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Decrease of urine creatinine in vitro in spinal cord injury patients.

D G Kaw1, E Levy, T Kahn

  • 1Department of Medicine, Bronx Veterans Administration Medical Center, NY.

Clinical Nephrology
|October 1, 1988
PubMed
Summary
This summary is machine-generated.

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Urine creatinine levels unexpectedly dropped in some spinal cord injury (SCI) patients even when refrigerated. This decline, linked to Streptococcus fecalis bacteria, highlights a potential issue in SCI patient monitoring.

Area of Science:

  • Nephrology
  • Microbiology
  • Urology

Background:

  • Urine creatinine concentration is a standard biomarker for kidney function.
  • Stability of urine creatinine is generally assumed under standard storage conditions.

Purpose of the Study:

  • To investigate the cause of a progressive decline in urine creatinine concentration observed in specific spinal cord injury (SCI) patients.
  • To identify factors contributing to creatinine instability in urine samples from SCI patients.

Main Methods:

  • Analysis of urine samples from SCI patients, normal individuals, and kidney disease patients over two weeks under refrigeration.
  • Microbiological culturing to identify bacterial presence in affected urine samples.
  • In vitro experiments incubating Streptococcus fecalis with creatinine solutions and urine samples.

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Main Results:

  • A progressive decline in creatinine concentration was observed in freshly voided urine from 3 SCI patients over 2 weeks when refrigerated.
  • Creatinine levels remained stable in normal individuals, kidney disease patients, and 9 other SCI patients.
  • Streptococcus fecalis, cultured from affected patients, caused a significant drop in creatinine when incubated in broth or normal urine, but this effect was reduced under refrigeration.

Conclusions:

  • Certain spinal cord injury patients exhibit a decrease in urine creatinine concentration even with refrigerated storage.
  • The presence of Streptococcus fecalis is strongly implicated as the cause of this creatinine decline.
  • Findings suggest potential challenges in using urine creatinine as a stable biomarker in specific SCI patient populations.