Serum Creatinine Reference Limits in Pediatric Population—A Single Center Electronic Health Record-Based Database in Taiwan

Abstract

Objective: To assess age- and sex-specific serum creatinine levels in a pediatric population using a hospital-based database in Taiwan.Study Design: Data on serum creatinine levels were obtained from the National Taiwan University Hospital-integrated Medical Database (NTUH-iMD). Due to the possibility of having acute kidney injury or chronic kidney disease, individuals with multiple serum creatinine measurements were excluded, and outliers in each age- and sex-specific group were also subsequently removed. The remaining creatinine measurements in each group were analyzed, and 95% reference limits were established.Results: Serum creatinine data of individuals aged between 1 month and 18 years from May 2011 to January 2018 were retrieved. After applying the exclusion criteria, 27,911 individuals with a single corresponding serum creatinine measurement were enrolled. Creatinine level reference limits for each age- and sex-specific group were generated. The upper reference limits (URLs), which are particularly useful in clinical practice, followed the natural trend of increasing serum creatinine with age.Conclusion: We generated serum creatinine reference limits from a single hospital-integrated medical database in Taiwan for different age- and sex-specific groups of children. Our results will aid physicians in clinical practice regarding renal function evaluation, especially for patients without a recent baseline serum creatinine level.

Assessment of the Clinical Course of Human Rhinovirus/Enterovirus Infections in Pediatric Intensive Care

“…Similarly, the Hg and urea-creatinine elevations detected in the older age group were also attributed to the increase in physiological Hg with age, independent of HRV/EV infection, and the gradual increase in serum creatinine level WAS due to the increase in muscle mass with age. 30,31 In the cases, 65.3% received COT, 33.3% received NIV, 32% received HFNC-OT and 16% received IMV support. The high rate of COT may be attributed to its role as both a primary treatment modality and a transitional method among other support techniques.…”

“…Similarly, the Hg and urea-creatinine elevations detected in the older age group were also attributed to the increase in physiological Hg with age, independent of HRV/EV infection, and the gradual increase in serum creatinine level WAS due to the increase in muscle mass with age. 30,31…”

Vitamin D Levels in COVID-19 and NonCOVID-19 Pediatric Patients and Its Relationship with Clinical and Laboratory Characteristics

“…In the study that we conducted, serum creatinine was higher in infected patients with vitamin D levels above the threshold value. Children's normal values for creatinine are highly age-dependent and influenced by sex, especially in adolescence when the muscle mass grows rapidly for males [95,96]. In a cohort study on over 1200 participants in Spain, González-Molero et al demonstrated that 25-hydroxyvitamin D levels were correlated with creatinine in the normal population [97].…”

Sustained acute kidney injury as an independent risk factor for neurodevelopmental and growth outcomes in a single NICU center

“…SCr is typically regarded as the “gold standard” biomarker for clinically diagnosing AKI. However, there are two drawbacks when using SCr as a biomarker in infancy: first, muscle mass, which varies between preterm and term neonates, significantly influences SCr levels [ 15 ] and second, during the first 1–2 weeks after birth, the SCr levels of neonates primarily reflect their mother’s SCr [ 7 ]. Typically, neonatal SCr levels stabilize within a few days or weeks [ 7 ].…”

“…SAKI is defined as AKI persisting > 7 days. Recovery from AKI is defined as one of the following: SCr level dropped to baseline at infancy or the initial level [ 15 ]; UO amount ≥ 0.5 mL/kg/h over 6 consecutive hours [ 6 , 16 ]; and RRT discontinued or no longer needed.…”