ArticleClinical kidney journal2019
A bedside clinical tool using creatinine kinetics to predict worsening renal injury and early recovery.
Article in Clinical kidney journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Dynamic monitoring of kidney injury status over 3 days in the intensive care unit as a sepsis phenotype associated with hospital mortality and hyperinflammation.Biomedical journal · 2022Article
- In creatinine kinetics, the glomerular filtration rate always moves the serum creatinine in the opposite direction.Physiological reports · 2021Article
- Estimating Creatinine Clearance in the Nonsteady State: The Determination and Role of the True Average Creatinine Concentration.Kidney medicineReview
- The Utility of the Creatinine Excretion to Production Ratio and the Plasma Creatinine and Cystatin C Based Kinetic Estimates of Glomerular Filtration Rates in Critically Ill Patients with Sepsis.Indian journal of nephrologyArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChanging creatinine concentrations during acute renal failure are often confusing to clinicians to interpret and can cloud the patient's true current state of renal injury. By modifying the formula for kinetic estimate of glomerular filtration rate (KeGFR), a simple bedside clinical tool can be used to identify subtle changes in renal function.
methodsThe KeGFR was rewritten to instead calculate a predicted peak creatinine after renal injury. By comparing the changes in predicted peak creatinine at two or more subsequent time intervals, the patient's current state of renal injury can be determined: whether improving, worsening or unchanged from prior.
resultsThree case examples are provided using the equation for predicted peak creatinine. In each case, the creatinine concentration has continued to rise at three sequentially measured times. The change in predicted peak creatinine is analyzed for each case, demonstrating scenarios involving (i) improving renal injury, (ii) unchanged renal injury continued by unfavorable hemodynamics and (iii) worsening renal injury despite interventions.
conclusionsThe use of this model may provide clinicians with an easy bedside tool to assess a patient's state of acute kidney injury. Reassessment of how the creatinine is changing is already a nonquantitative part of a nephrologist's approach to acute kidney injury. Providing an assessment of the patient's changing renal function would be a useful addition to potentially detect early renal recovery or worsening renal injury and appropriately adjust treatment strategies.
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