Prediction of creatinine clearance from serum creatinine in spinal cord injury patients

Mirahmadi, Mahdi; Byrne, C.; Barton, Cyril H.; Penera, N; Gordon, S; Vaziri, N. D.

doi:10.1038/sc.1983.4

Cited by 44 publications

(42 citation statements)

References 9 publications

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“…Our finding of a lower serum creatinine among paraplegic patients than in controls is probably due to reduced muscle mass, and confirms a previous report by Mirahmadi et al 12 The reason for the significantly raised ALAT is unclear. None of the drugs taken by the patients are known to be deleterious to the liver.…”

Section: Discussionsupporting

confidence: 82%

Bone mineral and hormone status in paraplegics

1992

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Nineteen men who had suffered permanent paraplegia a median of 4 years previously were studied. Eight also had varying degrees of neurological deficit of the upper extremities. Bone mineral, biochemical and hormonal values were compared to those in an age-matched control group in order to detect evidence of systemic osteopenia. There were very considerable individual variations in bone mineral density (BMD) deficits among patients compared to controls, probably partly due to methodological problems. Significant BMD deficits were found in the metaphysis (45%) and diaphysis (26% ) of the tibia, while the deficit of the distal forearm was barely significant for the group as a whole. There was a negative correlation between time since injury and degree of BMD deficit in the lower extremity. Those with neurological affection of the upper extremities had a greater BMD deficit of their arms than those with neurologic ally intact arms. It was concluded that osteopenia in paraplegics is largely confined to the paralysed extremities, and thus not systemic.Serum alanine aminotransferase, phosphate, follicle stimulating hormone, and free androgen index (testosterone/sex hormone binding globulin) were mainly within normal limits, but significantly higher in paraplegics than in controls. Osteopenia in these patients is thus not due to gonadal dysfunction.

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Section: Discussionsupporting

confidence: 82%

Bone mineral and hormone status in paraplegics

1992

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“…The patients need to have their renal function examined on a regular basis. 21,22 As a routine 51 Cr-EDTA-clearance, creatinine clearance and serum creatinine is used for this purpose. 51 Cr-EDTAclearance is laboratory-intensive and time consuming.…”

Section: Discussionmentioning

confidence: 99%

Serum cystatin C as a marker of the renal function in patients with spinal cord injury

et al. 2002

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Objective: To investigate the relationship between serum cystatin C, serum creatinine, and 51 Cr-EDTA-clearance in patients with spinal cord injury. Setting: The Spinal Cord Unit, Viborg-Kjellerup County Hospital. Methods: Twenty-four men and seven women aged 20.3 to 68.0 years with motor complete spinal cord injury (ASIA A or B) were included. Serum cystatin C was measured by an automated particle-enhanced nephelometric immunoassay (Dade Behring), serum creatinine by an enzymatic method (Vitros 950), and 51 Cr-EDTA-clearance by a multiple plasma sample method. Results: A linear relationship was found between 51 Cr-EDTA-clearance and the reciprocal values of cystatin C and creatinine. The correlation coe cient between 51 Cr-EDTA-clearance and 1/cystatin C was 0.72 compared to the correlation coe cient between 51 Cr-EDTAclearance and 1/creatinine being 0.26. Comparison of the area under the curves in the nonparametric receiver operating characteristics (ROC) plots for serum cystatin C (area under the curve (AUC)=0.912; SE=0.065), and serum creatinine (AUC=0.507; SE=0.115) revealed signi®cant di erences (P-values=0.0005). Conclusion: In patients with spinal cord injury serum cystatin C is a better marker of the renal function compared to serum creatinine.

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“…Although this formula tends to underestimate the true GFR, 20 it is widely accepted for clinical use, including those with SCI. 21,22 We also estimated GFR using the Modification of Diet in Renal Disease (MDRD) Study formula in a sub-population of the study sample.…”

Section: Renal Functionmentioning

confidence: 99%

Homocysteine and hypertension in persons with spinal cord injury

et al. 2005

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Study design: Cross-sectional analysis of a convenience sample of locally recruited participants, including both patients and volunteers. Objectives: To determine whether there is an association between plasma homocysteine and hypertension in persons with spinal cord injury (SCI). Setting: Spinal Cord Injury Service of the Veterans Affairs Palo Alto Medical Center (California, United States of America). Methods: The incidence of hypertension, dyslipidemia, insulin resistance, and the presence of metabolic syndrome were determined in 168 individuals with SCI (mean age 50.2712.8 years). Fasting lipids, insulin, glucose, plasma homocysteine, and anthropometric data was gathered for each subject. Results: Blood pressure values (Po0.001) and mean arterial pressure (Po0.05) increased with higher plasma homocysteine levels. Homocysteine values were also significantly greater among individuals with hypertension compared with those who were normotensive or prehypertensive (Po0.0001). There was an inverse relationship between plasma homocysteine levels and glomerular filtration rate and effective renal plasma flow (Po0.05). Conclusions: Plasma homocysteine levels are elevated in persons with SCI who have hypertension and inversely related to renal function, which suggests that renal dysfunction may be a link between homocysteine and hypertension in persons with SCI.

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Prediction of creatinine clearance from serum creatinine in spinal cord injury patients

Abstract: when applied to SCI patients can be misleading. Modification of the original formula using a correction factor of 0·8 in paraplegics and 0·6 in tetraplegics was found to allow prediction of Ccr from age, sex, body weight, and serum creatinine in these patients with reasonable accuracy.

Cited by 44 publications

References 9 publications

Bone mineral and hormone status in paraplegics

Bone mineral and hormone status in paraplegics

Serum cystatin C as a marker of the renal function in patients with spinal cord injury

Homocysteine and hypertension in persons with spinal cord injury

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