A Surviving Patient with Record High Creatinine

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DOI: 10.4236/ojneph.2013.34037    6,241 Downloads   8,491 Views   Citations

ABSTRACT

Creatinine is a product of muscle protein breakdown cleared by the kidneys at a constant rate. The glomerular filtration rate is estimated based on serum creatinine. There is no definitive level of serum creatinine which is itself incompatible with human survival. We present the highest serum creatinine associated with survival based on a thorough review of the literature. A 34-year-old male patient with baseline serum creatinine of 1.2 mg/dl presented our emergency department with a six week history of new onset of uremic symptoms. His past medical history was unremarkable. On exam, he was in no distress. His BMI was 28. His exam was significant only for elevated blood pressure and asterixis. His peak serum creatinine was 53.9 mg/dl. The patient subsequently required maintenance hemodialysis and later changed to long-term peritoneal dialysis. To our knowledge, based on a thorough review of the literature using PubMed, Cochrane Database and the United States Renal Data System (USRDS), this is the highest level of serum creatinine ever reported. We conclude that serum creatinine itself is non-lethal. It is more likely that other electrolyte and retained metabolic abnormalities of renal failure frequently cause symptoms or death before creatinine toxicity, if such a level exists, creatinine has reached.

Cite this paper

A. Storm, N. Htike, D. Cohen and R. Benz, "A Surviving Patient with Record High Creatinine," Open Journal of Nephrology, Vol. 3 No. 4, 2013, pp. 217-219. doi: 10.4236/ojneph.2013.34037.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] N. V. Bhagavan, “Protein and Amino Acid Metabolism,” In: J. Hayhurst, Ed., Medical Biochemistry, Harcourt/ Academic Press, Burlington, 2002, pp. 331-332.
[2] D. J. Newman and C. P. Price, “Nonprotein Nitrogen Metabolites,” In: C. A. Burtis and E. R. Ashwood, Eds., Tietz Fundamentals of Clinical Chemistry, W.B. Saunders Company, Philadelphia, 2001, pp. 414-422.
[3] J. M. Watras, “Berne & Levy Physiology,” 6th Edition. Mosy, Inc., Santa Clara, 2008, pp. 246-247.
[4] G. C. Curhan and W. E. Mitch, “Brenner & Rector’s The Kidney,” 8th Edition. Saunders, Philadelphia, 2008, pp. 1826-1827.
[5] A. S. Levey, T. Greene, J. W. Kusek, G. J. Beck and MDRD Study Group, “A Simplified Equation to Predict Glomerular Filtration Rate from Serum Creatinine,” Journal of the American Society of Nephrology, Vol. 11. Suppl. 2, 2000, p. 155.
[6] A. Yavuz, C. Tetta, F. F. Ersoy, V. D’intini, et al., “Uremic Toxins: A New Focus on an Old Subject,” Seminars in Dialysis, Vol. 18, No. 3, 2005, pp. 203-211.
http://dx.doi.org/10.1111/j.1525-139X.2005.18313.x
[7] S. Levine and A. Saltzman, “Are Urea and Creatinine Uremic Toxins in the Rat?” Renal Failure, Vol. 23, No. 1, 2001, pp. 53-59.
http://dx.doi.org/10.1081/JDI-100001283
[8] S. Giovannetti, M. Biagini, P. L. Balestri, R. Navalesi, P. Giagnoni, A. De Matteis, P. Ferro-Milone and C. Perfetti, “Uraemia-Like Syndrome in Dogs Chronically Intoxicated with Methyl Guanidine and Creatinine,” Clinical Science, Vol. 36, No. 3, 1969, pp. 445-452.
[9] J. C. Fink, R. A. Burdick, S. J. Kurth, S. A. Blahut, N. C. Armistead, M. S. Turner, L. M. Shickle and P. D. Light, “Significance of Serum Creatinine Values in New End-Stage Renal Disease Patients,” American Journal of Kidney Diseases, Vol. 34, No. 4, 1999, pp. 694-701.
http://dx.doi.org/10.1016/S0272-6386(99)70395-1
[10] US Renal Data System. USRDS 1995-2010 Data Report: Atlas of End-Stage Renal Disease in the United States. http://www.usrds.org/2010/view

  
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