Predicting Glomerular Function from Adjusted Serum Creatinine

Gault, M. H.; Longerich, L; Harnett, John D.; Wesolowski, Carl A.

doi:10.1159/000187054

Cited by 271 publications

(181 citation statements)

References 23 publications

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“…The equations of Cockcroft and Gault (7,8) and the one derived from the Modification of Diet in Renal Disease (MDRD) study (10) are the most widely accepted; however, the competence of such formulas to predict GFR in patients with normal values of serum creatinine is debated.…”

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confidence: 99%

Influence of Muscle Mass and Physical Activity on Serum and Urinary Creatinine and Serum Cystatin C

Baxmann

Ahmed

Marques

et al. 2008

Clinical Journal of the American Society of Nephrology

631

512

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Background and objectives: For addressing the influence of muscle mass on serum and urinary creatinine and serum cystatin C, body composition was assessed by skinfold thickness measurement and bioelectrical impedance analyses.Design, setting, participants, & measurements: A total of 170 healthy individuals (92 women, 78 men) were classified as sedentary or with mild or moderate/intense physical activity. Blood, 24-h urine samples, and 24-h food recall were obtained from all individuals.Results: Serum and urinary creatinine correlated significantly with body weight, but the level of correlation with lean mass was even greater. There was no significant correlation between body weight and lean mass with cystatin C. Individuals with moderate/intense physical activity presented significantly lower mean body mass index (23.1 ؎ 2.5 versus 25.7 ؎ 3.9 kg/m 2 ) and higher lean mass (55. A multivariate analysis of covariance showed that lean mass was significantly related to serum and urinary creatinine but not with cystatin, even after adjustment for protein/meat intake and physical activity.3Conclusions: Cystatin C may represent a more adequate alternative to assess renal function in individuals with higher muscle mass when mild kidney impairment is suspected.Clin J Am Soc Nephrol 3: 348-354, 2008348-354, . doi: 10.2215 A ccurate renal function measurements are important in the diagnosis and treatment of kidney diseases, adjustment of drug dosages, and decision-making regarding when to initiate renal replacement therapy. Serum creatinine is the most commonly used indicator of renal function, but its measurement suffers from a variety of analytical interferences and significant standardization problems (1,2).Serum creatinine can be affected by age, gender, ethnicity, dietary protein intake, and lean mass and may remain within the reference range despite marked renal impairment in patients with low muscle mass. Consequently, the sensitivity of serum creatinine for the early detection of kidney disease is poor and not a good predictor when analyzing the elderly (3,4). Conversely, theoretically, serum creatinine may be falsely increased in individuals with higher muscle mass and normal renal function.The GFR represents the best overall assessment of kidney function, but the gold standard techniques for the measurement of GFR, such as inulin clearance, [125 I]iothalamate, 51 Cr-EDTA, 99m Tc-diethylenetriaminepentaacetic acid, and iohexol are too labor-intensive and costly for routine clinical use (5,6), so creatinine clearance is used instead.To rid the need of 24-h urine collections, several serum creatinine-based prediction formulas have been proposed to predict GFR (7-16). The equations of Cockcroft and Gault (7,8) and the one derived from the Modification of Diet in Renal Disease (MDRD) study (10) are the most widely accepted; however, the competence of such formulas to predict GFR in patients with normal values of serum creatinine is debated.Despite the important influence of muscle mass on serum creatinine, the differ...

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mentioning

confidence: 99%

Influence of Muscle Mass and Physical Activity on Serum and Urinary Creatinine and Serum Cystatin C

Baxmann

Ahmed

Marques

et al. 2008

Clinical Journal of the American Society of Nephrology

631

512

View full text Add to dashboard Cite

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“…The relatively high serum creatinine cutoff used in many trials (eg, Ͼ180 mol/l (2 mg/dl)) did not exclude patients with significant loss of glomerular filtration. For example, a 60-year-old woman weighing 60 kilograms with a serum creatinine of 170 mol/l (1.9 mg/dl), and therefore Cockcroft-Gault equation 46 estimated creatinine clearance of only 30 ml/min, would have been enrolled. Many studies included patients with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Does treatment of non-malignant hypertension reduce the incidence of renal dysfunction? A meta-analysis of 10 randomised, controlled trials

Hsu

2001

J Hum Hypertens

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Objective: It remains controversial whether non-malignant 'benign' hypertension causes renal dysfunction. The effect of lowering blood pressure on the incidence of renal dysfunction among patients with non-malignant hypertension is not clear. This meta-analysis was conducted to determine whether antihypertensive drug therapy reduces the incidence of renal dysfunction in patients with non-malignant hypertension. Methods: Randomised, controlled trials of antihypertensive drug therapy of more than 1 year duration that reported renal dysfunction as an outcome were identified through MEDLINE search and literature review. A random effects model was used to obtain summary estimates. Results: Ten trials were identified, involving 26 521 individuals and 114 000 person-years. All excluded subjects with advanced baseline renal disease. Definition of renal

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“…The haematological toxicities were evaluated with white blood cell counts (WBC) and haemoglobin levels (Hb). Renal toxicity was examined by renal function estimated by creatinine clearance with the Cockcroft-Gault formula (Gault et al, 1992). Levels of sodium and potassium were evaluated using electrolyte statuses.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Treatment Compliance and Nutritional Outcomes among Patients with Nasopharyngeal Carcinoma with and without Percutaneous Endoscopic Gastrostomy during Chemoradiation

Peerawong

Phungrassami²,

Pruegsanusak³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Aims: The study aimed to compare treatment compliance and nutritional outcomes in nasopharyngeal carcinoma (NPC) patients during chemoradiation. Methods: Clinical information of patients with NPC that underwent chemoradiation during 2004-2009 were retrieved from the hospital database and retrospectively reviewed. Patients were categorised into a prophylactic percutaneous endoscopic gastrostomy (PPEG) group and a non-PPEG group. Clinical information including treatment compliance, weight, haematological and renal toxicity was compared. Results: A total of 219 patients were reviewed and categorised into PPEG (n=77) and non-PPEG (n=142). Significant differences in absolute percentage weight loss between groups were found from the 3 rd cycle of chemotherapy. There were 24.2, 20.3 and 24.8% in the third, the fourth and the fifth cycles of chemotherapy, respectively. Migration of grade 2 to grade 3 weight loss was obviously seen in the 3 rd cycle as well. A significant difference of grade 3 or more hypokalemia was found with values of 14.3% and 50% in the PPEG and non-PPEG groups, respectively. Other toxicity parameters and treatment compliance were not different between the groups. Conclusions: Use of PPEG resulted in decreased severe weight loss, reduced migration from grade 2 to grade 3 weight loss and reduced hypokalaemia. However, benefits in treatment compliance could not be detected. So consideration of PPEG in NPC patients requires care.

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Predicting Glomerular Function from Adjusted Serum Creatinine

Cited by 271 publications

References 23 publications

Influence of Muscle Mass and Physical Activity on Serum and Urinary Creatinine and Serum Cystatin C

Influence of Muscle Mass and Physical Activity on Serum and Urinary Creatinine and Serum Cystatin C

Does treatment of non-malignant hypertension reduce the incidence of renal dysfunction? A meta-analysis of 10 randomised, controlled trials

Comparison of Treatment Compliance and Nutritional Outcomes among Patients with Nasopharyngeal Carcinoma with and without Percutaneous Endoscopic Gastrostomy during Chemoradiation

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