ESPN 50th Annual Meeting

ESPN 2017


 
GFR-estimation by serum creatinine during glucocorticosteroid therapy
E den Bakker den Bakker 1 BPF Koene Koene JAE van Wijk van Wijk I Hubeek Hubeek RJBJ Gemke Gemke A Bökenkamp Bökenkamp

1- VU Medical Centre, Amsterdam
 
Introduction:

While glucocorticosteroids (GCS) are widely used in patients with kidney disease, little is known about their effect on serum creatinine, the most commonly used endogenous marker of kidney function.

Material and methods:

We assessed the effect of GCS on the relationship between estimated GFR using the Schwartz equation (eGFR) and measured GFR using a single injection inulin clearance (Cin) in children both in a paired analysis and a cross-sectional study. Primary outcome parameter was the difference between eGFR and Cin (DGFR). Paired analysis was done in 22 patients during and without GCS treatment (median GFR 114 ml/min/1.73m2, median prednisone dose 35.5 mg/m2/d). In a cross sectional analysis in 50 patients, 31 of which received GCS (median dose of 12 mg/m2/d) a dose-dependent effect was explored using univariate linear regression of various variables including GCS dosage, with DGFR as dependent variable.

Results:

The paired analysis showed no significant difference in DGFR with or without GCS (-23 [SD 53] vs. -9 [SD 41] ml/min/1.73m2, p = 0.203). Linear regression analysis showed a significant correlation between age and DGFR, while GCS dose was not related to DGFR.

Conclusions:

GCS use does not hamper the use of creatinine as a marker for kidney function.