Limitations of Creatinine as a Filtration Marker in Glomerulopathic Patients

Shemesh, Ovadia; Golbetz, Helen; Kriss, Joseph P.; Myers, Bryan D.

doi:10.1016/s0022-5347(17)46009-5

Cited by 286 publications

(376 citation statements)

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“…Calculated GFRs underestimate true GFRs at borderline levels of creatinine (65). However, once the plasma creatinine level exceeds 1.5-2.0 mg/dl (or 132.6-176.8 moles/liter), the secretory process is effectively saturated, and a change in the plasma creatinine level corresponds to a change in the GFR (64).…”

Section: Resultsmentioning

confidence: 98%

“…However, in early renal disease, an initial decline in the GFR may lead to only a slight increase (Յ0.2 mg/dl [or 17.7 moles/liter]) in the concentration of plasma creatinine because of an increase in proximal tubular secretion of creatinine. The net effect is that patients with a true GFR as low as 60-80 ml/minute may still have a plasma creatinine level that is 1.0 mg/dl (or 88.4 moles/liter) (64). Thus, a relatively stable plasma creatinine level in the normal or near-normal range does not necessarily imply that renal function is stable.…”

Section: Resultsmentioning

confidence: 99%

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The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Liang

Schur

Fortin

et al. 2006

Arthritis & Rheumatism

228

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Liang

Schur

Fortin

et al. 2006

Arthritis & Rheumatism

228

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“…The cystatin equation is not more accurate than creatinine equation, but the combined creatinine-cystatin equation is more precise than either of the two methods used separately [11]. Serum creatinine alone should not be used to assess the GFR or to detect the presence of CKD because it is affected by the GFR and by factors independent of GFR, including age, sex, race, body size, diet, certain drugs, and laboratory analytical methods [12]. According to Myers et al calibration bias and measurement imprecision for serum creatinine have a much larger impact on the uncertainty in estimated GFR when serum creatinine is close to the reference value, which is the relevant range for detecting early CKD [GFR \60 mL/min/1.73 m 2 [13].…”

Section: Discussionmentioning

confidence: 99%

Correlation of Microalbuminuria with Estimated GFR (eGFR) by Cockcroft–Gault and MDRD Formula in Type 2 Diabetics and Hypertensives

et al. 2014

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Increase in urine albumin excretion rate (AER) precede a fall in glomerular filtration rate in patients developing diabetic chronic kidney disease (CKD). Our results have shown that 7 (50 %) of diabetic and hypertensive individuals with decreased GFR do not have increased AER. In this cross-sectional study, we measured AER of 75 patients with type 2 diabetes and hypertension by immunoturbidimetric method. We correlated the results with eGFR values obtained by Cockcroft-Gault and MDRD method. The method used was not a compensated method. We measured serum creatinine by modified Jaffe's kinetic method in autoanalyzer XL-600. Analysis of data showed positive correlation between eGFR and microalbuminuria by both the methods with eGFR \60 mL/min/ 1.73 m 2 . Pearson's correlation co-efficient (r) was 0.9 (p = 0.0001) by Cockcroft-Gault formula and 0.69 (p = 0.0063) by MDRD formula. Our results concluded that there was positive correlation between AER and eGFR \60 mL/min/1.73 m 2 . We have recognized that these two parameters provide a complimentary benefit in management of cases with CKD.

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“…Patients with advanced kidney disease have a creatinine clearance that exceeds the GFR by more than twofold due to enhanced creatinine excretion in renal tubules [9]. Both formulas estimating GFR (Cockcroft-Gault and MDRD) generally overestimates GFR in patients with advanced (GFR 15-29 ml/min) or end-stage renal disease (GFR below 15 ml/min) [10]. In the recent article of Kuan et al [11], MDRD equation was more accurate in predicting GFR in patients with end-stage renal disease (but not yet on dialyses) than Cockcroft-Gault formula.…”

Section: Discussionmentioning

confidence: 99%

Hepcidin, iron status, and renal function in chronic renal failure, kidney transplantation, and hemodialysis

Małyszko

Pawlak

et al. 2006

Am. J. Hematol.

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Hepcidin is a small defensin-like peptide whose production by hepatocytes is modulated in response to anemia, hypoxia, or inflammation. Hepcidin could also act as an indicator of functional iron deficiency in these patients. Cross-sectional study was performed to assess hepcidin correlations with renal function, iron status, and hsCRP in patients with chronic renal failure on conservative treatment, on hemodialyses, and in kidney transplant recipients. Iron status, complete blood count, creatinine, albumin, lipids were assessed using standard laboratory methods. GFR was estimated using MDRD formula. Hepcidin and high sensitivity CRP were measured using commercially available kits. Ferritin and hepcidin were higher in hemodialyzed patients, kidney transplant recipients, and patients with chronic renal failure over controls. In patients with chronic renal failure, hepcidin correlated significantly with total protein, albumin, creatinine, and eGRF. In kidney transplant recipients, hepcidin correlated significantly in univariate analysis, with total protein, ferritin, time after transplantation, creatinine, eGRF and tended to correlate with cholesterol. In hemodialyzed patients hepcidin, correlated significantly with triglycerides, albumin, creatinine, urea, residual renal function, and hsCRP. In healthy volunteers, hepcidin was related to triglycerides and ferritin. Multiple regression analysis in hemodialyzed patients showed that hepcidin was independently related to creatinine, triglycerides, and residual renal function. Multiple regression analysis in kidney transplant recipients showed that hepcidin was independently related only to GFR and ferritin. Elevated hepcidin in all groups of patients studied may be due to low grade inflammation, frequently encountered in this population and mainly to impaired renal function. Am. J. Hematol. 81:832-837, 2006. V V C 2006 Wiley-Liss, Inc.

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Limitations of Creatinine as a Filtration Marker in Glomerulopathic Patients

Cited by 286 publications

References 0 publications

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

The American college of rheumatology response criteria for proliferative and membranous renal disease in systemic lupus erythematosus clinical trials

Correlation of Microalbuminuria with Estimated GFR (eGFR) by Cockcroft–Gault and MDRD Formula in Type 2 Diabetics and Hypertensives

Hepcidin, iron status, and renal function in chronic renal failure, kidney transplantation, and hemodialysis

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