50 years follow-up on plasma creatinine levels after spinal cord injury

TY - JOUR

T1 - 50 years follow-up on plasma creatinine levels after spinal cord injury

AU - Elmelund, Marlene

AU - Oturai, P S

AU - Biering-Sørensen, F

PY - 2014/3/11

Y1 - 2014/3/11

N2 - Study design:Retrospective chart review.Objectives:To investigate the role of plasma creatinine (p-creatinine) in monitoring renal deterioration in patients up to 50 years after spinal cord injury (SCI).Setting:The Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark.Methods:A total of 119 patients with a traumatic SCI during the years 1944-1975 were included in the study. P-creatinine measurements, results from renography and glomerular filtration rate (GFR) measured with 51 Cr-EDTA clearance were obtained from medical records and analyzed using a linear mixed model and linear regression analyses.Results:When compared with median p-creatinine level in the first 5-year period after injury, the level of p-creatinine was stable throughout the first 30 years and decreased significantly after the 30th until 45th year post injury. Only patients with a functional distribution outside the 30-70% limits on renography or a relative GFR ≤51% of that expected had a significantly elevated level of p-creatinine. Significance was not found for patients with a distribution outside the 40-60% limits on renography or relative GFR ≤75%. By comparing Cr-EDTA clearance and p-creatinine in terms of exceeding the upper reference level, p-creatinine revealed 17% sensitivity, 100% specificity, 100% positive predictive value and 73% negative predictive value as a diagnostic test for renal deterioration defined as GFR ≤75%.Conclusion:P-creatinine decreases over time in patients with SCI with a level below the upper reference limit and is a poor detector of early renal deterioration in patients with SCI.

AB - Study design:Retrospective chart review.Objectives:To investigate the role of plasma creatinine (p-creatinine) in monitoring renal deterioration in patients up to 50 years after spinal cord injury (SCI).Setting:The Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark.Methods:A total of 119 patients with a traumatic SCI during the years 1944-1975 were included in the study. P-creatinine measurements, results from renography and glomerular filtration rate (GFR) measured with 51 Cr-EDTA clearance were obtained from medical records and analyzed using a linear mixed model and linear regression analyses.Results:When compared with median p-creatinine level in the first 5-year period after injury, the level of p-creatinine was stable throughout the first 30 years and decreased significantly after the 30th until 45th year post injury. Only patients with a functional distribution outside the 30-70% limits on renography or a relative GFR ≤51% of that expected had a significantly elevated level of p-creatinine. Significance was not found for patients with a distribution outside the 40-60% limits on renography or relative GFR ≤75%. By comparing Cr-EDTA clearance and p-creatinine in terms of exceeding the upper reference level, p-creatinine revealed 17% sensitivity, 100% specificity, 100% positive predictive value and 73% negative predictive value as a diagnostic test for renal deterioration defined as GFR ≤75%.Conclusion:P-creatinine decreases over time in patients with SCI with a level below the upper reference limit and is a poor detector of early renal deterioration in patients with SCI.

KW - Adult

KW - Aged

KW - Chromium Radioisotopes

KW - Creatinine

KW - Edetic Acid

KW - Female

KW - Glomerular Filtration Rate

KW - Humans

KW - Kidney Diseases

KW - Linear Models

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Radioisotope Renography

KW - Retrospective Studies

KW - Spinal Cord Injuries

U2 - 10.1038/sc.2014.24

DO - 10.1038/sc.2014.24

M3 - Journal article

C2 - 24614854

SN - 1362-4393

VL - 52

SP - 368

EP - 372

JO - Spinal Cord

JF - Spinal Cord

IS - 5

ER -