Role of Creatinine Clearance as a Screening Test in Persons With Spinal Cord Injury

Sepahpanah, Farhad; Burns, Stephen P.; McKnight, Barbara; Yang, Claire C.

doi:10.1016/j.apmr.2005.11.032

Cited by 26 publications

(18 citation statements)

References 15 publications

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“…Although repeat creatinine or cystatin measurement and their subsequent clearances show great within-participant variability (40,41), no included studies assessed renal function more than once in any one patient, which could also lead to patient misclassification and therefore decrease the generalizability of our findings.…”

Section: Discussionmentioning

confidence: 73%

A Systematic Review of Glomerular Hyperfiltration Assessment and Definition in the Medical Literature

Cachat

Combescure

Cauderay³

et al. 2015

Clinical Journal of the American Society of Nephrology

159

138

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Background and objectives Evaluation of glomerular hyperfiltration (GH) is difficult; the variable reported definitions impede comparisons between studies. A clear and universal definition of GH would help in comparing results of trials aimed at reducing GH. This study assessed how GH is measured and defined in the literature.Design, setting, participants, & measurements Three databases (Embase, MEDLINE, CINAHL) were systematically searched using the terms "hyperfiltration" or "glomerular hyperfiltration". All studies reporting a GH threshold or studying the effect of a high GFR in a continuous manner against another outcome of interest were included.Results The literature search was performed from November 2012 to February 2013 and updated in August 2014. From 2013 retrieved studies, 405 studies were included. Threshold use to define GH was reported in 55.6% of studies. Of these, 88.4% used a single threshold and 11.6% used numerous thresholds adapted to participant sex or age. In 29.8% of the studies, the choice of a GH threshold was not based on a control group or literature references. After 2004, the use of GH threshold use increased (P,0.001), but the use of a control group to precisely define that GH threshold decreased significantly (P,0.001); the threshold did not differ among pediatric, adult, or mixedage studies. The GH threshold ranged from 90.7 to 175 ml/min per 1.73 m 2 (median, 135 ml/min per 1.73 m 2 ).Conclusion Thirty percent of studies did not justify the choice of threshold values. The decrease of GFR in the elderly was rarely considered in defining GH. From a methodologic point of view, an age-and sex-matched control group should be used to define a GH threshold.

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Section: Discussionmentioning

confidence: 73%

A Systematic Review of Glomerular Hyperfiltration Assessment and Definition in the Medical Literature

Cachat

Combescure

Cauderay³

et al. 2015

Clinical Journal of the American Society of Nephrology

159

138

View full text Add to dashboard Cite

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“…This finding is consistent with previous studies showing no increase in p-creatinine over time. 7,9,14,15,17 The longest follow-up in previous 14 and only one study with maximum 16 years follow-up found a significant decrease in p-creatinine over time. 7 To our knowledge, our study has the longest follow-up period of 50 YPI.…”

Section: Discussionmentioning

confidence: 99%

50 years follow-up on plasma creatinine levels after spinal cord injury

2014

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Study design: Retrospective chart review. Objectives: To investigate the role of plasma creatinine (p-creatinine) in monitoring renal deterioration in patients up to 50 years after spinal cord injury (SCI). Setting: The Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark. Methods: A total of 119 patients with a traumatic SCI during the years were included in the study. P-creatinine measurements, results from renography and glomerular filtration rate (GFR) measured with 51 Cr-EDTA clearance were obtained from medical records and analyzed using a linear mixed model and linear regression analyses. Results: When compared with median p-creatinine level in the first 5-year period after injury, the level of p-creatinine was stable throughout the first 30 years and decreased significantly after the 30th until 45th year post injury. Only patients with a functional distribution outside the 30-70% limits on renography or a relative GFR p51% of that expected had a significantly elevated level of p-creatinine. Significance was not found for patients with a distribution outside the 40-60% limits on renography or relative GFR p75%. By comparing Cr-EDTA clearance and p-creatinine in terms of exceeding the upper reference level, p-creatinine revealed 17% sensitivity, 100% specificity, 100% positive predictive value and 73% negative predictive value as a diagnostic test for renal deterioration defined as GFR p75%. Conclusion: P-creatinine decreases over time in patients with SCI with a level below the upper reference limit and is a poor detector of early renal deterioration in patients with SCI.

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“…Sepahpanah et al [12] ont récemment apporté une série d'arguments contre l'utilisation dans ce sens. Bien que le NP apporté par leur travail ne dépasse pas le niveau 4 puisqu'il s'agit d'une étude rétrospective, leur article mérite une étude approfondie car il « dissèque » les différentes raisons qui pourraient amener à prendre ce type de décision.…”

Section: Insuffisance Rénaleunclassified

Suivi des vessies neurologiques du blessé médullaire et du patient porteur d'une myéloméningocèle Revue de la littérature et recommandations pratiques de suivi

Ruffion¹,

Sèze

Denys

et al. 2006

Pelv Perineol

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L'évolution des patients blessés médullaires (BM) ou porteurs d'une myéloméningocèle (MM) s'est profondément transformée au cours des soixante derniè-res années. Leur espérance de vie s'est considérablement accrue, jusqu'à approcher celle de la population générale. La pathologie urologique reste cependant une des plus grandes pourvoyeuses de morbi-mortalité dans cette population de patients. Dans un premier temps, nous avons souhaité, à travers une revue de la littérature, réactualiser les données épidémiologiques concernant les différentes facettes des pathologies urinaires susceptibles d'être observées chez ces patients. Ce travail s'est accompagné d'une réflexion sur la validité et la pertinence des examens complémentaires proposés dans le diagnostic de ces pathologies. À partir de ces données, nous avons dressé un cahier des charges du suivi neurourologique de ces patients.Mots clés : Vessie neurologique -Blessé médullaire -Myéloméningocèle -Pronostic uronéphrologique Care of neurogenic bladder in spinal cord injured patients and patients with myelomeningocele: Review of the literature and therapeutic recommendationsAbstract: The clinical course of spinal cord injured patients and those with myelomeningocele (MM) has radically changed over the last 60 years. Life expectancy has been significantly extended and is approaching that of the general population. Urologic disease remains, nonetheless, one of the most predictive factors of morbidity and mortality in this patient population. As a first step, we carried out a literature review in an effort to update the epidemiological data concerning the various aspects of urinary disorders observed in these patients. This paper also discusses the validity and appropriateness of additional diagnostic screening procedures for these disorders. Based on this data, we have created clinical guidelines for the neurological and urologic care of these patients.

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Role of Creatinine Clearance as a Screening Test in Persons With Spinal Cord Injury

Cited by 26 publications

References 15 publications

A Systematic Review of Glomerular Hyperfiltration Assessment and Definition in the Medical Literature

A Systematic Review of Glomerular Hyperfiltration Assessment and Definition in the Medical Literature

50 years follow-up on plasma creatinine levels after spinal cord injury

Suivi des vessies neurologiques du blessé médullaire et du patient porteur d'une myéloméningocèle Revue de la littérature et recommandations pratiques de suivi

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