Increased Creatinine
Physiology
- Determinants of Cr
- Rate of Cr production
- Apparent volume of distribution for Cr
- Rate of Cr elimination
- Use of Cr to determine estimate GFR in the ICU is limited, as Cr is not in a steady-state
- Use of Cr lacks sensitivity and underestimates the degree of kidney dysfunction in critically ill patients
- Increases in serum Cr lag behind reductions in GFR
Etiology
- Primary Renal Disease
- Drugs
- Cimetidine (Tagamet) (see Cimetidine, [[Cimetidine]]): decreased tubular secretion of creatinine
- Dronedarone (Multaq) (see Dronedarone, [[Dronedarone]]): likely due to a partial inhibition of tubular organic cation
- Sulfamethoxazole-Trimethoprim (Bactrim, Septra) (see Sulfamethoxazole-Trimethoprim, [[Sulfamethoxazole-Trimethoprim]]): decreased tubular secretion of creatinine
transporters
- Toxins
References
- Dronedarone: a new antiarrhythmic agent. Drugs Today 2006;42:75-86
- Effect of dronedarone on cardiovascular events in atrial fibrillation. N Engl J Med 2009;360:668-678