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Related Concept Videos

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

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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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Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

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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.
637
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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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

350
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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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

110
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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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
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Biological follow-up in amyotrophic lateral sclerosis: decrease in creatinine levels and increase in ferritin levels

F Patin1,2, P Corcia1,3, B Madji Hounoum1

  • 1Unité mixte de recherche U930, Institut National de la Santé et de la Recherche Médicale, Université François-Rabelais, Equipe Neurogénétique et Neurométabolomique, Tours, France.

European Journal of Neurology
|June 23, 2015
PubMed
Summary

Changes in ferritin and creatinine levels can predict the progression of amyotrophic lateral sclerosis (ALS). Monitoring these biochemical markers may improve patient care and prognosis for this motor neuron disease.

Keywords:
amyotrophic lateral sclerosisbiomarkercreatinineferritinprognostic factorssurvival

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Area of Science:

  • Neurology
  • Biochemistry
  • Clinical Medicine

Background:

  • Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron disease with variable prognosis.
  • Effective patient care necessitates reliable diagnostic and prognostic biomarkers.
  • Sporadic ALS (SALS) presents a significant challenge in predicting disease course.

Purpose of the Study:

  • To investigate the prognostic value of routine biochemical markers in sporadic ALS.
  • To identify biomarkers that correlate with disease progression and patient survival.

Main Methods:

  • Retrospective analysis of clinical and biological data from 216 SALS patients.
  • Assessment of disease duration and annual decline in ALS Functional Rating Scale-Revised (ALSFRS-R).
  • Evaluation of temporal changes in biochemical variables in relation to disease progression.

Main Results:

  • Creatinine levels decreased, while ferritin levels increased during ALS progression.
  • These changes were statistically significant (creatinine P=0.0166, ferritin P=0.0306).
  • Early changes in ferritin levels independently predicted patient survival (P=0.0048).

Conclusions:

  • Temporal changes in ferritin and creatinine are associated with ALS progression.
  • This study is the first to document these specific biochemical changes during ALS.
  • Ferritin and creatinine serve as potential prognostic indicators in SALS management.