Abstract
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 51Cr-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.
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Acknowledgements
The study has been supported by grants from the Lundbeck foundation. We thank Julie Forman, Associate Professor from the Department of Biostatistics, University of Copenhagen, for statistical assistance.
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Elmelund, M., Oturai, P. & Biering-Sørensen, F. 50 years follow-up on plasma creatinine levels after spinal cord injury. Spinal Cord 52, 368–372 (2014). https://doi.org/10.1038/sc.2014.24
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DOI: https://doi.org/10.1038/sc.2014.24
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