4727.0.55.002 - Australian Aboriginal and Torres Strait Islander Health Survey: Users' Guide, 2012-13  
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 10/09/2014  First Issue
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Creatinine is a by-product of muscle metabolism, which circulates around the body at a constant rate in blood serum and is excreted by the body, within the urine, through the kidney filters.1

A serum creatinine result is used to calculate the estimated glomerular filtration rate (eGFR) using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for the diagnosis of Chronic Kidney Disease (CKD).2 Whilst serum creatinine concentration is a good measure of eGFR, not all persons with CKD have a reduced eGFR, and as such, health professionals use other creatinine calculations which have been used to diagnose CKD.3 As an example, a urine creatinine result can be used with a urine albumin result to calculate the albumin/creatinine ratio (ACR) for the diagnosis of macro and microalbuminuria and subsequent CKD.1,4 Whilst serum creatinine is created at a constant rate, urinary excretion levels are influenced by muscle mass, which differ by age, sex and ethnicity. As such, there are no recommended ethnicity-specific or age-specific cut off points for ACR.3

Further information on eGFR, ACR and CKD is available in the Chronic Kidney Disease, Albumin/Creatinine Ratio and Estimated Glomerular Filtration Rate pages of this product.

In the National Aboriginal and Torres Strait Islander Health Measures Survey (NATSIHMS), two creatinine tests were used to measure the amount of serum creatinine in the blood, and urinary creatinine in the urine, at the time of the test.


Urine and serum creatinine results were obtained for persons aged 18 years and over, who participated in the NATSIHMS and who provided a urine and/or blood sample. Fasting was not required for this test.


A urine and/or blood sample was collected from participants and creatinine levels were measured at the Douglass Hanly Moir (DHM) laboratory.

There is no consensus on the epidemiological cut off reference values for measuring creatinine in serum and/or urine as creatinine production varies pending muscle mass and varies throughout infancy and childhood.3 As such, no cut off points have been defined in the NATSIHMS.

Note that the creatinine assay (test method) used to measure serum creatinine was traceable to Isotope Dilution Mass Spectrometry (IDMS) to improve assay precision. Further information about the analysis method and machines used to measure creatinine levels is available in Excel spreadsheet format in the Downloads page of this product.

Data items

The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.


Points to be considered when interpreting data for this topic include the following:

  • Creatinine test results do not confirm a specific diagnosis without consultation with a health professional.
  • There are a number of different test methods to measure creatinine levels and each test method may produce different results. The data from this topic should therefore be used with caution when comparing creatinine results from other studies using a different test method.

Comparability with other surveys

The NATSIHMS is the first ABS Aboriginal and Torres Strait Islander survey to collect biomedical information. Given it was also the first national level survey (ABS or otherwise) to collect such data for the Aboriginal and Torres Strait Islander population, no comparisons with previous surveys for this population are possible.

However, biomedical data was also collected for all Australians in the 2011-12 National Health Measures Survey (NHMS) and information about comparisons between the NHMS results and those of non-ABS surveys is available from the Comparisons with other Australian surveys section of the Biomedical Results for Chronic Diseases, 2011-12 publication.


1 Kidney Health Australia 2013, What is Kidney disease?, <http://www.kidney.org.au/kidneydisease/tabid/578/default.aspx>, Last accessed 08/09/2014.
2 Johnson DW, Jones GRD, Mathew TH, Ludlow MJ, Doogue MP, Jose MD, Langham RG, Lawton PD, McTaggart SJ, Peake MJ, Polkinghorne K, Usherwood T; Australasian Creatinine Consensus Working Group, 2012, 'Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: new developments and revised recommendations', Med J Aust 2012, 197(4):224-225, <https://www.mja.com.au/journal/2012/197/4/chronic-kidney-disease-and-automatic-reporting-estimated-glomerular-filtration>, Last accessed 08/09/2014.
3 Johnson DW, Jones GRD, Mathew TH, Ludlow MJ, Chadban SJ, Usherwood T, Polkinghorne K, Colagiuri S, Jerums G, MacIsaac R, Martin H; Australasian Proteinuria Consensus Working Group, 2012, 'Chronic kidney disease and measurement of albuminuria or proteinuria: a position statement' Med J Aust. 2012;197:224–5, <https://www.mja.com.au/journal/2012/197/4/chronic-kidney-disease-and-measurement-albuminuria-or-proteinuria-position>, Last accessed 08/09/2014.
4 Kidney Health Australia 2013, Albuminuria, <http://www.kidney.org.au/portals/0/assets/documents/patient_information/Fact%20Sheets/Albuminuria%20fact%20sheet%20APRIL%202013.pdf>, Last accessed 08/09/2014.

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