Establishment of creatinine clearance reference values for older women

1994 ◽  
Vol 40 (12) ◽  
pp. 2276-2281 ◽  
Author(s):  
L J Sokoll ◽  
R M Russell ◽  
J A Sadowski ◽  
F D Morrow
Keyword(s):  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Older Women ◽  
Research Unit ◽  
Reference Ranges ◽  
Prediction Formula ◽  
Urine Creatinine ◽  
Gault Formula ◽  
Modification Factor ◽  
Metabolic Research Unit

Abstract Age-adjusted reference ranges for creatinine clearance were determined in 279 women, ages 40-95 years, who were housed in a metabolic research unit and consumed a meat-free diet. Creatinine clearance, but not serum creatinine, declined with age by 0.63 mL/min per 1.73 m2 per year. Serum and urine creatinine concentrations, used to calculate clearances, were analyzed by a kinetic Jaffé procedure. In a subset of 100 subjects, fasting serum creatinine values averaged 8.3 +/- 5.2 (SD) mumol/L higher when measured by the kinetic Jaffé procedure than by an enzymatic method (creatinine PAP). The Cockcroft-Gault formula for estimating creatinine clearance from serum creatinine in women was validated, and the modification factor for the male equation was determined to be 0.84 (95% confidence interval 0.83-0.86) confirming the suggested 15% correction. A prediction formula derived from this population was similar in accuracy to the Cockcroft-Gault formula.

scholarly journals Biological Variation of Serum and Urine Creatinine and Creatinine Clearance: Ramifications for Interpretation of Results and Patient Care

1988 ◽  
Vol 25 (3) ◽  
pp. 259-263 ◽  
Author(s):  
Elizabeth M S Gowans ◽  
Callum G Fraser
Keyword(s):  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Population Based ◽  
Initial Assessment ◽  
Reference Ranges ◽  
Critical Difference ◽  
Urine Creatinine ◽  
Serial Serum ◽  
Line Test ◽  
Analytical Standards

Analytical and intra- and inter-individual components of variation were assessed over a 40-week period in 15 apparently healthy subjects, seven men and eight women, for serum creatinine, urine creatinine expressed in both concentration and output terms, and creatinine clearance, both uncorrected and corrected to standard surface area of 1·73 m2. Serum creatinine, even when considered separately for men and women, has marked individuality, and conventional population-based reference ranges are consequently of limited value. In contrast, urinary creatinine and creatinine clearance have less individuality, and reference ranges are more useful. Desirable analytical standards are not attained for serum creatinine assays, but are achieved for urine creatinine and clearance determinations. Creatinine clearance is, therefore, the favoured first-line test for initial assessment of patients. However, the small critical difference required for two serum creatinine results to be significantly different, and the comparatively large critical difference for clearance, make serial serum creatinine assays more useful for monitoring individuals.

scholarly journals Characterizing dynamics of serum creatinine and creatinine clearance in extremely low birth weight neonates during the first 6 weeks of life

2020 ◽  
Author(s):  
Tamara van Donge ◽  
Karel Allegaert ◽  
Verena Gotta ◽  
Anne Smits ◽  
Elena Levtchenko ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Mode Of Delivery ◽  
Extremely Low Birth Weight ◽  
Reference Ranges ◽  
Mixed Effect ◽  
Postnatal Maturation ◽  
Elbw Neonates

Abstract Background Characterizing the dynamics of serum creatinine concentrations (Scr) and associated creatinine clearance (CLcr) as a measure of kidney function in extremely low birth weight (≤ 1000 g; ELBW) neonates remains challenging. Methods We performed a retrospective study that included longitudinal Scr (enzymatic assay) data from 148 ELBW neonates up to 6 weeks after birth. Change of Scr and inter-individual variability was characterized with nonlinear mixed-effect modeling. Key covariates such as gestational age (GA), mode of delivery (MOD), and treatment with ibuprofen or inotropic agents were investigated. Results A total of 2814 Scr concentrations were analyzed. GA was associated with Scr at birth (higher with advancing GA), and GA and MOD showed an association with postnatal maturation of CLcr (faster clearance increase with advancing GA and after C-section). Small CLcr decrease (≤ 5%) was quantified during ibuprofen treatment. For a GA of 27 weeks, mean Scr (estimated CLcr) at birth was 0.61 mg/dl (0.23 ml/min), increasing to 0.87 mg/dl (0.27 ml/min) at day three, and decreasing to 0.36 mg/dl (0.67 ml/min) at day 42 after birth. Conclusions We report the first mathematical model able to characterize Scr and CLcr in ELBW neonates during the first 6 weeks of life in a quantitative manner as a function of GA, MOD, and ibuprofen treatment. This model allows the derivation of GA-adjusted reference ranges for ELBW neonates and provides a rationale for normative Scr concentrations, and as such will help clinicians to further optimize monitoring and treatment decisions in this vulnerable patient population.

scholarly journals Effect of pre-eclampsia on glomerular filtration rate in Sudanese women

2017 ◽  
Vol 5 (3) ◽  
pp. 1053 ◽  
Author(s):  
Hind Mamoun Beheiry ◽  
Ibrahim Abdelrhim Ali ◽  
Duria A. M. Rayis ◽  
Amal M Saeed
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Normal Pregnancy ◽  
Maternity Hospital ◽  
Urine Creatinine ◽  
The Mean ◽  
Control Study

Background: Creatinine clearance is safest method to measure glomerular filtration rate (GFR) in pregnancy. The objectives was to study a case-control study conducted in Omdurman Maternity Hospital aimed to assess GFR, using creatinine clearance and magnitude of changes of serum creatinine in pre-eclampsia.Methods: Pre-eclamptic were 70, normal pregnant 96 and non-pregnant 63. Investigations were done at St Hellier's hospital London. Serum and urine creatinine were measured using Jaffé reaction and spectrophotometer. 24-hour urine output was measured and creatinine clearance calculated to find GFR. GFR was calculated in ml/min/mm2 using John Hopkins’ method.Results: The mean serum creatinine in pre-eclamptic (68.6µmol/L) was less than non-pregnant (75.5µmol/L) (P=0.001) but was higher than normal pregnant (62.4µmol/L) (P=0.003). Mean GFR pre-eclamptic (68.6ml/min.1.73m2) was less than non-pregnant (87.0ml/min/1.73m2) (P=0.0001) and normal pregnant (89.0ml/min/1.73ml/min/1.73m2) (P =0.0001).Conclusions: GFR decreased at term in normal pregnancy and even more in pre-eclampsia. Serum creatinine levels increased and did not correlate with GFR changes in pre-eclampsia.

scholarly journals Cystatin C based eGFR - for early detection of diabetic kidney disease

2019 ◽  
Vol 7 (9) ◽  
pp. 3402
Author(s):  
Sudarshan N. Shelke ◽  
Jyoti S. Tele
Keyword(s):  
Kidney Disease ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Diabetic Kidney Disease ◽  
Diabetic Patients ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Diabetic Kidney ◽  
Urine Creatinine

Background: Diabetic kidney disease is the leading cause of premature death in young diabetic patients. Detection of diabetic kidney disease as early as possible in the disease process currently offers the best chance of delaying or possibly preventing progression to end-stage renal disease. The present study was aimed to evaluate utility of serum cystatin C based eGFR for early diagnosis of diabetic kidney disease.Methods: Diagnosed patients of type 2 diabetes mellitus having frank proteinuria were excluded. Patients without proteinuria were tested for microalbuminuria.  50 patients having microalbuminuria were tested for 24 hour urine creatinine, serum creatinine and serum cystatin C. Both cystatin C based eGFR and eGFR by Cockcroft and Gault equation were compared with standard GFR by 24 hour urine Creatinine clearance respectively.Results: There was statistically significant positive correlation between cystatin C based eGFR and standard GFR by 24 hr Creatinine clearance (r=0.87). For eGFR by Cockcroft-Gault equation, it was 0.36 (r=0.36).Conclusions: The results of this study suggest that serum cystatin C based eGFR  measurement is a useful, practical tool for the evaluation of renal involvement in the course of diabetes. As serum creatinine values are affected by many factors like age, sex, muscle mass and diet, serum cystatin C based eGFR estimation offers a hope that diabetic kidney disease can be well prevented with appropriate interventions.

scholarly journals Postprandial increases in serum antioxidant capacity in older women

2000 ◽  
Vol 89 (3) ◽  
pp. 877-883 ◽  
Author(s):  
Guohua Cao ◽  
Ronald L. Prior
Keyword(s):  
Uric Acid ◽  
Antioxidant Capacity ◽  
Older Women ◽  
Antioxidant Status ◽  
Research Unit ◽  
Total Antioxidant Activity ◽  
Blood Samples ◽  
Postprandial Response ◽  
Total Antioxidant ◽  
Metabolic Research Unit

Eight women were recruited for studying the effects of a meal on overall antioxidant status. Subjects resided in a metabolic research unit for two 36-h periods. During period A, subjects fasted overnight (12 h) and were then given a breakfast, a lunch, a snack, and a dinner. During period B, subjects fasted for 23 h and were then given a dinner. These meals were designed to contain negligible antioxidants. Blood samples were collected for analyzing total antioxidant capacity (TAC) and individual antioxidants. The results showed that serum TAC significantly increased by up to 23% after the consumption of the lunch and dinner during period A. Serum TAC did not increase until after the consumption of the dinner during period B. Among the antioxidants (vitamin C, α-tocopherol, bilirubin, and uric acid) examined, serum uric acid was the only one that showed a significant postprandial increase, which was also parallel to the postprandial response in serum TAC. These results indicate that food intake, even if low in antioxidants, can increase the serum total antioxidant activity.

scholarly journals Adult Reference Ranges for Serum Cystatin C, Creatinine and Predicted Creatinine Clearance

2000 ◽  
Vol 37 (1) ◽  
pp. 49-59
Author(s):  
Hazel Finney ◽  
David J Newman ◽  
Christopher P Price
Keyword(s):  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Cystatin C ◽  
Blood Donors ◽  
Reference Range ◽  
Reference Interval ◽  
Reference Intervals ◽  
Reference Ranges ◽  
Serum Cystatin C ◽  
Serum Cystatin

Serum cystatin C measurement has been previously shown by ourselves and others to be a better indicator of changes in glomerular filtration rate (GFR) than serum creatinine. However, the available literature on reference values for cystatin C concentration remains surprisingly sparse; we thus set out to determine an adult reference range. Blood was taken from 309 healthy blood donors and creatinine and cystatin C concentrations were measured using commercially available automated methodologies. In addition, predicted creatinine clearances were calculated using the Cockcroft and Gault formula. The 95% reference intervals for creatinine, predicted creatinine clearance and cystatin C for all blood donors, regardless of gender, were 68–118 μmol/L, 58–120 ml/min/1·73 m2 and 0·51–0·98 mg/L, respectively. For women, the intervals were 68–98 μmol/L, 60–119 ml/min/1·73 m2 and 0·49–0·94 mg/L; for men, they were 78–123 μmol/L, 57–122 ml/min/1·73 m2 and 0·56–0·98 mg/L. The mean 95% reference interval for cystatin C in all donors under 50 years of age was 0·53–0·92 mg/L; for those over 50 years of age it was 0·58–1·02 mg/L. The small difference between male and female ranges meant that a single reference range for cystatin C could be established for all adults under 50 years of age without adjustment for body surface area. Serum cystatin C measurement offers a simpler and more sensitive screening test than serum creatinine for early changes in GFR.

scholarly journals Estimating the glomerular filtration rate in pregnancy: The evaluation of the Nanra and CKD-EPI serum creatinine-based equations

2020 ◽  
pp. 1753495X2090417
Author(s):  
Michael Gao ◽  
Eswari Vilayur ◽  
David Ferreira ◽  
Ranjit Nanra ◽  
Joan Hawkins
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Pregnant Women ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
A Priori ◽  
Urine Creatinine ◽  
In Pregnancy

Aim To compare the performance of the Nanra and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for estimating glomerular filtration rate in pregnancy against the 24 h urine creatinine clearance. Methods Pregnant women had 24 h urine collections with simultaneous serum creatinine levels. Measured 24 h urine creatinine clearance was compared to two equations: Nanra and CKD-EPI. Level of concordance was measured, with an a priori bias acceptance of ±15 ml/min/1.73 m2. Results A total of 53 synchronous urine and serum creatinine samples were analysed. The Nanra equation had a bias of −13.4 ml/min/1.73 m2 while the CKD-EPI equation had bias of 14.2 ml/min/1.73 m2. Both equations showed a high degree of proportional error and had poor agreement with 24 h urine creatinine clearance. Conclusions None of the equations were shown to reliably measure the estimated glomerular filtration rate in pregnant women. A valid serum creatinine-based estimated glomerular filtration rate equation in pregnancy is yet to be established.

scholarly journals The Effect of Cadmium on GFR Is Clarified by Normalization of Excretion Rates to Creatinine Clearance

2021 ◽  
Vol 22 (4) ◽  
pp. 1762
Author(s):  
Soisungwan Satarug ◽  
David A. Vesey ◽  
Muneko Nishijo ◽  
Werawan Ruangyuttikarn ◽  
Glenda C. Gobe ◽  
...  
Keyword(s):  
Creatinine Clearance ◽  
Tubular Injury ◽  
Creatinine Concentration ◽  
Thai Subjects ◽  
Urine Creatinine ◽  
Wide Range ◽  
Nephron Loss ◽  
Urine Cadmium ◽  
Excretion Rates ◽  
Cd Exposure

Erroneous conclusions may result from normalization of urine cadmium and N-acetyl-β-D-glucosaminidase concentrations ([Cd]u and [NAG]u) to the urine creatinine concentration ([cr]u). In theory, the sources of these errors are nullified by normalization of excretion rates (ECd and ENAG) to creatinine clearance (Ccr). We hypothesized that this alternate approach would clarify the contribution of Cd-induced tubular injury to nephron loss. We studied 931 Thai subjects with a wide range of environmental Cd exposure. For x = Cd or NAG, Ex/Ecr and Ex/Ccr were calculated as [x]u/[cr]u and [x]u[cr]p/[cr]u, respectively. Glomerular filtration rate (GFR) was estimated according to the Chronic Kidney Disease (CKD) Epidemiology Collaboration (eGFR), and CKD was defined as eGFR < 60 mL/min/1.73m2. In multivariable logistic regression analyses, prevalence odds ratios (PORs) for CKD were higher for log(ECd/Ccr) and log(ENAG/Ccr) than for log(ECd/Ecr) and log(ENAG/Ecr). Doubling of ECd/Ccr and ENAG/Ccr increased POR by 132% and 168%; doubling of ECd/Ecr and ENAG/Ecr increased POR by 64% and 54%. As log(ECd/Ccr) rose, associations of eGFR with log(ECd/Ccr) and log(ENAG/Ccr) became stronger, while associations of eGFR with log(ECd/Ecr) and log(ENAG/Ecr) became insignificant. In univariate regressions of eGFR on each of these logarithmic variables, R2 was consistently higher with normalization to Ccr. Our tabular and graphic analyses uniformly indicate that normalization to Ccr clarified relationships of ECd and ENAG to eGFR.

Serum creatinine and creatinine clearance in healthy neonates and prematures during the first 10 days of life

1988 ◽  
Vol 148 (2) ◽  
pp. 143-145 ◽  
Author(s):  
N. Gordjani ◽  
R. Burghard ◽  
J. U. Leititis ◽  
M. Brandis
Keyword(s):  
Serum Creatinine ◽  
Creatinine Clearance
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