RT Journal Article
SR Electronic
T1 Stability of plasma creatinine concentrations in acute complex long-stay admissions to a general medical service
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 540
OP 543
DO 10.7861/clinmedicine.10-6-540
VO 10
IS 6
A1 Donna Siriwardane
A1 Richard Woodman
A1 Paul Hakendorf
A1 Jennifer H Martin
A1 Graham H White
A1 David I Ben-Tovim
A1 Campbell H Thompson
YR 2010
UL http://www.rcpjournals.org/content/10/6/540.abstract
AB Assessment of glomerular filtration rate (GFR) is essential for calculating safe dosages of renally cleared drugs. Formulae for estimating reliable GFRs assume that plasma creatinine concentrations are stable. This study evaluates the variability of plasma creatinine (PCr) concentrations in patients admitted acutely to hospital. From 2,293 newly admitted patients, those in whom a subsequent clinically significant change (>20%) in PCr had occurred were identified. Median age was 81.1 years. Median baseline PCr was 90 umol/l (eGFR 60 ml/min). In total, 46.3% of the patients had a PCr that varied >20% from baseline three to seven days following admission. A 10-year increase in age increased the odds of a rise in PCr over the next week by 11.1% (odds ratio = 1.11, 95% confidence interval = 1.03, 1.20; p = 0.007). Overall, baseline creatinine was a poor predictor of subsequent variation in PCr. GFR formulae for calculating renally-cleared drug dosages should be used with caution in elderly patients admitted acutely to hospital.