Superiority of Disease-Specific over Conventional Formula in Predicting Creatinine Clearance from Serum Creatinine in Patients with Liver Cirrhosis

1988 ◽  
Vol 10 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Hirotoshi Echizen ◽  
Takashi Ishizaki
Keyword(s):  
Liver Cirrhosis ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Disease Specific

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.

Pathogenesis and Assessment of Renal Function in Patients With Liver Cirrhosis

Folia Medica ◽  
2012 ◽  
Vol 54 (4) ◽  
pp. 5-13 ◽  
Author(s):  
Bilyana H. Teneva
Keyword(s):  
Renal Function ◽  
Liver Cirrhosis ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Serum Markers ◽  
Meld Score ◽  
Kidney Damage ◽  
Early Assessment

Abstract In liver cirrhosis patients awaiting liver transplantation, it is prognostically equally important to assess the renal function before and after transplantation. This is evidenced by the inclusion of serum creatinine in the Model for End-Stage Liver Disease (MELD) score. Most of the causes of renal failure in liver cirrhosis are functional, the acute kidney damage including prerenal azotemia, acute tubular necrosis and hepatorenal syndrome. A major index of the renal function, the glomerular filtration rate (GFR) is determined in a specific way in patients with liver cirrhosis. Clinically, serum creatinine is considered the best indicator of kidney function, although it is rather unreliable when it comes to early assessment of renal dysfunction. Most of the patients with liver cirrhosis have several concomitant conditions, which are the reason for the false low creatinine levels, even in the presence of moderate to severe kidney damage. This also holds for the creatinine clearance and creatinine-based estimation equations for assessment of the glomerular filtration rate (the Cockroft-Gault and MDRD formulas), which overestimate the real glomerular filtration. Clearance of exogenous markers is considered a gold standard, but the methods for their determination are rather costly and hard to apply. Alternative serum markers (e.g., cystatin C) have been used, but they should be better studied in cases of liver cirrhosis assessment.

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

MO190NORMATIVE DATA FOR GLOMERULAR FILTRATION RATE IN HEALTHY KIDNEY DONOR POPULATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ashish Bhoyar ◽  
Vinant Bhargava ◽  
Ashwani Gupta ◽  
Anurag Gupta ◽  
Vaibhav Tiwari ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Filtration Rate ◽  
Age Groups ◽  
Kidney Donor ◽  
Urinary Creatinine ◽  
Donor Population ◽  
Sample Method ◽  
Clearance Methods

Abstract Background and Aims Glomerular filtration rate (GFR) is estimated traditionally from 24-hour urinary creatinine clearance. Creatinine is mainly filtered by glomerulus. The collection of 24-hour urinary sample is a difficult task with many patients fail to collect all the urine samples. As measuring GFR is cumbersome, expensive, and not easily available in all centers, various equations are developed for estimating GFR from creatinine like MDRD, CKD EPI creatinine. GFR obtained from serum creatinine shows wide variation as muscle mass and dietary protein intake are important determinants of serum creatinine concentration. Literature shows very few studies with GFR estimation with reference to age in Indian population. Hence, this study is planned to develop age specific nomogram for GFR in healthy kidney donor population as well as to study agreement between GFR obtained by 99m Tc DTPA three sample method and GFR estimated by 24-hour urinary creatinine. The aim of this stidy was to develop age-specific nomogram GFR in healthy kidney donor population and to study the agreement between the GFR measured by Technetium-99m diethylene triamine pentaacetic acid (99m Tc DTPA) and 24-hour urinary creatinine method. Method This study was conducted at Sir Ganga Ram hospital, New Delhi. All healthy individuals aged more than 20 years and less than 65 years, undergoing evaluation as prospective kidney donor at our hospital were the part of this study. GFR was measured by 99m Tc DTPA clearance using 3 sample method. GFR measured by DTPA method was used to develop nomogram. Creatinine Clearance was calculated from 24-hour urinary creatinine by formula U x V/P where, U is urinary creatinine level, P is plasma creatinine level and V is total volume of urine. Nomogram was developed with respect to these 3 Age groups; namely, 20 to 40 years, 40 to 50 years and 50 to 65 years Results Total 100 kidney donors were included in this study. Enrolled subjects were divided into 3 age groups; 20 to 40 years (n=28), 40 to 50 years (n=46) and 50 to 65 years (n=26). Majority of the donors were females (n=80). The agreement between GFR obtained by 99m Tc DTPA and 24-hour urinary creatinine clearance methods was 92.6 vs. 94 ml/min, 80.4 vs. 76 ml/min and 76.3 vs. 70 ml/min in respective age groups. Conclusion In the younger age group (20 to 40 years), there is better agreement in GFR measured by 99m Tc DTPA method and 24-hour urinary creatinine clearance methods.

scholarly journals Renal impairment after Spontaneous Bacterial Peritonitis (SBP) in cirrhotic population.

2019 ◽  
Vol 26 (12) ◽  
pp. 2235-2240
Author(s):  
Asif Javaid Wakani ◽  
Riaz Hussain Awan ◽  
Seema Nayab ◽  
Khadim Hussain Awan ◽  
Faqir Muhammad Awan
Keyword(s):  
Liver Cirrhosis ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Spontaneous Bacterial Peritonitis ◽  
National Hospital ◽  
Cross Sectional ◽  
Bacterial Peritonitis ◽  
Serum Blood Urea Nitrogen ◽  
Patient’S Information ◽  
The Mean

Objectives: To evaluate the frequency of renal impairment after spontaneous bacterial peritonitis (SBP) in cirrhotic population. Study Design: The study was conducted as Descriptive Cross-Sectional. Setting: Liaquat National Hospital Karachi. Period: For six months (October 01, 2015 to March 31, 2016). Methodology: The subjects with liver cirrhosis spontaneous bacterial peritonitis (SBP) were evaluated for serum creatinine and serum blood urea nitrogen (BUN) for evaluation of renal impairment while the patient’s information was recorded on proforma and analyzed in SPSS-15.0. Results: The mean ±SD of age, BUN and serum creatinine for whole population was 50.69±10.69 years, 22.4197±11.64742 and 1.2207±0.92535. Renal impairment was detected in 40 (27.2%) individuals while it is normal in 107 (72.8%) subjects. Conclusion: The renal impairment after SBP in cirrhotic population is higher in present study.

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 Factors associated with renal dysfunction in hepatitis C-related cirrhosis and its correlation with Child-Pugh score

2019 ◽  
Vol 6 (1) ◽  
pp. e000286 ◽  
Author(s):  
Hamza Waqar Bhatti ◽  
Umama Tahir ◽  
Noman Ahmed Chaudhary ◽  
Sania Bhatti ◽  
Muhammad Hafeez ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Cross Sectional ◽  
Disease Epidemiology ◽  
Factors Associated ◽  
Level Of Significance

ObjectivesTo assess factors associated with renal dysfunction (RD) in hepatitis C virus (HCV) cirrhosis, correlate renal parameters with Child-Pugh score (CPS) and find a cut-off value of CPS to determine RD.Materials and methodsIt was a cross-sectional study that included 70 cases of liver cirrhosis secondary to HCV from a period of 6 months at Combined Military Hospital, Multan. Diagnosis of HCV was confirmed by serological assay and liver cirrhosis by ultrasonography. CPS was determined and lab reports were taken. Patients were divided into two groups as not having RD (serum creatinine≤1.5 mg/dL) and having RD (serum creatinine≥1.5 mg/dL). Estimated glomerular filtration rate (eGFR) was calculated by chronic kidney disease epidemiology collaboration (CKD-EPI) formula. Data were analyzed using SPSS V.23.0. χ2, Kruskal-Wallis test and Pearson coefficient of correlation were applied. ROC curve was drawn to evaluate cut-off value of CPS for the presence of RD. Level of significance was set at p<0.05.ResultsPatients with CP grade B or C develop RD as compared to patients with CP grade A (p=0.000). Mean age, urea, creatinine and eGFR varies significantly among patients who develop RD and patients who do not (p=0.02, p=0.000, p=0.000 and p=0.000, respectively). eGFR negatively correlates with CPS (r=−0.359, p=0.002). Creatinine, urea and ALBI score positively correlates with CPS (r=+0.417, p=0.000; r=+0.757, p=0.000; r=+0.362, p=0.002, respectively).ConclusionAscites and encephalopathy are associated with RD in HCV cirrhosis.

scholarly journals Improved Prediction of Decreased Creatinine Clearance by Serum Cystatin C: Use in Cancer Patients before and during Chemotherapy

2000 ◽  
Vol 46 (2) ◽  
pp. 193-197 ◽  
Author(s):  
Borut Štabuc ◽  
Levin Vrhovec ◽  
Mirna Štabuc-Šilih ◽  
Tomaž Edvard Cizej
Keyword(s):  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Cancer Patients ◽  
Cystatin C ◽  
Stepwise Regression ◽  
Roc Analysis ◽  
Cysteine Protease Inhibitor ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Turbidimetric Immunoassay

Abstract Background: Serum cystatin C, a cysteine protease inhibitor, has been suggested as a new marker of glomerular filtration rate (GFR). This study explored the possibility of replacing the creatinine clearance (CrCl) estimation of GFR with cystatin C in early detection of renal impairment in cancer patients on chemotherapy. Methods: Serum creatinine and cystatin C concentrations as well as 24-h CrCl were determined simultaneously in 72 cancer patients. Among them, 60 were treated with combined chemotherapy with cisplatin (CDDP). Creatinine was determined enzymatically with a spectrophotometric method. Serum cystatin C was determined by a particle-enhanced turbidimetric immunoassay. Results: Cystatin C and creatinine correlated significantly (P = 0.001) with CrCl. The correlation was significantly better for cystatin C than creatinine (r = 0.84 vs 0.74; P = 0.01). Stepwise regression analysis identified no differences for the correlations between cystatin C and CrCl in patients with or without metastases (r = 0.82 and 0.84, respectively) as well as before treatment and before the fourth cycle of chemotherapy (r = 0.70 and 0.75, respectively). A cystatin C cutoff concentration of 1.33 mg/L had 87% sensitivity and 100% specificity for detecting CrCl &lt;78 mL/min. ROC analysis indicated that cystatin C was superior to serum creatinine for predicting CrCl &lt;78 mL/min (P &lt;0.04). Conclusions: Serum cystatin C is superior to serum creatinine for detection of decreased CrCl and potentially for the estimation of GFR in cancer patients independent of the presence of metastases or chemotherapy.

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