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Amylase, Urine (Amylase/Creatinine Clearance Ratio [ALCR])


Definition


  • The ratio between amylase and creatinine in serum and urine. Also referred as fractional excreted of amylase. ALCR is calculated as:View OriginalView Original
  • Normal range:
    • Amylase urine: 1 " “17 U/hour
    • ALCR: 1 " “4%

Use


  • Differential diagnosis of pancreatitis
  • Diagnosis of pseudocyst of the pancreas, where the urine amylase may remain elevated for weeks after the serum amylase has returned to normal, after a bout of acute pancreatitis.

Interpretation


Increased In


  • Pancreatitis (>6%)
  • DKA
  • Renal insufficiency
  • Duodenal perforation
  • Large doses of corticosteroids
  • Pancreatic cancer
  • Myeloma and light chain disease

Decreased In


  • Macroamylasemia

Limitations


  • Macroamylasemia is characterized by high serum amylase but normal urine amylase. The ALCR remains useful for the diagnosis of macroamylasemia. In macroamylasemia, the clearance is very low.
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