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Amylase-Creatinine Clearance Ratio

James Lumeng, MD
Arch Intern Med. 1978;138(11):1750. doi:10.1001/archinte.1978.03630360114048.
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To the Editor. —  During the past three years, after numerous articles related to the amylase-creatinine clearance ratio in the diagnosis of acute pancreatitis, we have investigated the usefulness of this test and found consistently that the clearance ratio is a relatively insensitive test for patients with acute pancreatitis. It should be emphasized that, by performing the ratio, there are actually four analytical determinations, ie, two amylase and two creatinine. On the basis of cost effectiveness, the ratio should, therefore, be compared with the four separate determinations of either serum or urine amylase. We found that the clearance ratio is no more effective than doing a single determination of both serum and urine amylase in the diagnosis of acute pancreatitis.I have one suggestion to put at rest the amylase-creatinine clearance ratio; the title of the article by Farrar and Calkins published in the Archives (138:958-962, 1978) should be entitled


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