Creatinine Assays: Time for Action?

Lawson, Nigel; Lang, T; Broughton, Arthur; Prinsloo, Peter; Turner, Charles; Marenah, C B

doi:10.1177/000456320203900609

Cited by 29 publications

(21 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, our study did not demonstrate that the rate of deterioration in renal function in diabetic CKD patients is more accurately associated with the degree of renal tubulointerstitial damage than with the severity of glomerular lesions. Though there are many studies suggesting that creatinine and GFR based on creatinine show low accuracy for measuring of renal function, GFR is still thought to be a reliable marker for estimating renal function in our study [27,28]. …”

Section: Discussionmentioning

confidence: 78%

Urinary Neutrophil Gelatinase-Associated Lipocalin Levels in Comparison with Glomerular Filtration Rate for Evaluation of Renal Function in Patients with Diabetic Chronic Kidney Disease

et al. 2012

View full text Add to dashboard Cite

BackgroundNeutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker of acute kidney injury. There is a growing body of evidence suggesting that NGAL is also a marker of kidney disease and severity in chronic kidney disease (CKD). We studied the utility of urinary NGAL in more accurately predicting renal function in patients with diabetic CKD.MethodsWe studied possible relationships between urinary NGAL, estimated glomerular filtration rate (eGFR), and proteinuria in diabetic CKD patients and in healthy populations.ResultsUrinary NGAL levels were significantly higher in CKD patients than in healthy controls (96.0 [2.7 to 975.2] ng/mL vs. 18.8 [1.3 to 81.9] ng/mL, P=0.02), and the GFR was lower among CKD patients (49.3 [13.1 to 78.3] mL/min/1.73 m2 vs. 85.6 [72 to 106.7] mL/min/1.73 m2, P<0.0001). The urinary NGAL level showed a significant inverse correlation with GFR (r=-0.5634, P<0.0001). The correlation analyses between urinary protein level and urinary NGAL levels and GFR were as follows: urine protein and urinary NGAL (r=0.3009, P=0.0256), urine protein and GFR (r=-0.6245, P<0.0001), urine microalbumin and urinary NGAL (r=0.1794, P=0.2275), and urine microalbumin and GFR (r=-0.5190, P=0.0002).ConclusionFrom these results, we concluded that urinary NGAL is a reliable marker of renal function in diabetic CKD patients. However, urinary NGAL did not provide more accurate information regarding renal function than GFR.

show abstract

Section: Discussionmentioning

confidence: 78%

Urinary Neutrophil Gelatinase-Associated Lipocalin Levels in Comparison with Glomerular Filtration Rate for Evaluation of Renal Function in Patients with Diabetic Chronic Kidney Disease

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Currently, serum creatinine concentration is widely used to estimate GFR because this estimation is simple and inexpensive [22]. However, serum creatinine can be affected by age, gender, ethnicity, dietary protein intake, and muscle mass, and its measurement requires a variety of analytical interferences and is associated with significant standardization problems [1,6,7,8,9,10,23,24]. In contrast, although the notion that the capacity of cystatin C to predict GFR is not influenced by body composition has been controversial, several studies have reported that the use of cystatin C has the advantages of being less influenced by age, gender, weight, and muscle mass compared to the use of serum creatinine [11,12,13,14,15,25].…”

Section: Discussionmentioning

confidence: 99%

Clinical Usefulness of Serum Cystatin C as a Marker of Renal Function

et al. 2014

View full text Add to dashboard Cite

BackgroundAccurate renal function measurements are important in the diagnosis and treatment of kidney diseases. In contrast to creatinine, the production of serum cystatin C has been extensively reported to be unaffected by body muscle mass, age, gender, and nutritional status.MethodsOur study included 37 samples from diabetic chronic kidney disease (CKD) patients for whom serum creatinine tests had been requested and 40 samples from a healthy populations in Dong-A University Hospital between May 2010 and June 2010. The assay precision (i.e., the coefficient of variation) and the reference range of the serum cystatin C test were evaluated. We compared the estimated glomerular filtration rates (GFRs) based on cystatin C with those based on creatinine. Moreover, we investigated the influences of age, gender, weight, and muscle mass on serum creatinine and serum cystatin C.ResultsThere was a positive correlation between GFR based on creatinine and that based on cystatin C (r=0.79, P<0.0001) among the diabetic CKD patients. Serum creatinine and cystatin C were significantly correlated with body weight and muscle mass, but the strengths of these correlations were greater for serum creatinine. The precision study revealed excellent results for both the high and low controls. The 95% reference interval of cystatin C in the healthy population was 0.371 to 1.236 mg/L.ConclusionBased on these results, we conclude that, despite the strong correlation between serum creatinine and cystatin C, cystatin C is less affected by weight and muscle mass and might represent a better alternative for the assessment of renal function.

show abstract

“…78 The degree of interference varies between individuals but collectively may account for 20% of measured 'creatinine' at physiological concentrations. [79][80][81] More importantly for patients with cirrhosis bilirubin may interfere with laboratory creatinine assays due to spectral effects or reaction with assay reagents. Bilirubin is generally a negative interferent, with 5.8mg/dL (100 μmol/L) bilirubin reducing measured serum creatinine by 0.11-0.15mg/dL (10-15 μmol/L) in three widely used commercial assays.…”

Section: Using Serum Creatinine To Define Aki In Cirrhotic Patientsmentioning

confidence: 99%

Acute kidney injury in acute-on-chronic liver failure: where does hepatorenal syndrome fit?

Davenport

Sheikh

Lamb

et al. 2017

Kidney International

100

View full text Add to dashboard Cite

Renal dysfunction occurs in 25% to 50% of patients with cirrhosis admitted to the hospital with an acute episode of hepatic decompensation and may be due to underlying chronic kidney disease, an acute deterioration, or both. An acute deterioration in renal function in cirrhotic patients is now collectively referred to as acute kidney injury (AKI), which has been subclassified into different grades of severity that identify prognostic groups. Acute-on-chronic liver failure is characterized by acute hepatic and/or extrahepatic organ failure driven by a dysregulated immune response and systemic inflammatory response. AKI is also one of the defining features of ACLF and a major component in grading the severity of acute-on-chronic liver failure. As such, the pattern of AKI now observed in patients admitted to the hospital with acutely decompensated liver disease is likely to be one of inflammatory kidney injury including acute tubular injury (referred in this review as non-hepatorenal syndrome [HRS]-AKI) rather than HRS. As the management and supportive treatment of non-HRS-AKI potentially differ from those of HRS, then from the nephrology perspective, it is important to distinguish between non-HRS-AKI and HRS-AKI when reviewing patients with acute-on-chronic liver failure and AKI, so that appropriate and early management can be instituted.

show abstract

Creatinine Assays: Time for Action?

Cited by 29 publications

References 2 publications

Urinary Neutrophil Gelatinase-Associated Lipocalin Levels in Comparison with Glomerular Filtration Rate for Evaluation of Renal Function in Patients with Diabetic Chronic Kidney Disease

Urinary Neutrophil Gelatinase-Associated Lipocalin Levels in Comparison with Glomerular Filtration Rate for Evaluation of Renal Function in Patients with Diabetic Chronic Kidney Disease

Clinical Usefulness of Serum Cystatin C as a Marker of Renal Function

Acute kidney injury in acute-on-chronic liver failure: where does hepatorenal syndrome fit?

Contact Info

Product

Resources

About