Serum creatinine is a poor marker of glomerular filtration rate in patients with spina bifida

Quan, Albert; Adams, Richard N.; Ekmark, Elaine; Baum, Michel

doi:10.1111/j.1469-8749.1997.tb07547.x

Cited by 35 publications

(14 citation statements)

References 13 publications

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“…Fourth, the fact that the stratum-specific OR for participants who were nondiabetic is significantly different from the null; whereas, the stratum-specific OR for participants who were diabetic is not, which is largely a consequence of the difference in the sample sizes. Additionally, eGFR was estimated based on a single serum creatinine measurement, which might have been influenced by recent diet, nutrition status, or inflammatory status (Branten et al 2005; Quan et al 1997). Finally, our findings, which were based on a population-based sample of adults ≥ 30 years of age, may not apply to specific population subgroups such as the elderly or those with specific comorbid conditions that might increase their susceptibility to renal disease as a consequence of PM exposure.…”

Section: Discussionmentioning

confidence: 99%

Associations between Long-Term Particulate Matter Exposure and Adult Renal Function in the Taipei Metropolis

Yang

Chen

et al. 2017

Environ Health Perspect

114

106

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Background:Studies on the effect of air pollutions on kidney diseases are still limited.Objective:We aimed to investigate the associations between particulate matter (PM) exposures and renal function among adults.Methods:We recruited 21,656 adults as participants from 2007 to 2009. The Taiwanese Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used to derive the estimated glomerular filtration rate (eGFR). Subjects with an eGFR lower than 60 mL/min/1.73 m2 were defined as having chronic kidney disease (CKD). Land use regression (LUR) models were used to estimate individual exposures to PM with an aerodynamic diameter < 10 μm (PM10), coarse particles (PMCoarse), fine particles (PM2.5), and PM2.5Absorbance. Generalized linear and logistic regression models were used to estimate the associations between PM exposure and renal function.Results:An IQR increase in PM10 (5.83 μg/m3) was negatively associated with eGFR by –0.69 (95% CI: –0.89, –0.48) mL/min/1.73 m2 and positively associated with the prevalence of CKD with adjusted OR = 1.15 (95% CI: 1.07, 1.23). An IQR increase in PMCoarse (6.59 μg/m3) was significantly associated with lower eGFR by –1.07 (95% CI: –1.32, –0.81) mL/min/1.73 m2 and CKD with OR = 1.26 (95% CI: 1.15, 1.38). In contrast, neither outcome was significantly associated with PM2.5 or PM2.5Absorbance. Stratified analyses indicated that associations of CKD with both PM10 and PMCoarse were limited to participants < 65 years of age, and were stronger (for PM10) or limited to (PMCoarse) women. Associations also appeared to be stronger in those without (vs. with) hypertension, and in normal versus overweight participants.Conclusions:Exposure during the previous year to PM10 and PMCoarse, but not PM2.5 or PM2.5Absorbance, was associated with reduced renal function among Taiwanese adults.Citation:Yang YR, Chen YM, Chen SY, Chan CC. 2017. Associations between long-term particulate matter exposure and adult renal function in the Taipei metropolis. Environ Health Perspect 125:602–607; http://dx.doi.org/10.1289/EHP302

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Section: Discussionmentioning

confidence: 99%

Associations between Long-Term Particulate Matter Exposure and Adult Renal Function in the Taipei Metropolis

Yang

Chen

et al. 2017

Environ Health Perspect

114

106

View full text Add to dashboard Cite

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“…Based on prior publications from our center on GFRs and serum creatinine values, if a trending upward is noted on creatinine measures, a 24-hour urine collection for creatinine clearance is obtained. 17 If abnormal or borderline, referral for direct measure of GFR through nephrology is initiated.…”

Section: Discussionmentioning

confidence: 99%

Incidence of New Onset Metabolic Acidosis Following Enteroplasty for Myelomeningocele

et al. 2010

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To our knowledge no previous study has examined the matched paired results of before and after development of metabolic acidosis among children (serving as their own controls) with myelomeningocele undergoing ileal or colonic enteroplasty. The negative statistical results in this controlled cohort are clinically significant. If a child with myelomeningocele has metabolic acidosis after enteroplasty, other clinical reasons beyond the effects of surgery warrant careful consideration.

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“…22,23 Additionally, most SB programs do not have specialists in nephrology to assist with long-term followup and prevention of ESRD in these patients. Lastly, serum creatinine is a poor measure of renal function in patients with poor muscle mass such as those with SB 24 and, thus, recognizing renal dysfunction in this population may be quite delayed. It is imperative to monitor for upper tract changes by ultrasound at regular intervals and perform nuclear medicine studies such as dimercapto-succinic acid to assess for renal scarring.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Survival of Patients with End Stage Renal Disease and Spina Bifida in the United States Renal Data System

et al. 2015

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Purpose We describe the characteristics, treatments and survival of patients with spina bifida in whom end stage renal disease developed from 2004 through 2008 in the United States Renal Data System. Materials and Methods We used ICD-9-CM code 741.* to identify individuals with spina bifida using hospital inpatient data from 1977 to 2010, and physician and facility claims from 2004 to 2008. We constructed a 5:1 comparison group of patients with end stage renal disease without spina bifida matched by age at first end stage renal disease service, gender and race/ethnicity. We assessed the risk of mortality and of renal transplantation while on dialysis using multivariate cause specific proportional hazards survival analysis. We also compared survival after the first renal transplant from the first end stage renal disease service to August 2011. Results We identified 439 patients with end stage renal disease and spina bifida in whom end stage renal disease developed at an average younger age than in patients without spina bifida (41 vs 62 years, p <0.001) and in whom urological issues were the most common primary cause of end stage renal disease. Compared to patients with end stage renal disease without spina bifida those who had spina bifida showed a similar mortality hazard on dialysis and after transplantation. However, patients with end stage renal disease without spina bifida were more likely to undergo renal transplantation than patients with spina bifida (HR 1.51, 95% CI 1.13–2.03). Hospitalizations related to urinary tract infections were positively associated with the risk of death on dialysis in patients with end stage renal disease and spina bifida (HR 1.42, 95% CI 1.33–1.53). Conclusions Spina bifida was not associated with increased mortality in patients with end stage renal disease on dialysis or after renal transplantation. Proper urological and bladder management is imperative in patients with spina bifida, particularly in adults.

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Serum creatinine is a poor marker of glomerular filtration rate in patients with spina bifida

Cited by 35 publications

References 13 publications

Associations between Long-Term Particulate Matter Exposure and Adult Renal Function in the Taipei Metropolis

Associations between Long-Term Particulate Matter Exposure and Adult Renal Function in the Taipei Metropolis

Incidence of New Onset Metabolic Acidosis Following Enteroplasty for Myelomeningocele

Characteristics and Survival of Patients with End Stage Renal Disease and Spina Bifida in the United States Renal Data System

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