Characteristics of population with normal serum creatinine impaired renal function and: The validation of a MDRD formula in a healthy general population

2005 ◽  
Vol 63 (04) ◽  
pp. 258-266 ◽  
Author(s):  
Y.S. Kang ◽  
K.H. Han ◽  
S.Y. Han ◽  
H.K. Kim ◽  
D.R. Cha
Keyword(s):  
Renal Function ◽  
General Population ◽  
Serum Creatinine ◽  
Impaired Renal Function ◽  
Normal Serum ◽  
Mdrd Formula ◽  
Normal Serum Creatinine

Identification Of aHUS and Complement Mutations In Patients Presenting With Acute Thrombotic Microangiopathy

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1073-1073
Author(s):  
Elizabeth H Phillips ◽  
John Connolly ◽  
John-Paul Westwood ◽  
Siobhan McGuckin ◽  
Daniel P Gale ◽  
...  
Keyword(s):  
Renal Function ◽  
Platelet Count ◽  
Serum Creatinine ◽  
Normal Serum ◽  
Control Group ◽  
Complement Inhibitor ◽  
Complement Pathway ◽  
Alternative Complement ◽  
Normal Serum Creatinine

Abstract Increasing understanding of abnormalities within the alternative complement pathway in atypical hemolytic uremic syndrome (aHUS) is changing the way the disease is both diagnosed and treated. It is rarely possible to definitively diagnose aHUS at the time of initial acute presentation and treatment, with plasma exchange, is initiated on clinical grounds. With the risk of further acute episodes and increasing availability of terminal complement inhibitors accurate molecular diagnosis is imperative. Aim to determine the clinical phenotype and nature of complement abnormalities within a cohort of aHUS patients referred to a large thrombotic thrombocytopenic purpura (TTP) referral centre. Patients and methods Data from 14 patients with a clinical diagnosis of aHUS was retrospectively analysed. 13 patients were referred with thrombotic microangiopathy not initially requiring renal replacement therapy (RRT). 1 patient presented to another institution requiring urgent RRT and was subsequently transferred to our care following recovery of renal function. All patients had ADAMTS13 levels above 30% and negative anti-ADAMTS13 antibody levels at presentation to exclude a diagnosis of TTP. 3 patients had diarrhoea at presentation; all were enterotoxin negative. Patients were subsequently assessed for mutations within complement factors H (CFH), I (CFI), B (CFB), C3 and membrane cofactor protein (MCP), at risk haplotypes and CFH antibodies. A control group of 14 acute acquired TTP patients with confirmed ADAMTS13 levels <5% were assessed for the same abnormalities within complement regulatory proteins. Results In the aHUS cohort, the median age of presentation was 25.5 years (11 months to 72 years). The median serum creatinine was 275 µmol/l (range 79-1812 µmol/l), platelet count 27 x109/l (10-115) and LDH was 2016 IU (342-4621). In the TTP group, presenting creatinine was 106 µmol/l (61-353) µmol/l, platelets 13 x109/l (5-74) and LDH 1954 IU (756-3518). aHUS precipitants at initial presentation or relapse included pregnancy (n=2), upper respiratory tract infection (n=6), vaccination (n=1), abdominal sepsis (n=4). In 3 cases, there was no identified trigger. Headache was a common presenting symptom; only one hypertensive patient (72 years) had a transient ischemic attack; no other neurological events were documented in the aHUS group. In 57% (8/14 patients) variants of the alternative complement pathway were identified; 5 with MCP mutations, encoding p.R59X, p.C157Y (present in 2 brothers), p.C64F and c.286+2T>C/c.286+2T>G (both present in the same patient); 2 with CFH mutations, encoding c.3134-5T>C and p.R1215X; and 1 with a CFB mutation (p.D371G). All of the mutations identified, except CFH c.3134-5T>C, are of clear functional significance. 2 of the patients with MCP mutations had a normal serum creatinine at presentation. C3/4 levels were low in 3/8 patients. In the control group of TTP patients with ADAMTS13 <5% no complement mutations were identified. 13/14 aHUS patients were treated initially with plasma exchange; 1 received eculizumab subsequently. 3 patients required temporary RRT and 1 died within 24 hours of presentation with progressive cardiorespiratory failure. At follow-up, all patients had platelet counts >150 x109/l and 12/13 had normal serum creatinine levels; one patient had a creatinine of 122 µmol/l. 5/13 patients had recurrent episodes, 4 of whom had confirmed complement pathway abnormalities (3 MCP mutated, 1 CFB mutated). None required long-term RRT or progressed to end-stage renal failure (ESRD) at a median follow-up of 2 years (range 0.25-28 years). Conclusions This aHUS cohort, without ESRD, demonstrates the difficulty in clinically differentiating TTP from complement mediated TMAs. We demonstrate that diagnostic differentiation based on platelet count, renal function and serum C3/C4 levels is insufficient to predict an underlying complement mutation. This distinction is increasingly important with the proven efficacy of complement inhibitor therapy in targeting complement activation in aHUS. Specifically, we demonstrate a very high frequency of functionally significant MCP mutations which mimic relapsing/remitting TTP. An ADAMTS13 activity >5% in a patient with a TMA should necessitate genetic screening for complement gene mutations prior to consideration of complement inhibitor therapy. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Assessment of renal function in recently admitted critically ill patients with normal serum creatinine

2005 ◽  
Vol 20 (4) ◽  
pp. 747-753 ◽  
Author(s):  
E. A. J. Hoste ◽  
J. Damen ◽  
R. C. Vanholder ◽  
N. H. Lameire ◽  
J. R. Delanghe ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Normal Serum ◽  
Normal Serum Creatinine

Estimation of Renal Function in Subjects With Normal Serum Creatinine Levels: Influence of Age and Body Mass Index

2005 ◽  
Vol 46 (2) ◽  
pp. 233-241 ◽  
Author(s):  
Jacobien C. Verhave ◽  
Pierre Fesler ◽  
Jean Ribstein ◽  
Guilhem du Cailar ◽  
Albert Mimran
Keyword(s):  
Body Mass Index ◽  
Renal Function ◽  
Serum Creatinine ◽  
Body Mass ◽  
Normal Serum ◽  
Normal Serum Creatinine

scholarly journals Serum Cystatin C as a Marker of Renal Function in Critically Ill Patients With Normal Serum Creatinine

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Mohammad Mahdi Sagheb ◽  
Soha Namazi ◽  
Bita Geramizadeh ◽  
Amin Karimzadeh ◽  
Mohammad Bagher Oghazian ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Normal Serum ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Normal Serum Creatinine

scholarly journals Estimation of renal function in adult outpatients with normal serum creatinine

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Temesgen Fiseha ◽  
Tizita Mengesha ◽  
Rahel Girma ◽  
Edosa Kebede ◽  
Angesom Gebreweld
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Normal Serum ◽  
Normal Serum Creatinine

Comparison of methods for determination of glomerular filtration rate in hypertensive subjects with normal serum creatinine

2010 ◽  
Vol 19 (5) ◽  
pp. 278-286 ◽  
Author(s):  
Alberto Mazza ◽  
Domenico Montemurro ◽  
Antonio Piccoli ◽  
Antonio Pagnan ◽  
Achille Cesare Pessina ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Normal Serum ◽  
Comparison Of Methods ◽  
Normal Serum Creatinine
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