P0657CHANGES IN CREATININE MAY NO REFLECT MEASURED RENAL FUNCTION CHANGES IN PREDIALYSIS

• Published in: Nephrology, dialysis, transplantation Vol. 35; no. Supplement_3
• Main Authors: Beatriz, Escamilla Cabrera, Sánchez Dorta, Nuria Victoria, Negrã­n Mena, Natalia, Luis-Lima, Sergio, Gonzalez Rinne, Federico, Porrini, Esteban, Torres Ramírez, Armando
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.06.2020
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfaa142.P0657

Abstract Background and Aims Serum creatinine is the most used biomarker of renal function in clinical practice. However, the correlation between creatinine and measured GFR is poor with a variability as wide as 200%. The causes of this phenomena are not clear. Some studies observed tubular handling (reabsorption and secretion) as well as intestinal secretion of creatinine, and depends of nutritional status . Importantly, these changes increased with the loss of renal function, masking changes in the evolution of real renal function. However, scarce evidence is available about the reliability of creatinine in reflecting the changes of renal function over the time in predialysis patients, compared to measured GFR. This information is relevant in the setting of clinical decisions. Method Spanish unicenter study developed at the Hospital Universitario de Canarias (Tenerife). In the pre-dialysis outpatient clinic, subjects are followed with measured GFR (clearance of iohexol by DBS). Measured GFR is performed at baseline and repeated as suggested by the clinical evolution. For this study we included all patients with repeated determinations of creatinine and measured GFR. The changes of creatinine in terms of increase (>10%), decrease (<10%) and stability (±10%) were compared with the changes in measured GFR. Results 89 cases with repeated measurement of GFR and creatinine were evaluated. In 61 cases (68.53%) discrepancies between changes in creatinine and measured GFR were evident. Graphic 1 shows differents discordancing cases with 39 cases (43.8%) overestimation, 7 (7.8%) of infraestimation and 15 cases (24.7%) not change of mGFR with changes on Cr. Conclusion Changes in creatinine do not reflect real changes in real renal function in about 70% of the cases. Whenever possible, the measurement of GFR by whichever method available should be considered in the renal care and follow-up of these patients. Figure: