Elevated serum creatinine in a patient with normal renal function: The value of Cystatin C

Nephrology ◽  
2015 ◽  
Vol 20 (5) ◽  
pp. 383-384
Author(s):  
Sheena Sahota ◽  
Roger A Rodby ◽  
Stephen M Korbet
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Normal Renal Function ◽  
Elevated Serum ◽  
Elevated Serum Creatinine

scholarly journals The elevated serum urea : creatinine ratio in canine babesiosis in South Africa is not of renal origin

2006 ◽  
Vol 77 (4) ◽  
Author(s):  
M.P. De Scally ◽  
A.L. Leisewitz ◽  
R.G. Lobetti ◽  
P.N. Thompson
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Elevated Serum ◽  
Serum Urea ◽  
Canine Babesiosis ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Renal Origin

Pigmented serum, usually due to free haemoglobin and/or bilirubin, is a common finding in dogs with babesiosis, resulting in interference with all biochemical tests that rely on photochemistry. This is particularly true of urea and creatinine determinations, complicating the diagnosis of acute renal failure, which is a serious complication of babesiosis. A disproportionately raised serum urea concentration of unknown origin occurs in severely anaemic canine babesiosis patients and gives rise to an increased serum urea:creatinine ratio. The assay for cystatin-C, an excellent measure of glomerular filtration rate, is unaffected by free serum haemoglobin, and due to its different intrinsic origins, is free of influence by the metabolic derangements and organ pathology, other than renal disease, encountered in canine babesiosis. Serum cystatin-C was used to compare the concentrations of serum urea and serum creatinine in dogs with the severely anaemic form of canine babesiosis as well as a canine babesiosis-free reference group. Mean serum urea and mean serum urea:creatinine ratio were significantly elevated in the babesia-infected group relative to the reference population in this study. Mean serum creatinine and mean serum cystatin-C were within the reference ranges. Therefore an elevated urea:creatinine ratio in canine babesiosis in the presence of a normal serum creatinine concentration is considered to be caused by an elevated serum urea concentration and is most likely of non-renal origin. Serum creatinine was therefore as specific a measure of renal function as serum cystatin-C in canine babesiosis in this study. The sensitivity of serum creatinine as a measure of renal function was not established by this study. Serum urea, however, proved to be of little use compared to serum cystatin-C and serum creatinine. Serum urea should therefore not be used to diagnose renal failure in canine babesiosis.

Stable Cystatin C Serum Levels Confirm Normal Renal Function in Patients With Dronedarone-Associated Increase in Serum Creatinine

2012 ◽  
Vol 18 (2) ◽  
pp. 109-112 ◽  
Author(s):  
David Duncker ◽  
Hanno Oswald ◽  
Ajmal Gardiwal ◽  
Ulrich Lüsebrink ◽  
Thorben König ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Cystatin C ◽  
Normal Renal Function ◽  
Serum Levels

Renal involvement in diffuse aggressive lymphomas: results of treatment with combination chemotherapy.

1985 ◽  
Vol 3 (5) ◽  
pp. 646-653 ◽  
Author(s):  
D B Geffen ◽  
R I Fisher ◽  
D L Longo ◽  
R C Young ◽  
V T DeVita
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Combination Chemotherapy ◽  
Normal Renal Function ◽  
Systemic Disease ◽  
Renal Involvement ◽  
Elevated Serum ◽  
Aggressive Lymphoma

Nine (5.1%) of 175 patients with advanced disseminated diffuse aggressive non-Hodgkin's lymphoma presented with renal involvement and were initially treated with combination chemotherapy alone. These patients were classified as having renal involvement based on histologic and radiographic criteria. Five of the nine patients presented with a serum creatinine level greater than 2.5 mg/dL. Four patients achieved a complete remission of all systemic disease. Eight patients had complete resolution of renal involvement. Two patients later had recurrent renal disease associated with other sites of recurrence. All five patients who presented with an elevated serum creatinine level recovered normal renal function; in fact, four patients had normal renal function by the end of the first cycle of therapy. No patient required hemodialysis. Only one patient remains alive and free of disease at 55 months; five patients have died with disseminated disease; two patients have died without evidence of disease; and one patient was lost to follow-up while in remission. Initial local control of renal involvement including normalization of renal function in diffuse aggressive lymphoma can be rapidly achieved by combination chemotherapy alone.

scholarly journals Comparing the Value of Cystatin C and Serum Creatinine for Evaluating the Renal Function and Predicting the Prognosis of COVID-19 Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Sichao Chen ◽  
Jinpeng Li ◽  
Zeming Liu ◽  
Danyang Chen ◽  
Ling Zhou ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Disease Severity ◽  
Cystatin C ◽  
Curve Fitting ◽  
Roc Curve ◽  
Predictive Value ◽  
Cox Regression ◽  
Elevated Serum ◽  
Elevated Creatinine

Background: Coronavirus disease- (COVID-19-) related renal function abnormality is associated with poor prognosis. However, the clinical significance of dynamic changes in renal function indicators has not been studied, and no studies have evaluated the renal function in COVID-19 patients by cystatin C.Objective: This study aimed to evaluate the effect of abnormal renal function on admission on prognosis of COVID-19 patients and the prognostic value of various renal function indicators.Methods: A total of 1,764 COVID-19 patients without a history of chronic kidney disease were categorized into two groups, an elevated cystatin C group and a normal cystatin C group, based on the results of renal function tests on admission. The clinical characteristics were compared between the two groups, and logistic or Cox regression analyses were performed to explore the associations between elevated cystatin C/serum creatinine levels and disease severity and survival. We also performed receiver operating characteristic (ROC) curve, Kaplan–Meier survival, and curve fitting analyses.Results: When adjusted for several significant clinical variables, elevated cystatin C levels on admission were independent predictors of disease severity (p < 0.001), and elevated creatinine levels were independent predictors of death (p = 0.020). Additionally, the ROC curve analysis shows that elevated cystatin C levels [area under the curve (AUC): 0.656] have a better predictive value for disease severity than elevated creatinine levels (AUC: 0.540). The survival curves of patients with elevated cystatin C/creatinine levels show a sharper decline than those of patients with normal cystatin C/creatinine levels (p < 0.001). The curve fitting analysis revealed that, compared to the flat curves of cystatin C and creatinine levels for patients who survived, the curves for patients who died kept rising, and cystatin C levels rose above the normal range earlier than creatinine.Conclusions: Elevated cystatin C, which occurs earlier than serum creatinine, is useful for the early detection of renal function abnormality and might have better predictive value for disease severity in COVID-19 patients, while elevated serum creatinine may have a better predictive value for risks of death.

scholarly journals Off-Pump Technique May Prevent Worsening of Renal Function in CAD with CKD Undergoing CABG

2021 ◽  
Vol 05 (01) ◽  
pp. 007-011
Author(s):  
Shaheen Afsal ◽  
K. Sujani ◽  
Shashank Viswanathan ◽  
Akshay Bhati ◽  
Harish BR ◽  
...  
Keyword(s):  
Renal Function ◽  
Cardiac Surgery ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Normal Renal Function ◽  
Artery Bypass ◽  
Significant Proportion ◽  
Renal Dialysis ◽  
Off Pump ◽  
Preoperative Serum

AbstractCardiovascular disease (CVD) is a major cause for a significant proportion of all deaths and disability worldwide. Postoperative renal dysfunction following cardiac surgery is not an uncommon complication of cardiac surgery, which has serious implications with regard to morbidity, mortality, financial expenditure, and resource utilization. This study was performed to compare outcomes of patients with preoperative renal dysfunction with those having normal renal function undergoing off-pump coronary artery bypass grafting (OPCABG). Patients were divided into two categories, depending on their preoperative serum creatinine and glomerular filtration rate (GFR). The preoperative renal dysfunction was defined as serum creatinine >1.3 mg/dL and/or estimated GFR (eGFR) of <60 mL/min/1.73 m2. The category A patients had normal renal function defined as serum creatinine ≤1.3 mg/dL and/or eGFR of ≥60 mL/min/1.73 m2 while the category B patients had preoperative renal dysfunction that did not necessitate renal dialysis. Blood samples were collected from both category patients for serum creatinine prior to surgery, following surgery, on postoperative days 1, 2, 3, 4, 5, and on the day of discharge. The occurrence of acute kidney injury (AKI) was defined as an increase in the serum creatinine levels of ≥0.3 mg/dL within 48 hours or an increase of ≥1.5 above baseline known or presumed to have occurred within the previous 7 days based on Kidney Disease Improving Global Outcomes criteria. This study demonstrated that there was worsening of renal function in 7.4% of patients with normal renal function and 10.74% of patients with renal dysfunction that was not statistically different. Based on the results, we conclude that preoperative renal dysfunction may be a contributing predictor of AKI following OPCABG, and we recommend that the patients with more severe renal dysfunction with eGFR of 45–60 mL/min should be studied to demonstrate this hypothesis.

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