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Variable Creatinine Levels in Critical Care Patients: A Concerning Knowledge Gap
An accurate creatinine (Cr) estimate is pivotal for the assessment of renal function. Both patient- and practice-spawned factors palliate the test accuracy of serum creatinine (sCr) and can erratically represent actual kidney function. This study evaluated the caregivers’ awareness of enzymatic seru...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071156/ https://www.ncbi.nlm.nih.gov/pubmed/33920766 http://dx.doi.org/10.3390/jcm10081689 |
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author | Shah, Trushil Narasimhan, Madhusudhanan Rathinam, Mary Latha Relle, Karen Kim, Melanie Muthukumar, Tharani Tharpe, William Bartolome, Sonja Mahimainathan, Lenin Muthukumar, Alagarraju |
author_facet | Shah, Trushil Narasimhan, Madhusudhanan Rathinam, Mary Latha Relle, Karen Kim, Melanie Muthukumar, Tharani Tharpe, William Bartolome, Sonja Mahimainathan, Lenin Muthukumar, Alagarraju |
author_sort | Shah, Trushil |
collection | PubMed |
description | An accurate creatinine (Cr) estimate is pivotal for the assessment of renal function. Both patient- and practice-spawned factors palliate the test accuracy of serum creatinine (sCr) and can erratically represent actual kidney function. This study evaluated the caregivers’ awareness of enzymatic serum creatinine (E-sCr) assay interfering in dopamine/dobutamine (DD)-infused patient samples and the frequency of such interference in a critical care setting. We conducted an sCr awareness survey among UT Southwestern physicians, nurses, and pharmacists. We then performed a cross-sectional E-sCr comparison against the kinetic Jaffe method using the DD-infused patient samples collected from central venous catheters (CVC), peripherally inserted central catheter (PICC) lines, and the peripheral vein (PV). We retrospectively compared the longitudinal E-sCr results of the CVC/PICC draws with the corresponding blood urea nitrogen (BUN) levels. The survey results show a significant lack of awareness among caregivers about the negative interference of DD infusions on E-sCr. Cross-sectional E-sCr assessment relative to the Jaffe method displayed a negative interference in 12% of CVC/PICC line samples (7/57 DD-infused patients) compared to none in the PV draws. A longitudinal assessment of E-sCr, BUN, and potassium (K) levels from CVC/PICC line samples further confirmed a spurious decrease for E-sCr in about 12/50 (24%) patients who did not show a concurrent BUN or K decrease. The results suggest that a direct PV sampling accompanied by clinical laboratory-directed proactive discussion/activities can foster awareness among caregivers and eschew the false E-sCr estimates in DD-infused patients. |
format | Online Article Text |
id | pubmed-8071156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-80711562021-04-26 Variable Creatinine Levels in Critical Care Patients: A Concerning Knowledge Gap Shah, Trushil Narasimhan, Madhusudhanan Rathinam, Mary Latha Relle, Karen Kim, Melanie Muthukumar, Tharani Tharpe, William Bartolome, Sonja Mahimainathan, Lenin Muthukumar, Alagarraju J Clin Med Article An accurate creatinine (Cr) estimate is pivotal for the assessment of renal function. Both patient- and practice-spawned factors palliate the test accuracy of serum creatinine (sCr) and can erratically represent actual kidney function. This study evaluated the caregivers’ awareness of enzymatic serum creatinine (E-sCr) assay interfering in dopamine/dobutamine (DD)-infused patient samples and the frequency of such interference in a critical care setting. We conducted an sCr awareness survey among UT Southwestern physicians, nurses, and pharmacists. We then performed a cross-sectional E-sCr comparison against the kinetic Jaffe method using the DD-infused patient samples collected from central venous catheters (CVC), peripherally inserted central catheter (PICC) lines, and the peripheral vein (PV). We retrospectively compared the longitudinal E-sCr results of the CVC/PICC draws with the corresponding blood urea nitrogen (BUN) levels. The survey results show a significant lack of awareness among caregivers about the negative interference of DD infusions on E-sCr. Cross-sectional E-sCr assessment relative to the Jaffe method displayed a negative interference in 12% of CVC/PICC line samples (7/57 DD-infused patients) compared to none in the PV draws. A longitudinal assessment of E-sCr, BUN, and potassium (K) levels from CVC/PICC line samples further confirmed a spurious decrease for E-sCr in about 12/50 (24%) patients who did not show a concurrent BUN or K decrease. The results suggest that a direct PV sampling accompanied by clinical laboratory-directed proactive discussion/activities can foster awareness among caregivers and eschew the false E-sCr estimates in DD-infused patients. MDPI 2021-04-15 /pmc/articles/PMC8071156/ /pubmed/33920766 http://dx.doi.org/10.3390/jcm10081689 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Shah, Trushil Narasimhan, Madhusudhanan Rathinam, Mary Latha Relle, Karen Kim, Melanie Muthukumar, Tharani Tharpe, William Bartolome, Sonja Mahimainathan, Lenin Muthukumar, Alagarraju Variable Creatinine Levels in Critical Care Patients: A Concerning Knowledge Gap |
title | Variable Creatinine Levels in Critical Care Patients: A Concerning Knowledge Gap |
title_full | Variable Creatinine Levels in Critical Care Patients: A Concerning Knowledge Gap |
title_fullStr | Variable Creatinine Levels in Critical Care Patients: A Concerning Knowledge Gap |
title_full_unstemmed | Variable Creatinine Levels in Critical Care Patients: A Concerning Knowledge Gap |
title_short | Variable Creatinine Levels in Critical Care Patients: A Concerning Knowledge Gap |
title_sort | variable creatinine levels in critical care patients: a concerning knowledge gap |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8071156/ https://www.ncbi.nlm.nih.gov/pubmed/33920766 http://dx.doi.org/10.3390/jcm10081689 |
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