The emerging trend in North America follows the guidelines recently
published by the National Kidney Foundation of the USA.
The NKF K/DOQI Guidelines can be located at
http://www.kidney.org/professionals/doqi/kdoqi/toc.htm and have been
described (Eknoyan G, Levey AS, Levin NW, Keane WF. The national epidemic of
chronic kidney disease. What we know and what we can do.
Postgrad Med. 2001 Sep;110(3):23-9.)
Essentially, what is recommended is that the GFR is calculated using the
MDRD calculation (see guidelines). This requires the s-creatinine
concentration and the age and gender of the patient. The reported GFR is
then linked to a classification table and the classification, in turn, to
Clinical Practice Guidelines.
Thus, the s-creatinine (and what reference range to express) becomes
secondary.
Michael McNeely MD FRCPC
[log in to unmask]
Vancouver BC Canada
-----Original Message-----
From: Paul Masters [mailto:[log in to unmask]]
Sent: February 12, 2003 3:24 AM
To: [log in to unmask]
Subject: Creatinine reference ranges
I am interested in whether, and how, colleagues report age and sex related
adult creatinine ranges. Serum creatinine is higher in men at all ages,
no doubt due to muscle mass. But male creatinine ranges are much more skewed
at older ages. My view is to report a different ULN for women
and men, but to use the young adult values for all ages and not to age
correct. (ULNs 100 umol/l for women, 120 umol/l for men.) Although it
may be common for the elderly to have higher creatinines ( Whitehead's BUPA
tables suggest 183 umol/l as the 97.5%ile for men >72, for
example) it is not desirable as it reflects decreased GFR. My concern is
that clinicians would be falsely reassured that renal function was normal
and not modify their prescribing of renally-excreted drugs appropriately.
What do other people do: single adult range, sex-related only, or age and
sex-related?
Paul Masters
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
http://www.acb.org.uk
List Archives
http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html
List Instructions (How to leave etc.)
http://www.jiscmail.ac.uk/
|