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Related Concept Videos

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...
Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...

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Related Experiment Video

Updated: Jun 22, 2026

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
09:09

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice

Published on: August 9, 2013

Serum creatinine values underestimate surgical risk.

Raquel Dourado1, João Queiroz e Melo, João Abecasis

  • 1Hospital de Santa Cruz - CHLO, Carnaxide, Portugal. raqueldourado@yahoo.com

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|June 2, 2009
PubMed
Summary

Renal dysfunction significantly increases cardiac surgery mortality. Even mild renal dysfunction, often missed by normal serum creatinine, is a key predictor of in-hospital death. Calculating glomerular filtration rate is crucial for accurate risk assessment.

Related Experiment Videos

Last Updated: Jun 22, 2026

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
09:09

Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice

Published on: August 9, 2013

Area of Science:

  • Nephrology
  • Cardiology
  • Surgical Risk Assessment

Background:

  • Renal insufficiency is a significant risk factor for mortality and morbidity following cardiac surgery.
  • Serum creatinine (SCr) is a common but potentially unreliable marker for assessing renal function, especially in elderly or low-weight patients.

Purpose of the Study:

  • To determine the prevalence and prognostic impact of preoperative renal dysfunction (RD) in cardiac surgery patients.
  • To assess how often patients with moderate to severe RD have normal SCr levels.

Main Methods:

  • Retrospective analysis of 1314 adult cardiac surgery patients.
  • Renal dysfunction staged using National Kidney Foundation classification based on estimated glomerular filtration rate (GFR) via Cockcroft-Gault equation.
  • Multivariate analysis adjusted for EuroSCORE components to assess impact on in-hospital mortality.

Main Results:

  • Prevalence of stages 3, 4, and 5 RD was 30.2%, 3.4%, and 4.3% respectively.
  • Stage 3 or higher RD independently predicted in-hospital mortality (OR 2.0).
  • 61% of patients with stage 3+ RD had SCr < 1.50 mg/dl, and 83% had SCr < 2.26 mg/dl.

Conclusions:

  • Renal impairment is prevalent in cardiac surgery patients and linked to higher mortality, even in mild forms.
  • Normal SCr levels frequently mask moderate to severe renal dysfunction.
  • Systematic GFR calculation is essential to avoid underestimating surgical risk.