Use of Serum Creatinine Concentration for Estimation of Glomerular Filtration Rate

1993 ◽  
Vol 147 (7) ◽  
pp. 719
Author(s):  
STANLEY HELLERSTEIN
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Serum Creatinine Concentration ◽  
Creatinine Concentration

scholarly journals Lack of Effect of DX-619, a Novel Des-Fluoro(6)-Quinolone, on Glomerular Filtration Rate Measured by Serum Clearance of Cold Iohexol

2007 ◽  
Vol 51 (6) ◽  
pp. 1912-1917 ◽  
Author(s):  
Nenad Sarapa ◽  
Prachi Wickremasingha ◽  
NanXiang Ge ◽  
Richard Weitzman ◽  
Merynda Fuellhart ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Healthy Volunteers ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Serum Creatinine Concentration ◽  
Bacterial Strains ◽  
Creatinine Concentration ◽  
Significant Difference ◽  
The Mean

ABSTRACT DX-619 is a novel des-fluoro(6)-quinolone with activity against a broad range of bacterial strains, including methicillin-resistant Staphylococcus aureus. The effects of DX-619 on the glomerular filtration rate (GFR) were evaluated because drug-related increases in serum creatinine levels were observed in studies with healthy volunteers. Forty-one healthy subjects were randomized to receive intravenous DX-619 at 800 mg or placebo once daily for 4 days, and the GFR was directly measured by determination of the clearance of a bolus iohexol injection in 33 subjects who completed the study per protocol. DX-619 was noninferior to placebo for the GFR on the basis of a criterion for a clinically significant difference of −12 ml/min/1.73 m2. The mean GFRs on day 4 were 101.1 ± 14.2 ml/min/1.73 m2 and 100.2 ± 15.6 ml/min/1.73 m2 for the volunteers receiving placebo and DX-619, respectively. On day 4 the mean serum creatinine concentration for volunteers receiving DX-619 increased by 30 to 40%, with a corresponding decrease in mean creatinine clearance. Both parameters normalized within 7 days after the cessation of DX-619 treatment. Nonclinical studies suggest that DX-619 increases the serum creatinine concentration by inhibiting excretory tubular transporters. In conclusion, DX-619 administered intravenously at 800 mg once a day for 4 days did not affect the GFR in healthy volunteers. Glomerular toxicity is not expected to present a risk to patients receiving DX-619 in clinical trials, but monitoring of the renal function, with an emphasis on the serum creatinine concentration, is still warranted.

scholarly journals Assessing glomerular filtration rate in patients with severe heart failure: comparison between creatinine-based formulas

2012 ◽  
Vol 130 (5) ◽  
pp. 289-293 ◽  
Author(s):  
Alexandre Libório ◽  
Russian Uchoa ◽  
João Neto ◽  
Juan Valdivia ◽  
Elizabeth De Francesco Daher ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Severe Heart Failure ◽  
Creatinine Concentration ◽  
Cross Sectional ◽  
Gfr Estimation

CONTEXT AND OBJECTIVE: Severe heart failure is highly associated with chronic kidney disease (CKD). Serum creatinine is a poor indicator of renal function and glomerular filtration rate (GFR) estimation is an accessible method for assessing renal function. The most popular formulas for GFR estimation are the Cockcroft-Gault (CG), the four-variable Simplified Modification of Diet in Renal Disease (sMDRD) and the recently introduced CKD-Epidemiology Collaboration (CKD-EPI). The objective of the study was to analyze the correlation between these three equations for estimating GFR in patients with severe heart failure. DESIGN AND SETTING: Cross-sectional observational study at a university reference center. METHODS: GFR was estimated in patients with severe heart failure who were awaiting heart transplantation, using the CG, sMDRD and CKD-EPI formulas. These estimates were analyzed using Pearson's correlation and Bland-Altman analysis. RESULTS: This study included 157 patients, of whom 32 (20.3%) were female. Normal serum creatinine concentration was observed in 21.6%. The mean GFR according to CG, sMDRD and CKD-EPI was 70.1 ± 29.5, 70.7 ± 37.5 and 73.7 ± 30.1 ml/min/1.73 m²; P > 0.05. Pearson's coefficient demonstrated good correlations between all the formulas, as did Bland-Altman. However, the patients presented GFR < 60 ml/min more frequently with the sMDRD formula (54.1% versus 40.2% for CG and 43.2% for CKD-EPI; P = 0.02). CONCLUSION: Despite the good correlation and agreement between the three methods, the sMDRD formula classified more patients as presenting GFR less than 60 ml/min.

scholarly journals DIABETIC NEPHROPATHY;

2017 ◽  
Vol 24 (04) ◽  
pp. 554-559
Author(s):  
Muhammad Imran ◽  
Muhammad Usman Bashir ◽  
Ameena Nasir
Keyword(s):  
Uric Acid ◽  
Diabetic Nephropathy ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Serum Uric Acid ◽  
Filtration Rate ◽  
Uric Acid Concentration ◽  
Creatinine Concentration ◽  
Serum Uric Acid Concentration

Objectives: To compare serum uric acid levels in different stages of diabeticnephropathy. Study Design: Descriptive analytical study. Setting: University of Health ScienceLahore. Period: February 2010 to January 2011. Subjects and methods: A sample size of195 diabetic subjects. They were divided among normoalbuminuric, microalbuminuric andmacroalbuminuric groups, according to their daily urinary albumin excretion rate (AER), with65 patients in each group. Their glomerular filtration rate (GFR), daily AER and serum uricacid was evaluated by conducting tests on serum and urine samples. Statistics: Kruskal-Wallis test and Mann-Whitney U test were used to observe differences of medians in differentgroups. P value less than 0.05 was taken statistically significant. Results: There was majority ofmales in microalbuminuric and macroalbuminuric groups while females were more in numberin normoalbuminuric group. Significant differences were found in serum urea concentration,serum creatinine concentration, serum uric acid concentration, glomerular filtration rate, urinarycreatinine concentration, urine flow rate, daily albumin excretion rate and urinary albuminconcentration among the three groups. Urinary creatinine concentration and glomerularfiltration rate were in the highest ranges in normoalbuminuric group and in the lowest rangesin macroalbuminuric group. While rest of the parameters (ie. age, duration of diabetes, serumurea concentration, serum creatinine concentration, urine flow rate, daily AER , urinary albuminconcentration and serum uric acid concentration) were in the lowest ranges in normoalbuminuricgroup and in the highest ranges in macroalbuminuric group. There was significant increaseserum uric acid levels in advancing stages of diabetic nephropathy. p <0.05 was takenstatistically significant. Conclusion: It is concluded that serum uric acid increases with theadvancing stages of diabetic nephropathy. Progressive decline in glomerular filtration rate andgradual rise in serum creatinine level occurs throughout the course of diabetic nephropathy.

Iohexol clearance in unstable critically ill patients: a tool to assess glomerular filtration rate

2016 ◽  
Vol 54 (11) ◽  
Author(s):  
Charlotte Salmon-Gandonnière ◽  
Isabelle Benz-de Bretagne ◽  
Emmanuelle Mercier ◽  
Aurélie Joret ◽  
Jean-Michel Halimi ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Filtration Rate ◽  
Circulatory Failure ◽  
Serum Creatinine Concentration ◽  
Acute Circulatory Failure ◽  
Creatinine Concentration

AbstractBackground:Acute kidney injury (AKI) is associated with significant morbidity and mortality, particularly in unstable critically ill patients. In this context, serum creatinine concentration is an imperfect tool for estimating glomerular filtration rate (GFR), an index of renal function. The objective of this pilot study was to evaluate the feasibility of measuring iohexol clearance for GFR assessment in critically ill patients with acute circulatory failure at intensive care unit (ICU) admission.Methods:ICU patients were prospectively included within 12 h of acute circulatory failure; a non-toxic dose of iohexol (5 mL) was infused intravenously and iohexol plasma concentration decrease was measured over 24 h. Urinary iohexol concentration was measured in urine samples collected four times, every 6 h for 24 h. The Kidney Disease Improving Global Outcome score, measuring AKI, was calculated each day.Results:Among 18 patients with acute circulatory failure, AKI developed in 15; 14 showed decreased serum creatinine concentration during the first 24 h even though 10 presented AKI. The absolute variation in serum creatinine concentration was correlated with fluid balance over 24 h. Median [min; max] plasma clearance of iohexol was 39.4 mL/min [6.1; 154.0] and iohexol urinary clearance 32.8 mL/min [0.8–170.4]. The correlation between plasma and urinary clearance was ρ=0.97, p<0.0001.Conclusions:GFR may be estimated by plasma iohexol clearance in unstable critically ill patients. This method is reliable, correlates very well with urinary iohexol clearance and does not depend on input/output fluid balance and fluid infusion, as compared with serum creatinine concentration.

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