Acute Changes in Serum Creatinine Are Not a Meaningful Metric in Randomized Controlled Trials and Clinical Care

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Background: Acute changes in serum creatinine are labeled clinically as acute kidney injury (AKI). However, not all acute changes in serum creatinine are deleterious and need to be acted upon. Summary: Intravenous fluids in response to AKI should be judiciously administered, and volume overload should be avoided. Since congestion is the driver of poor outcomes in patients with acute decompensated heart failure and must be managed, AKI that occurs at the expense of decongestion does not confer increased risk. We still do not have evidence of therapies that reduce AKI which will translate into any meaningful improvements in clinical outcomes. Finally, particularly in the setting of application of therapies designed to reduce cardiorenal risk, acute changes in serum creatinine are often in the opposite direction of the ultimate clinical outcomes, both renal and nonrenal. Key Messages: Given the complexities and the nuance of acute changes in serum creatinine, it has ruled itself as an unreliable surrogate for randomized controlled trials and often hinders appropriate care in the clinical setting.

Original languageEnglish
Pages (from-to)57-60
Number of pages4
JournalNephron
Volume147
Issue number1
DOIs
StatePublished - 1 Feb 2023

Keywords

  • Acute renal failure
  • Acute renal injury
  • Epidemiology

Fingerprint

Dive into the research topics of 'Acute Changes in Serum Creatinine Are Not a Meaningful Metric in Randomized Controlled Trials and Clinical Care'. Together they form a unique fingerprint.

Cite this