. Lower Urinary Tract Dysfunction Congress
September 22-23,2016 Austria
22. 7th world orin congress
September 20, 2016 UK
23. Asian urological association 13th meeting
September 3-5, 2015 China
24. Society for interstitial cystitis and bladder pain syndrome
September 17-19, 2015 Italy
25. 33rd World Congress on ENDOUROLOGY & SWL
October 1-4, 2015 UK
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