Delimitation of Plasma Creatinine Concentration Values for Assessment of Relative Renal Function in Adult Patients

1977 ◽  
Vol 11 (3) ◽  
pp. 257-262 ◽  
Author(s):  
J. Brøchner-Mortensen ◽  
S. Jensen ◽  
P. Rødbro
Keyword(s):  
Renal Function ◽  
Adult Patients ◽  
Plasma Creatinine ◽  
Creatinine Concentration ◽  
Plasma Creatinine Concentration

Iohexol Plasma Clearance in Animal Models: The Clear Choice for Measuring Early Renal Dysfunctio

2018 ◽  
Author(s):  
Mandy Turner
Keyword(s):  
Renal Function ◽  
Animal Models ◽  
Kidney Function ◽  
Kidney Failure ◽  
Plasma Clearance ◽  
Inulin Clearance ◽  
Plasma Creatinine ◽  
Creatinine Concentration ◽  
Plasma Creatinine Concentration ◽  
Iohexol Plasma Clearance

Glomerular filtration rate is a measure of the kidney’s ability to filter blood. In animal models of early kidney failure, there is no routine method to accurately measure GFR. The expensive gold standard of GFR measurement is exogenous inulin clearance. The commonly used method, endogenous plasma creatinine concentration, is unreliable and insensitive, especially at normal levels of renal function. This study investigates the utility of iohexol, an inexpensive radio-contrast agent as a promising exogenous marker for plasma clearance kidney function evaluation in rats. Early stages of progressive kidney failure were induced with a 0.25% adenine diet in male Sprague Dawley rats (N=8) over 5 weeks. Both plasma clearance of iohexol and inulin and creatinine concentration were evaluated following weekly venous injections and blood sampling. Plasma iohexol clearance and plasma inulin clearance strongly correlate (R2=0.95). However, plasma creatinine concentration correlated weakly with iohexol(R2=0.53) and inulin(R2=0.58). Iohexol plasma clearance accurately measures changes in kidney function, especially in in comparison to creatinine analysis. The data demonstrates creatinine is an inappropriate marker for renal function in early adenine-induced CKD rat models. Ongoing analysis of this data suggests refinement of the protocol will yield a simple method for routine measure of kidney function in murine lab animals. This tool will facilitate advancement in kidney disease onset and allow for more accurate interpretation of kidney function in the various animal models.

Urinary Beta-Thromboglobulin Correlates with Impairment of Renal Function in Patients with Diabetic Nephropathy

1986 ◽  
Vol 56 (02) ◽  
pp. 229-231 ◽  
Author(s):  
A H Hopper ◽  
H Tindall ◽  
J A Davies
Keyword(s):  
Renal Function ◽  
Diabetic Nephropathy ◽  
Microvascular Disease ◽  
Normal Subjects ◽  
Specific Protein ◽  
Creatinine Concentration ◽  
Β2 Microglobulin ◽  
Plasma Creatinine Concentration ◽  
Insulin Dependent ◽  
Indium 111

SummaryTBeta-thromboglobulin (βTG) is a platelet-specific protein and since its concentration in plasma rises when platelets are activated, it has been used as an indicator of platelet involvement in vascular disease. Since platelets might be involved in the pathogenesis of diabetic microvascular disease we measured urinary βTG in 20 insulin-dependent diabetics with nephropathy and compared the results with those from 20 normal subjects. Measurement of βTG in urine was undertaken to avoid errors induced by blood sampling and to gain information over a prolonged period using a single assay. Measurements were made of βTG, β2-microglobulin and total protein in urine collected for 24 h and creatinine and β2 microglobulin in plasma. Survival of indium-111-labelled platelets was measured in nine patients. Urinary PTG was significantly (p <0.02) increased in the 20 patients compared with 20 normal volunteers (median value 1.3 vs 0.8 μg/24 h). There was a strong correlation between urinary βTG excretion and plasma creatinine concentration (r = 0.8, p <0.0001) and plasma β2-microglobulin concentration (r = 0.9, p <0.0001). Urinary βTG concentration did not correlate with platelet survival. The results indicate that although urinary βTG is significantly increased in patients with diabetic nephropathy its concentration in urine correlates with indicators of glomerular filtration rather than with a test of platelet activation.

Evaluation of Renal Function During Childhood

1996 ◽  
Vol 17 (5) ◽  
pp. 175-180
Author(s):  
Bassam A. Atiyeh ◽  
Shermine S. Dabbagh ◽  
Alan B. Gruskin
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Neonatal Period ◽  
Urinary Concentration ◽  
Urine Collection ◽  
Limited Capacity ◽  
Urea Clearance ◽  
Schwartz Formula ◽  
Creatinine Concentration ◽  
Plasma Creatinine Concentration

There are several methods to evaluate renal function during childhood. The use of serum creatinine, either alone or in combination with the Schwartz formula, is reliable and quick, but requires knowledge of conceptual age. A plasma creatinine concentration of 88.4 µmol/L (1.0 mg/dL), for example, represents normal renal function in an adolescent but more than 50% loss of renal function in a 5-year-old child. A timed urine collection for creatinine clearance is another evaluative method, but the adequacy of the urine collection always should be determined first. Urea clearance rarely is used to measure GFR because of the complex factors that influence urea excreation. Measurement of the disappearance of radioactive-labeled substances in plasma can be used to determine GFR. Radionuclide renal scans also can be used and offer the advantage of estimating the GFR of each kidney. Although infants and newborns have an intact urine diluting ability, their concentrating ability is impaired. The maximal urinary concentration in the neonatal period is less than 700 mOsm/kg, but reaches adult values of 1200 mOsm/kg by 6 to 12 months of life. Similarly, the infant kidney has a limited capacity for salt regulation, predisposing the infant to salt disturbances.

scholarly journals Plasma creatinine medians from patients partitioned by gender and age used as a tool for assessment of analytical stability at different concentrations

2019 ◽  
Vol 58 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Steen Ingemann Hansen ◽  
Per Hyltoft Petersen ◽  
Flemming Lund ◽  
Callum G. Fraser
Keyword(s):  
Systematic Errors ◽  
Reference Intervals ◽  
Plasma Creatinine ◽  
Creatinine Concentration ◽  
Medical Laboratories ◽  
Analytical Stability ◽  
Plasma Creatinine Concentration ◽  
Gender And Age ◽  
Performance Specifications

Abstract Background Monthly medians of patient results are useful in assessment of analytical quality in medical laboratories. Separate medians by gender makes it possible to generate two independent estimates of contemporaneous errors. However, for plasma creatinine, reference intervals (RIs) are different by gender and also higher over 70 years of age. Methods Daily, weekly and monthly patient medians were calculated from the raw data of plasma creatinine concentrations for males between 18 and 70 years, males >70 years, females between 18 and 70 years and females >70 years. Results The medians of the four groups were all closely associated, with similar patterns. The mean of percentage bias from each group defined the best estimate of bias. The maximum half-range (%) of the bias evaluations provided an estimate of the uncertainty comparable to the analytical performance specifications: thus, bias estimates could be classified as optimum, desirable or minimum quality. Conclusions Medians by gender and age are useful in assessment of analytical stability for plasma creatinine concentration ranging from 60 to 90 μmol/L. The daily medians are valuable in rapid detection of large systematic errors, the weekly medians in detecting minor systematic errors and monthly medians in assessment of long-term analytical stability.

Changes in Plasma Creatinine Concentration after Cardiac Anesthesia with Isoflurane, Propofol, or Sevoflurane

2001 ◽  
Vol 95 (4) ◽  
pp. 842-848 ◽  
Author(s):  
David A. Story ◽  
Stephanie Poustie ◽  
Guoming Liu ◽  
P. Larry McNicol
Keyword(s):  
Coronary Artery ◽  
Renal Impairment ◽  
Plasma Creatinine ◽  
Coronary Artery Surgery ◽  
Primary Analysis ◽  
Creatinine Concentration ◽  
Sevoflurane Group ◽  
Isoflurane Group ◽  
Plasma Creatinine Concentration ◽  
Median Maximum

Background Renal impairment often follows cardiac surgery. The authors investigated whether sevoflurane produces greater increases in plasma creatinine concentration than isoflurane or propofol after elective coronary artery surgery. Methods As part of maintenance anesthesia, including during cardiopulmonary bypass, patients were randomly allocated to receive one of three agents: isoflurane (n = 118), sevoflurane (n = 118), or propofol (n = 118). Fresh gas flows were 3 l/min. The preoperative plasma creatinine concentration was subtracted from the highest creatinine concentration in the first 3 postoperative days. A median maximum increase greater than 44 microM (0.5 mg/dl) was regarded as clinically important. Data were analyzed on an intention-to-treat basis. Subgroup analyses were performed on per-protocol patients and those with preoperative renal impairment (creatinine concentration &gt; 130 microM [1.47 mg/dl] or urea &gt; 7.7 mM [blood urea nitrogen, 21.6 mg/dl]). Results The differences between the groups were small, clinically unimportant, and not statistically significant for the primary analysis and subgroups. The proportions of patients with creatinine increases greater than 44 microM were 15% in the isoflurane group, 17% in the sevoflurane group, and 11% in the propofol group (P = 0.45). The median increases were 8 microM in the isoflurane group, 4 microM in the sevoflurane group, and 6 microM in the propofol group. The differences between the three median maximum increases were 1-4 microM (P &gt; 0.45). In the subgroup with preoperative renal impairment, the median increases were 10 microM in the isoflurane group, 15 microM in the sevoflurane group, and 5 microM in the propofol group (P = 0.72). Conclusions Sevoflurane did not produce greater increases in creatinine than isoflurane or propofol after elective coronary artery surgery.

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