Serum Creatinine in the Critically Ill Patient With Sepsis

Abstract

A 73-year-old man underwent esophageal resection for cancer. He had a history of hypertension that was treated with an angiotensin receptor blocker. Preoperative estimated glomerular filtration rate (GFR) was 98 mL/min/1.73 m 2 . On the second postoperative day, body temperature was 38.6°C. Chest x-ray revealed bilateral lung consolidations consistent with pneumonia. Blood pressure decreased from 145/72 mm Hg to 96/53 mm Hg with a heart rate of 105/min. The patient was admitted to the intensive care unit (ICU) with acute respiratory failure and was placed on mechanical ventilation. In the ICU, urine output was 50 mL over 3 hours. On day 3, he received 4.5 L of Ringer lactate over 12 hours. Laboratory values are shown in the Table . Answer B. The patient has acute kidney injury most likely related to sepsis.

Data analytics and clinical feature ranking of medical records of patients with sepsis

“…For septic shock, Random Forests selected creatinine as a top feature, differently from the traditional univariate biostatistics approaches ("Septic shock feature ranking" section). Recent scientific discoveries confirm this trend: the level of creatinine in the blood is often used as a biomarker for sepsis [42], especially in presence of a serious kidney injury [43].…”

Gender-specific association of oxidative stress and immune response in septic shock mortality using NMR-based metabolomics

“…34,63 During septic shock, there is enhanced muscle protein conversion and decreased energy supply irrespective of gender, leading to impaired creatine metabolism. 64,65 Sepsis and septic shock are associated with hypermetabolism, 66 oxidative stress, and peripheral protein catabolism. 67 There is an augmented release of amino acids from peripheral tissues for promoting hepatic protein synthesis, urea generation, and gluconeogenesis.…”

Machine learning applied to serum and cerebrospinal fluid metabolomes revealed altered arginine metabolism in neonatal sepsis with meningoencephalitis

“…Serum creatinine is a marker of acute kidney injury in critically ill neonates [41] . Legrand et al found that sepsis can reduce creatinine production [42] , but the specific role of changes in serum creatinine levels in the pathogenesis of sepsis is still unclear. Considering that arginine can be converted directly to homo- l -arginine and guanidinoacetic acid (GAA) by arginine:glycine amidinotransferase, a decrease in the homo- l -arginine level may be accompanied by a decrease in the GAA level.…”