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Drug-induced alterations in serum creatinine concentrations
M P Ducharme1, M Smythe, G Strohs
1Department of Pharmacy Practice, Wayne State University, Detroit, MI 48202.
This review examines how certain drugs can affect serum creatinine measurements, which are used to estimate kidney function. The study focuses on drugs that either interfere with the tests used to measure creatinine or change how creatinine is eliminated from the body. Two common testing methods are affected: Jaffé-based and enzymatic assays. The findings suggest that drugs like trimethoprim, cimetidine, and salicylates can lead to falsely elevated creatinine levels. The authors propose that pharmacists and clinicians should be aware of these effects and consider alternative methods for measuring creatinine in affected patients. The review highlights the importance of recognizing these drug effects to ensure accurate renal function assessment in clinical practice.
Area of Science:
- Clinical pharmacology
- Renal function assessment
- Drug interaction studies
Background:
Serum creatinine is a widely used biomarker for estimating kidney function. However, drug-induced alterations in serum creatinine concentrations can lead to misinterpretation of renal function. Prior research has shown that certain medications interfere with creatinine assays or modify creatinine elimination pathways. This uncertainty drives the need for a clearer understanding of how drugs affect creatinine measurements. The Jaffé-based and enzymatic methods are the primary analytical systems used in clinical practice. No prior work had resolved the full spectrum of drug effects on both assay types. This gap motivated a comprehensive review of drug-induced alterations in serum creatinine. The review aims to clarify the mechanisms and clinical implications of these drug effects. Understanding these interactions is essential for accurate renal function assessment in patients.
Purpose Of The Study:
The aim of this review is to summarize the clinical relevance of drug-induced changes in serum creatinine concentrations. The study focuses on identifying drugs that interfere with creatinine assays or alter creatinine elimination. Emphasis is placed on clinical studies relevant to practitioners. The review seeks to inform pharmacists and clinicians about the potential for drug-induced interference. The goal is to propose alternative methods for determining creatinine in affected patients. This approach ensures better interpretation of renal function in drug-treated individuals. The study also aims to highlight the importance of assay variability in clinical practice. The findings may guide decisions on drug use in patients with renal impairment.
Main Methods:
The authors conducted a MEDLINE search to identify relevant literature on drug-induced alterations in serum creatinine. Reference lists from identified articles were also reviewed. The review included abstracts and review articles to ensure comprehensive coverage. Emphasis was placed on clinical studies directly relevant to practitioners. The literature was evaluated for methodology, results, and conclusions. Both Jaffé-based and enzymatic analytical systems were considered in the analysis. The review focused on drugs known to interfere with creatinine assays or alter elimination pathways. The findings were synthesized to highlight clinical implications for pharmacists and clinicians.
Main Results:
Two primary analytical systems are used for serum creatinine: Jaffé-based and enzymatic methods. Several drugs interfere with both systems, causing assay interference. Trimethoprim, cimetidine, and salicylates elevate creatinine by altering elimination pathways. Phenacemide increases creatinine elimination, though the mechanism is unknown. The review highlights the variability in drug effects across different assay systems. Specific drugs were identified as having significant impact on creatinine measurements. The findings suggest that drug-induced changes may lead to inaccurate renal function estimates. Pharmacists are advised to consider alternative methods in affected patients.
Conclusions:
The authors propose that drug-induced alterations in serum creatinine may lead to misinterpretation of renal function. The review suggests that pharmacists should be aware of these drug effects. Alternative methods of determining creatinine may be necessary in selected patients. The findings emphasize the importance of recognizing assay interference in clinical practice. The authors propose that drug effects on creatinine elimination pathways should be considered. The review suggests that trimethoprim, cimetidine, and salicylates may elevate creatinine. The findings may inform decisions on drug use in patients with renal impairment. The authors propose that further awareness of these drug effects is needed in clinical settings.
Frequently Asked Questions
Trimethoprim, cimetidine, and salicylates are known to interfere with serum creatinine measurements.
These drugs alter the normal elimination pathways of creatinine, leading to elevated serum creatinine concentrations.
Both Jaffé-based and enzymatic methods can be affected by drug interference, which may lead to inaccurate results.
Such changes may lead to misinterpretation of renal function, affecting drug dosing and patient management.
The authors propose alternative methods of determining creatinine in selected patients to ensure accurate renal function assessment.
Pharmacists should recognize these changes and propose alternative methods for creatinine determination in affected patients.