Creatinine measurements often yielded false estimates of progression in chronic renal failure

Journal Article · Thu Sep 01 00:00:00 EDT 1988 · Kidney Int.; (United States)

DOI:https://doi.org/10.1038/ki.1988.196· OSTI ID:6797935

Walser, M; Drew, H H; LaFrance, N D

In 9 of 22 observation periods (lasting an average of 15 months) in 17 patients with moderate to severe chronic renal failure (GFR 4 to 23 ml/min), rates of progression as estimated from the linear regression on time of 24-hour creatinine clearance (b1) differed significantly from rates of progression as estimated from the regression on time of urinary clearance of 99mTc-DTPA (b2), during all or part of the period of observation. b1 exceeded b2 in four cases and was less than b2 in the other five. Thus there were gradual changes in the fractional tubular secretion of creatinine in individual patients, in both directions. Owing to these changes, measurements of creatinine clearance gave erroneous impressions of the rate or existence of progression during all or a portion of the period of observation in nearly half of these patients. In the 22 studies as a group, using the entire periods of observation, b1 indicated significantly more rapid progression (by 0.18 +/- 0.06 ml/min/month, P less than 0.01) than did b2, and had a significantly greater variance. Measurements of progression based on the rate of change of reciprocal plasma creatinine (multiplied by an average rate of urinary creatinine excretion in each study) were equally misleading, even though less variable. We conclude that sequential creatinine measurements are often misleading as measures of progression and should, when feasible, be replaced by urinary clearance of isotopes in following patients with chronic renal failure.

• Research Organization: Johns Hopkins Univ. School of Medicine, Baltimore, MD (USA)
• OSTI ID: 6797935
• Journal Information: Kidney Int.; (United States), Journal Name: Kidney Int.; (United States) Vol. 34:3; ISSN KDYIA
• Country of Publication: United States
• Language: English

Related Subjects

550901* -- Pathology-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
AMINO ACIDS
AZOLES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARBOXYLIC ACIDS
CHELATING AGENTS
CLEARANCE
CREATININE
DISEASES
DRUGS
DTPA
DYNAMIC FUNCTION STUDIES
ERRORS
EXCRETION
HETEROCYCLIC COMPOUNDS
HOURS LIVING RADIOISOTOPES
IMIDAZOLES
IMINES
INTERMEDIATE MASS NUCLEI
ISOMERIC NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
KIDNEYS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANOMETALLIC COMPOUNDS
ORGANS
PATHOGENESIS
PATIENTS
RADIOISOTOPES
RADIOPROTECTIVE SUBSTANCES
RENAL CLEARANCE
TECHNETIUM 99
TECHNETIUM ISOTOPES
UROGENITAL SYSTEM DISEASES
YEARS LIVING RADIOISOTOPES