1711 is serum creatinine a suitable marker to monitor renal function in patients with spina bifida?

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Neurogenic Voiding Dysfunction1 Apr 20131711 IS SERUM CREATININE A SUITABLE MARKER TO MONITOR RENAL FUNCTION IN PATIENTS WITH SPINA BIFIDA? Wayne Lam, Ray Hsu, and Frank Lee Wayne LamWayne Lam London, United Kingdom More articles by this author , Ray HsuRay Hsu London, United Kingdom More articles by this author , and Frank LeeFrank Lee London, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2957AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Reliable renal function surveillance is essential to guide treatment and prevent progression of chronic kidney disease in patients with spina bifida. Traditional methods of measuring renal function include inulin-clearance Glomerular Filtration Rate (GFR), or 51Cr-Ethylenediamine Tetra-acetic Acid GFR (Cr EDTA GFR). However, these methods are time-consuming, costly, and the latter involves radiation exposure. The use of serum creatinine (SCr) has been suggested an alternative method. However, SCr has been considered unreliable, due to low muscle mass and underdeveloped musculature of the lower limbs in patients with spina bifida. Despite this, SCr, either singularly or in combination with renal ultrasound and urodynamic study, is still commonly used to monitor renal function in spina bifida patients. This study aims to evaluate the reliability of SCr as a renal function marker in a modern cohort of spina bifida patients using Cr EDTA GFR. METHODS A series of patients with spina bifida from a single institution were prospectively analysed. Patients with SCr and Cr EDTA GFR (corrected for body height and weight) measured within one month were included for the study. Correlation between SCr and Cr EDTA GFR was examined using Pearson's correlation co-efficient. RESULTS 49 patients (71 data points) have matching SCr and Cr EDTA GFR were eligible for the study. SCr ranged from 13 to 102 umol/L. Cr EDTA GFR ranged from 30 to 174 ml/min/1.73m2. Pearson r was -0.46 (P<0.0001, R2=0.21) (Figure 1). However, such inverse correlation between SCr and Cr EDTA GFR does not translate into clinical relevance. Inconsistent predictability of GFR based on SCr was identified on critical examination. Patients may share the same SCr but significantly different Cr EDTA GFR values (Figure 1 red data points). CONCLUSIONS The use of SCr alone to monitor renal function in spina bifida patients can be unreliable. SCr should not be used alone to monitor renal function in patients with spina bifida without additional investigations such as renal ultrasound and urodynamic study. Cr EDTA GFR remains the clinical gold standard for monitoring renal function in spina bifida patients. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e704 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wayne Lam London, United Kingdom More articles by this author Ray Hsu London, United Kingdom More articles by this author Frank Lee London, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...