Observational studyClinical journal of the American Society of Nephrology : CJASN2015
False-Positive Rate of AKI Using Consensus Creatinine-Based Criteria.
Observational study in Clinical journal of the American Society of Nephrology : CJASN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
68 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The influence of electronic AKI alert on prognosis of adult hospitalized patients: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Urinary Biomarkers and Kidney Injury in VA NEPHRON-D: Phenotyping Acute Kidney Injury in Clinical Trials.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024Pooled it
- Inclusion and definition of acute renal dysfunction in critically ill patients in randomized controlled trials: a systematic review.Critical care (London, England) · 2018Pooled it
- Kidney Biomarkers of Injury and Repair as Predictors of Contrast-Associated AKI: A Substudy of the PRESERVE Trial.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2020Trial
- Creatinine increases have consistent and differential prognostic impact across kidney function.Clinical kidney journal · 2026Article
- Urinary UDP-sugars provide actionable prediction of acute kidney injury in cardiac surgery patients.American journal of physiology. Heart and circulatory physiology · 2026Article
- Renal Ischemia-Reperfusion and Uremic Toxins Modulate the Aortic Adenosinergic Axis in Acute Kidney Injury.International journal of molecular sciences · 2026Article
- Development and Validation of an Automated Acute Kidney Injury E-Alert System Integrated with Clinical Decision Support for Hospitalized Patients.Journal of medical systems · 2026Article
- Quantifying Change in Proteinuria After Acute Kidney Injury Among Patients With Chronic Kidney Disease: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.Kidney medicine · 2026Article
- Symptoms of heat stress predict changes in serum creatinine among rural patients with chronic kidney disease during heatwave conditions in Northern India.BMC nephrology · 2025Observational
- Modification of the Cardiac Renal Angina Index for Predicting Adverse Kidney Events After Pediatric Cardiac Surgery.Journal of the American Heart Association · 2025Observational
- Acute kidney injury predicts the risk of adverse cardio renal events and all cause death in southeast Asian people with type 2 diabetes.Scientific reports · 2024Article
- Consistency of alerts generated by, and implementation of, the NHS England acute kidney injury detection algorithm in English laboratories.Journal of nephrology · 2024Article
- Sex bias in prediction and diagnosis of cardiac surgery associated acute kidney injury.BMC nephrology · 2024Observational
- Sex Bias in Prediction and Diagnosis of Cardiac Surgery Associated Acute Kidney Injury.Research square · 2024Article
- Acute kidney injury in hospitalized children with proteinuria: A multicenter retrospective analysis.PloS one · 2024Article
- Risk for Chronic Kidney Disease Progression After Acute Kidney Injury: Findings From the Chronic Renal Insufficiency Cohort Study.Annals of internal medicine · 2023Article
- Article
- Black and White Adults With CKD Hospitalized With Acute Kidney Injury: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Article
- Absence of long-term changes in urine biomarkers after AKI: findings from the CRIC study.BMC nephrology · 2022Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
BACKGROUND AND
objectivesUse of small changes in serum creatinine to diagnose AKI allows for earlier detection but may increase diagnostic false-positive rates because of inherent laboratory and biologic variabilities of creatinine. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined serum creatinine measurement characteristics in a prospective observational clinical reference cohort of 2267 adult patients with AKI by Kidney Disease Improving Global Outcomes creatinine criteria and used these data to create a simulation cohort to model AKI false-positive rates. We simulated up to seven successive blood draws on an equal population of hypothetical patients with unchanging true serum creatinine values. Error terms generated from laboratory and biologic variabilities were added to each simulated patient's true serum creatinine value to obtain the simulated measured serum creatinine for each blood draw. We determined the proportion of patients who would be erroneously diagnosed with AKI by Kidney Disease Improving Global Outcomes creatinine criteria.
resultsWithin the clinical cohort, 75.0% of patients received four serum creatinine draws within at least one 48-hour period during hospitalization. After four simulated creatinine measurements that accounted for laboratory variability calculated from assay characteristics and 4.4% of biologic variability determined from the clinical cohort and publicly available data, the overall false-positive rate for AKI diagnosis was 8.0% (interquartile range =7.9%-8.1%), whereas patients with true serum creatinine ≥1.5 mg/dl (representing 21% of the clinical cohort) had a false-positive AKI diagnosis rate of 30.5% (interquartile range =30.1%-30.9%) versus 2.0% (interquartile range =1.9%-2.1%) in patients with true serum creatinine values <1.5 mg/dl (P<0.001).
conclusionsUse of small serum creatinine changes to diagnose AKI is limited by high false-positive rates caused by inherent variability of serum creatinine at higher baseline values, potentially misclassifying patients with CKD in AKI studies.
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