2012
DOI: 10.2215/cjn.10821011
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Estimating Baseline Kidney Function in Hospitalized Patients with Impaired Kidney Function

Abstract: SummaryBackground and objectives Inaccurate determination of baseline kidney function can misclassify acute kidney injury (AKI) and affect the study of AKI-related outcomes. No consensus exists on how to optimally determine baseline kidney function when multiple preadmission creatinine measurements are available.Design, setting, participants, & measurements The accuracy of commonly used methods for estimating baseline serum creatinine was compared with that of a reference standard adjudicated by a panel of boa… Show more

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Cited by 241 publications
(248 citation statements)
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“…Although no approach to the assessment of baseline creatinine is perfect, the goal should be to reduce bias in anchoring the definition of AKD and its recovery. Towards that end, the use of known creatinine values is superior to imputation 41 . For patients in whom one or more pre-morbid serum creatinine values are available but show significant fluctuation, the choice of the serum creatinine measurement that best reflects the most appropriate baseline value may require adjudication by an expert clinician.…”
Section: Baseline Creatinine Assessmentmentioning
confidence: 99%
See 2 more Smart Citations
“…Although no approach to the assessment of baseline creatinine is perfect, the goal should be to reduce bias in anchoring the definition of AKD and its recovery. Towards that end, the use of known creatinine values is superior to imputation 41 . For patients in whom one or more pre-morbid serum creatinine values are available but show significant fluctuation, the choice of the serum creatinine measurement that best reflects the most appropriate baseline value may require adjudication by an expert clinician.…”
Section: Baseline Creatinine Assessmentmentioning
confidence: 99%
“…For patients in whom one or more pre-morbid serum creatinine values are available but show significant fluctuation, the choice of the serum creatinine measurement that best reflects the most appropriate baseline value may require adjudication by an expert clinician. In a large dataset, the mean serum creatinine value assessed 7-365 days before admission closely approximated expert clinical adjudication of baseline creatinine level 41 . Differences in misclassification were, however, modest compared with other available creatinine values, including the measurement taken at the time closest to hospital admission compared to the previous 7-365 days, which might be preferable in certain populations such as in patients undergoing elective surgery, those with progressive CKD, or those with a recent history of AKI.…”
Section: Baseline Creatinine Assessmentmentioning
confidence: 99%
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“…Patients with no SCr measurements during hospitalization were classified as not having AKI. Baseline SCr for KDIGO, AKIN, and RIFLE criteria was defined as the lowest SCr measurement during hospitalization (18) or, if available, the arithmetic mean of all outpatient SCr measurements 7-365 days before the index admission (28). In sensitivity analyses, we also explored the effects on incidence of alternate methods of assessing baseline SCr when missing (18), including multiple imputation (29).…”
Section: Definition and Staging Of Akimentioning
confidence: 99%
“…In the current issue of CJASN, Siew et al (16) compare the validity of different strategies for estimating baseline creatinine in the seemingly optimal situation when multiple preadmission values are available to the clinician. They studied 379 hospitalized patients who had evidence of kidney dysfunction or frank AKI and at least two serum creatinine values from the 24 months preceding admission.…”
mentioning
confidence: 99%