Variation of serum creatinine, cystatin C, and creatinine clearance tests in persons with normal renal function

Toffaletti, John G.; McDonnell, Elizabeth H.

doi:10.1016/j.cca.2008.05.020

Cited by 59 publications

(44 citation statements)

References 17 publications

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“…Creatinine is a by-product of skeletal muscle and is primarily removed from the blood via glomerular filtration (Toffaletti & McDonnell 2008). Interestingly, although we observed a significant reduction in plasma creatinine of obese rats treated with AM251, no differences were found between groups for estimated creatinine clearance standardised to body weight.…”

Section: Discussioncontrasting

confidence: 37%

Chronic administration of AM251 improves albuminuria and renal tubular structure in obese rats

Jenkin¹,

O’Keefe²,

Simcocks³

et al. 2015

Journal of Endocrinology

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Modulation of the endocannabinoid system as an anti-obesity therapeutic is well established; however, the direct effects of cannabinoid receptor 1 (CB 1 ) antagonism on renal function and structure in a model of diet-induced obesity (DIO) are unknown. The aim of this study was to characterise the renal effects of the CB 1 antagonist AM251 in a model of DIO. Male Sprague-Dawley rats were fed a low-or high-fat diet (HFD: 40% digestible energy from lipids) for 10 weeks to elicit DIO (nZ9). In a different cohort, rats were fed a HFD for 15 weeks. After 9 weeks consuming a HFD, rats were injected daily for 6 weeks with 3 mg/kg AM251 (nZ9) or saline via i.p. injection (nZ9). After 10 weeks consuming a HFD, CB 1 and megalin protein expression were significantly increased in the kidneys of obese rats. Antagonism of CB 1 with AM251 significantly reduced weight gain, systolic blood pressure, plasma leptin, and reduced albuminuria and plasma creatinine levels in obese rats. Importantly, there was a significant reduction in tubular cross-section diameter in the obese rats treated with AM251. An improvement in albuminuria was likely due to the reduction in tubular size, reduced leptinaemia and maintenance of megalin expression levels. In obese rats, AM251 did not alter diastolic blood pressure, sodium excretion, creatinine clearance or expression of the fibrotic proteins VEGFA, TGFB1 and collagen IV in the kidney. This study demonstrates that treatment with CB 1 antagonist AM251 improves renal outcomes in obese rats.

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Section: Discussioncontrasting

confidence: 37%

Chronic administration of AM251 improves albuminuria and renal tubular structure in obese rats

Jenkin¹,

O’Keefe²,

Simcocks³

et al. 2015

Journal of Endocrinology

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“…Renal assessment through inulin and p-amino hippurate clearance is impractical in large trials and estimated GFR has limitations [13]. Nevertheless, comparative temporal within-patient changes in estimated GFR and particularly plasma creatinine in our large sample are likely to remain robust [43]. Moreover, very few participants withdrew due to plasma creatinine rises and, to our knowledge, the washout study is the first of its type among agents with renal effects.…”

Section: Discussionmentioning

confidence: 88%

Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study

et al. 2010

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Aims/hypothesis Fenofibrate caused an acute, sustained plasma creatinine increase in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) and Action to Control Cardiovascular Risk in Diabetes (ACCORD) studies. We assessed fenofibrate's renal effects overall and in a FIELD washout sub-study. Methods Type 2 diabetic patients (n=9,795) aged 50 to 75 years were randomly assigned to fenofibrate (n=4,895) or placebo (n=4,900) for 5 years, after 6 weeks fenofibrate run-in. Albuminuria (urinary albumin/creatinine ratio measured at baseline, year 2 and close-out) and estimated GFR, measured four to six monthly according to the Modification of Diet in Renal Disease Study, were pre-specified endpoints. Plasma creatinine was re-measured 8 weeks after treatment cessation at close-out (washout sub-study, n=661). Analysis was by intention-to-treat. Results During fenofibrate run-in, plasma creatinine increased by 10.0 μmol/l (p<0.001), but quickly reversed on placebo assignment. It remained higher on fenofibrate than on placebo, but the chronic rise was slower (1.62 vs 1.89 μmol/l annually, p=0.01), with less estimated GFR loss (1.19 vs 2.03 ml min −1 1.73 m −2 annually, p<0.001). After washout, estimated GFR had fallen less from baseline on fenofibrate (1.9 ml min −1 1.73 m −2 , p=0.065) than on placebo (6.9 ml min −1 1.73 m −2 , p<0.001), sparing 5.0 ml min

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“…Because implementing manual adjudication in large-scale observational studies of AKI is not feasible, we sought to identify a quantitative rule that could be applied to a cohort of hospitalized patients to accurately classify changes in kidney function during hospitalization. The superiority of the mean outpatient creatinine in matching the adjudicated value may reflect a clinical recognition by the adjudicators that averaging multiple serum creatinine values, if available, reduces the inappropriate effect of outliers or the known effect of physiologic variation (18)(19)(20). This latter observation suggests that for a large proportion of patients at risk for AKI, baseline kidney function may be more accurately described as a range than as a single value.…”

Section: Discussionmentioning

confidence: 99%

Estimating Baseline Kidney Function in Hospitalized Patients with Impaired Kidney Function

Siew¹,

İkizler²,

Matheny

et al. 2012

Clinical Journal of the American Society of Nephrology

235

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SummaryBackground and objectives Inaccurate determination of baseline kidney function can misclassify acute kidney injury (AKI) and affect the study of AKI-related outcomes. No consensus exists on how to optimally determine baseline kidney function when multiple preadmission creatinine measurements are available.Design, setting, participants, & measurements The accuracy of commonly used methods for estimating baseline serum creatinine was compared with that of a reference standard adjudicated by a panel of board-certified nephrologists in 379 patients with AKI or CKD admitted to a tertiary referral center.Results Agreement between estimating methods and the reference standard was highest when using creatinine values measured 7-365 days before admission. During this interval, the intraclass correlation coefficient (ICC) for the mean outpatient serum creatinine level (0.91 [95% confidence interval (CI), 0.88-0.92]) was higher than the most recent outpatient (ICC, 0.84 [95% CI, 0.80-0.88]; P,0.001) and the nadir outpatient (ICC, 0.83 [95% CI, 0.76-0.87; P,0.001) serum creatinine. Using the final creatinine value from a prior inpatient admission increased the ICC of the most recent outpatient creatinine method (0.88 [95% CI,). Performance of all methods declined or was unchanged when the time interval was broadened to 2 years or included serum creatinine measured within a week of admission. ConclusionsThe mean outpatient serum creatinine measured within a year of hospitalization most closely approximates nephrologist-adjudicated serum creatinine values.

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Variation of serum creatinine, cystatin C, and creatinine clearance tests in persons with normal renal function

Cited by 59 publications

References 17 publications

Chronic administration of AM251 improves albuminuria and renal tubular structure in obese rats

Chronic administration of AM251 improves albuminuria and renal tubular structure in obese rats

Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study

Estimating Baseline Kidney Function in Hospitalized Patients with Impaired Kidney Function

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