A Simple Method to Detect Recovery of Glomerular Filtration Rate following Acute Kidney Injury
In acute kidney injury (AKI), elevated plasma creatinine is diagnostic of an earlier loss of glomerular filtration rate (GFR) but not of the concomitant GFR. Only subsequent creatinine changes will inform if GFR had already recovered or not. We hypothesized that the creatinine excretion rate to prod...
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| Veröffentlicht in: | BioMed research international 2014-01, Vol.2014 (2014), p.1-8 |
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| description | In acute kidney injury (AKI), elevated plasma creatinine is diagnostic of an earlier loss of glomerular filtration rate (GFR) but not of the concomitant GFR. Only subsequent creatinine changes will inform if GFR had already recovered or not. We hypothesized that the creatinine excretion rate to production rate ratio would provide this information. A retrospective analysis of 482 critically ill patients from two intensive care units (ICU) is shown. Plasma creatinine was measured on ICU entry and 12 hours later. Four-hour creatinine excretion rates (E) were measured on entry. Creatinine production rates were estimated (eG). The ability of the ratio E/eG to predict a decrease in plasma creatinine concentration, identify recovered AKI (≥0.3 mg/dL decrease), and predict AKI (≥0.3 mg/dL increase) was assessed by the area under the receiver operator characteristic curves (AUC). There was a linear relationship between reduced creatinine concentration and E/eG (r2=0.15; P |
| doi_str_mv | 10.1155/2014/542069 |
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Only subsequent creatinine changes will inform if GFR had already recovered or not. We hypothesized that the creatinine excretion rate to production rate ratio would provide this information. A retrospective analysis of 482 critically ill patients from two intensive care units (ICU) is shown. Plasma creatinine was measured on ICU entry and 12 hours later. Four-hour creatinine excretion rates (E) were measured on entry. Creatinine production rates were estimated (eG). The ability of the ratio E/eG to predict a decrease in plasma creatinine concentration, identify recovered AKI (≥0.3 mg/dL decrease), and predict AKI (≥0.3 mg/dL increase) was assessed by the area under the receiver operator characteristic curves (AUC). There was a linear relationship between reduced creatinine concentration and E/eG (r2=0.15; P<0.0001). E/eG predicted a decrease in creatinine (AUC 0.70 (0.65 to 0.74)), identified recovered AKI (0.75 (0.67 to 0.84)), and predicted AKI (0.80 (0.73 to 0.86)). A ratio of the rates of creatinine excretion to estimated production much less than 1 indicated a concomitant GFR below baseline, whereas a ratio much more than 1 indicated a recovering or recovered GFR.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2014/542069</identifier><identifier>PMID: 24982893</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Puplishing Corporation</publisher><subject>Acute Kidney Injury - blood ; Acute Kidney Injury - physiopathology ; Acute renal failure ; Area Under Curve ; Biomarkers ; Colleges & universities ; Creatinine ; Creatinine - blood ; Demography ; Female ; Glomerular filtration rate ; Glomerular Filtration Rate - physiology ; Health aspects ; Humans ; Intensive care ; Intensive Care Units ; Kidney Function Tests - methods ; Male ; Medical research ; Medicine, Experimental ; Middle Aged ; Older people ; Patients ; Physiological aspects ; ROC Curve ; Treatment Outcome ; Urine</subject><ispartof>BioMed research international, 2014-01, Vol.2014 (2014), p.1-8</ispartof><rights>Copyright © 2014 John W. Pickering and John Mellas.</rights><rights>COPYRIGHT 2014 John Wiley & Sons, Inc.</rights><rights>Copyright © 2014 John W. Pickering and John Mellas. John W. Pickering et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2014 J. W. Pickering and J. Mellas. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c527t-fc841b322cd127fd9b9d6bc6cb73cebb81b81de7ece4df7996a65f9e95466ad33</citedby><cites>FETCH-LOGICAL-c527t-fc841b322cd127fd9b9d6bc6cb73cebb81b81de7ece4df7996a65f9e95466ad33</cites><orcidid>0000-0003-3713-5737</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058281/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058281/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24982893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Macedo, Etienne</contributor><creatorcontrib>Pickering, John W.</creatorcontrib><creatorcontrib>Mellas, John</creatorcontrib><title>A Simple Method to Detect Recovery of Glomerular Filtration Rate following Acute Kidney Injury</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>In acute kidney injury (AKI), elevated plasma creatinine is diagnostic of an earlier loss of glomerular filtration rate (GFR) but not of the concomitant GFR. Only subsequent creatinine changes will inform if GFR had already recovered or not. We hypothesized that the creatinine excretion rate to production rate ratio would provide this information. A retrospective analysis of 482 critically ill patients from two intensive care units (ICU) is shown. Plasma creatinine was measured on ICU entry and 12 hours later. Four-hour creatinine excretion rates (E) were measured on entry. Creatinine production rates were estimated (eG). The ability of the ratio E/eG to predict a decrease in plasma creatinine concentration, identify recovered AKI (≥0.3 mg/dL decrease), and predict AKI (≥0.3 mg/dL increase) was assessed by the area under the receiver operator characteristic curves (AUC). There was a linear relationship between reduced creatinine concentration and E/eG (r2=0.15; P<0.0001). E/eG predicted a decrease in creatinine (AUC 0.70 (0.65 to 0.74)), identified recovered AKI (0.75 (0.67 to 0.84)), and predicted AKI (0.80 (0.73 to 0.86)). A ratio of the rates of creatinine excretion to estimated production much less than 1 indicated a concomitant GFR below baseline, whereas a ratio much more than 1 indicated a recovering or recovered GFR.</description><subject>Acute Kidney Injury - blood</subject><subject>Acute Kidney Injury - physiopathology</subject><subject>Acute renal failure</subject><subject>Area Under Curve</subject><subject>Biomarkers</subject><subject>Colleges & universities</subject><subject>Creatinine</subject><subject>Creatinine - blood</subject><subject>Demography</subject><subject>Female</subject><subject>Glomerular filtration rate</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Intensive Care Units</subject><subject>Kidney Function Tests - methods</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>ROC Curve</subject><subject>Treatment Outcome</subject><subject>Urine</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkV1rFDEUhgdRbKm98loJeCPK2nzP5EZYqq3FilD11pDJnOxmySRrZqZl_71Zpi7VG0MgJ5yH93y8VfWc4HeECHFGMeFnglMs1aPqmDLCF5Jw8vgQM3ZUnQ7DBpfTEImVfFodUa4a2ih2XP1com--3wZAX2Bcpw6NCX2AEeyIbsCmW8g7lBy6DKmHPAWT0YUPYzajTxHdmBGQSyGkOx9XaGmn8v_suwg7dBU3U949q544EwY4vX9Pqh8XH7-ff1pcf728Ol9eL6yg9bhwtuGkZZTajtDadapVnWyttG3NLLRtQ8rtoAYLvHO1UtJI4RQowaU0HWMn1ftZdzu1PXQWYukx6G32vck7nYzXf2eiX-tVutUci7IJUgRe3wvk9GuCYdS9HyyEYCKkadBESNkIxTkv6Kt_0E2acizjFYrXijJFHlArE0D76FKpa_eieslpjSkTeF_27UzZnIYhgzu0TLDeG6z3BuvZ4EK_fDjlgf1jZwHezMDax87c-f-ovZhhKAg4c4B5g3FN2G-907Z1</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Pickering, John W.</creator><creator>Mellas, John</creator><general>Hindawi Puplishing Corporation</general><general>Hindawi Publishing Corporation</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>CWDGH</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3713-5737</orcidid></search><sort><creationdate>20140101</creationdate><title>A Simple Method to Detect Recovery of Glomerular Filtration Rate following Acute Kidney Injury</title><author>Pickering, John W. ; Mellas, John</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c527t-fc841b322cd127fd9b9d6bc6cb73cebb81b81de7ece4df7996a65f9e95466ad33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute Kidney Injury - blood</topic><topic>Acute Kidney Injury - physiopathology</topic><topic>Acute renal failure</topic><topic>Area Under Curve</topic><topic>Biomarkers</topic><topic>Colleges & universities</topic><topic>Creatinine</topic><topic>Creatinine - blood</topic><topic>Demography</topic><topic>Female</topic><topic>Glomerular filtration rate</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Intensive Care Units</topic><topic>Kidney Function Tests - methods</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Patients</topic><topic>Physiological aspects</topic><topic>ROC Curve</topic><topic>Treatment Outcome</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pickering, John W.</creatorcontrib><creatorcontrib>Mellas, John</creatorcontrib><collection>الدوريات العلمية والإحصائية - 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Only subsequent creatinine changes will inform if GFR had already recovered or not. We hypothesized that the creatinine excretion rate to production rate ratio would provide this information. A retrospective analysis of 482 critically ill patients from two intensive care units (ICU) is shown. Plasma creatinine was measured on ICU entry and 12 hours later. Four-hour creatinine excretion rates (E) were measured on entry. Creatinine production rates were estimated (eG). The ability of the ratio E/eG to predict a decrease in plasma creatinine concentration, identify recovered AKI (≥0.3 mg/dL decrease), and predict AKI (≥0.3 mg/dL increase) was assessed by the area under the receiver operator characteristic curves (AUC). There was a linear relationship between reduced creatinine concentration and E/eG (r2=0.15; P<0.0001). E/eG predicted a decrease in creatinine (AUC 0.70 (0.65 to 0.74)), identified recovered AKI (0.75 (0.67 to 0.84)), and predicted AKI (0.80 (0.73 to 0.86)). A ratio of the rates of creatinine excretion to estimated production much less than 1 indicated a concomitant GFR below baseline, whereas a ratio much more than 1 indicated a recovering or recovered GFR.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Puplishing Corporation</pub><pmid>24982893</pmid><doi>10.1155/2014/542069</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3713-5737</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Kidney Injury - blood Acute Kidney Injury - physiopathology Acute renal failure Area Under Curve Biomarkers Colleges & universities Creatinine Creatinine - blood Demography Female Glomerular filtration rate Glomerular Filtration Rate - physiology Health aspects Humans Intensive care Intensive Care Units Kidney Function Tests - methods Male Medical research Medicine, Experimental Middle Aged Older people Patients Physiological aspects ROC Curve Treatment Outcome Urine |
| title | A Simple Method to Detect Recovery of Glomerular Filtration Rate following Acute Kidney Injury |
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