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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...
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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.
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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...
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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.
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Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice
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Blood creatinine level in postmortem cases.

Atsushi Nishida1, Hironao Funaki2, Masaki Kobayashi2

  • 1Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan; Department of Orthopedic Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan.

Science & Justice : Journal of the Forensic Science Society
|May 3, 2015
PubMed
Summary
This summary is machine-generated.

Postmortem blood creatinine analysis using high-performance liquid chromatography (HPLC) is valuable for assessing kidney function, even when serum is unavailable. Rigor mortis influences creatinine levels, requiring consideration in forensic evaluations.

Keywords:
BloodCreatinineHPLCPostmortem

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Area of Science:

  • Forensic toxicology
  • Clinical chemistry
  • Renal physiology

Background:

  • Accurate diagnosis in forensic cases relies on blood chemical analysis, similar to clinical settings.
  • Postmortem changes like hemolysis and putrefaction complicate obtaining reliable serum samples.
  • Evaluating renal function postmortem is challenging due to sample degradation and limited methods.

Purpose of the Study:

  • To assess the utility of blood creatinine analysis for evaluating postmortem renal function.
  • To investigate the influence of postmortem interval and cause of death on blood creatinine levels.
  • To establish high-performance liquid chromatography (HPLC) as a viable method for postmortem creatinine measurement.

Main Methods:

  • Blood creatinine levels were measured using HPLC in 77 postmortem whole blood samples.
  • Analysis included examining relationships between creatinine levels, postmortem interval, and cause of death.
  • Postmortem creatinine changes were further studied in mice to understand rigor mortis effects.

Main Results:

  • Median blood creatinine level was 1.15 mg/dL, with no significant variation between sample sites.
  • Creatinine levels remained stable for 3 days postmortem, then gradually increased.
  • Elevated creatinine was observed in deaths due to blunt injury, intoxication, and fire, suggesting acute renal dysfunction.

Conclusions:

  • HPLC is effective for postmortem renal function assessment, especially when serum is unobtainable.
  • Postmortem blood creatinine levels are consistently higher than clinical norms, even excluding renal dysfunction cases.
  • The emergence of rigor mortis significantly impacts postmortem blood creatinine values and must be considered.