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Feasibility of 24‐h urine creatinine clearance as a renal function monitoring tool in spinal cord injury patients
Objective Renal dysfunction is a major cause of morbidity in patients with spinal cord injury (SCI). A 24‐h urine creatinine (Cr) clearance (24‐h urine CCr) is cost‐effective and easy to implement compared to renal scintigraphy in the evaluation of renal function. This study aimed to verify the feas...
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| Published in: | International journal of urology 2023-01, Vol.30 (1), p.100-106 |
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| container_end_page | 106 |
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| container_title | International journal of urology |
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| creator | Shin, Ji Cheol Ahn, Kwang Ho Cho, Kye Hee Cho, Su Hyun IM, Sang Hee |
| description | Objective
Renal dysfunction is a major cause of morbidity in patients with spinal cord injury (SCI). A 24‐h urine creatinine (Cr) clearance (24‐h urine CCr) is cost‐effective and easy to implement compared to renal scintigraphy in the evaluation of renal function. This study aimed to verify the feasibility of 24‐h urine CCr in the SCI population by assessing the correlation with effective renal plasma flow (ERPF) on renal scintigraphy.
Methods
Data from 245 SCI patients (189 males, mean age: 50.2 years) were used in this retrospective review. Clinical characteristics, 24‐h urine CCr, serum Cr, comorbidities, and body composition analyses were assessed for correlation with laboratory parameters including renal scintigraphy. Strong predictors of ERPF were determined by multivariate linear regression analysis. Areas under receiver‐operating characteristic curves were calculated to evaluate the discriminating power of 24‐h urine CCr to predict ERPF |
| doi_str_mv | 10.1111/iju.15069 |
| format | article |
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Renal dysfunction is a major cause of morbidity in patients with spinal cord injury (SCI). A 24‐h urine creatinine (Cr) clearance (24‐h urine CCr) is cost‐effective and easy to implement compared to renal scintigraphy in the evaluation of renal function. This study aimed to verify the feasibility of 24‐h urine CCr in the SCI population by assessing the correlation with effective renal plasma flow (ERPF) on renal scintigraphy.
Methods
Data from 245 SCI patients (189 males, mean age: 50.2 years) were used in this retrospective review. Clinical characteristics, 24‐h urine CCr, serum Cr, comorbidities, and body composition analyses were assessed for correlation with laboratory parameters including renal scintigraphy. Strong predictors of ERPF were determined by multivariate linear regression analysis. Areas under receiver‐operating characteristic curves were calculated to evaluate the discriminating power of 24‐h urine CCr to predict ERPF <250 ml/min.
Results
Spinal cord injury patients showed tubular dysfunction despite normal serum Cr and 24‐h urine CCr. There was a significant correlation between 24‐h urine CCr and ERPF, and 24‐h urine CCr was one of the strongest predictors for ERPF (area under the curve 0.72, 95% CI 0.64–0.80, p < 0.000) among other parameters such as age, appendicular lean mass index, and body mass index. 24‐h urine CCr was an independent predictor of ERPF in subacute (R2 = 0.497, p < 0.001) and chronic SCI patients (R2 = 0.664, p < 0.0001). The optimized 24‐h urine CCr cut‐off was 139.4 ml/min/1.72 m2 for predicting decreased ERPF <250 ml/min (sensitivity 67.6% and specificity 64.0%).
Conclusion
24‐h urine CCr is a sensitive indicator for renal function deterioration of SCI patients. Further longitudinal studies with larger numbers of SCI patients are needed to confirm the feasibility of 24‐h urine CCr for monitoring this population.</description><identifier>ISSN: 0919-8172</identifier><identifier>EISSN: 1442-2042</identifier><identifier>DOI: 10.1111/iju.15069</identifier><identifier>PMID: 36305675</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>24‐h urine creatinine clearance ; Body composition ; Body mass index ; Comorbidity ; Creatinine ; effective renal plasma flow ; Feasibility Studies ; Glomerular Filtration Rate ; Humans ; Kidney - diagnostic imaging ; Kidney - physiology ; Kidney Function Tests ; Male ; Middle Aged ; Morbidity ; Renal function ; Scintigraphy ; Spinal Cord Injuries ; spinal cord injury ; Urine</subject><ispartof>International journal of urology, 2023-01, Vol.30 (1), p.100-106</ispartof><rights>2022 The Japanese Urological Association.</rights><rights>2023 The Japanese Urological Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3379-c6bd1c78a241ee4260a9cc67da397cebc255d90239a7909c5f3bfd168a463c8b3</cites><orcidid>0000-0001-5128-5526</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36305675$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shin, Ji Cheol</creatorcontrib><creatorcontrib>Ahn, Kwang Ho</creatorcontrib><creatorcontrib>Cho, Kye Hee</creatorcontrib><creatorcontrib>Cho, Su Hyun</creatorcontrib><creatorcontrib>IM, Sang Hee</creatorcontrib><title>Feasibility of 24‐h urine creatinine clearance as a renal function monitoring tool in spinal cord injury patients</title><title>International journal of urology</title><addtitle>Int J Urol</addtitle><description>Objective
Renal dysfunction is a major cause of morbidity in patients with spinal cord injury (SCI). A 24‐h urine creatinine (Cr) clearance (24‐h urine CCr) is cost‐effective and easy to implement compared to renal scintigraphy in the evaluation of renal function. This study aimed to verify the feasibility of 24‐h urine CCr in the SCI population by assessing the correlation with effective renal plasma flow (ERPF) on renal scintigraphy.
Methods
Data from 245 SCI patients (189 males, mean age: 50.2 years) were used in this retrospective review. Clinical characteristics, 24‐h urine CCr, serum Cr, comorbidities, and body composition analyses were assessed for correlation with laboratory parameters including renal scintigraphy. Strong predictors of ERPF were determined by multivariate linear regression analysis. Areas under receiver‐operating characteristic curves were calculated to evaluate the discriminating power of 24‐h urine CCr to predict ERPF <250 ml/min.
Results
Spinal cord injury patients showed tubular dysfunction despite normal serum Cr and 24‐h urine CCr. There was a significant correlation between 24‐h urine CCr and ERPF, and 24‐h urine CCr was one of the strongest predictors for ERPF (area under the curve 0.72, 95% CI 0.64–0.80, p < 0.000) among other parameters such as age, appendicular lean mass index, and body mass index. 24‐h urine CCr was an independent predictor of ERPF in subacute (R2 = 0.497, p < 0.001) and chronic SCI patients (R2 = 0.664, p < 0.0001). The optimized 24‐h urine CCr cut‐off was 139.4 ml/min/1.72 m2 for predicting decreased ERPF <250 ml/min (sensitivity 67.6% and specificity 64.0%).
Conclusion
24‐h urine CCr is a sensitive indicator for renal function deterioration of SCI patients. Further longitudinal studies with larger numbers of SCI patients are needed to confirm the feasibility of 24‐h urine CCr for monitoring this population.</description><subject>24‐h urine creatinine clearance</subject><subject>Body composition</subject><subject>Body mass index</subject><subject>Comorbidity</subject><subject>Creatinine</subject><subject>effective renal plasma flow</subject><subject>Feasibility Studies</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney - physiology</subject><subject>Kidney Function Tests</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Renal function</subject><subject>Scintigraphy</subject><subject>Spinal Cord Injuries</subject><subject>spinal cord injury</subject><subject>Urine</subject><issn>0919-8172</issn><issn>1442-2042</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp10ctKxDAUBuAgijOOLnwBCbjRRTWXNmmWIl4R3Oi6pOmpZugkY9Iis_MRfEafxMxFF4LZJIHv_JD8CB1SckbTOrfT4YwWRKgtNKZ5zjJGcraNxkRRlZVUshHai3FKCOWMlrtoxAUnhZDFGMVr0NHWtrP9AvsWs_zr4_MVD8E6wCaA7q1bHTvQQTsDWEescQCnO9wOzvTWOzzzzvY-zbzg3vsOW4fj3C6J8aFJ1-kQFniewsD1cR_ttLqLcLDZJ-j5-urp8jZ7eLy5u7x4yAznUmVG1A01stQspwA5E0QrY4RsNFfSQG1YUTSKMK60VESZouV121BR6lxwU9Z8gk7WufPg3waIfTWz0UDXaQd-iBWTnHCaRkWix3_o1A8hPWCphCoLUUqZ1OlameBjDNBW82BnOiwqSqplE1Vqolo1kezRJnGoZ9D8yp-vT-B8Dd5tB4v_k6q7--d15De_N5QI</recordid><startdate>202301</startdate><enddate>202301</enddate><creator>Shin, Ji Cheol</creator><creator>Ahn, Kwang Ho</creator><creator>Cho, Kye Hee</creator><creator>Cho, Su Hyun</creator><creator>IM, Sang Hee</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5128-5526</orcidid></search><sort><creationdate>202301</creationdate><title>Feasibility of 24‐h urine creatinine clearance as a renal function monitoring tool in spinal cord injury patients</title><author>Shin, Ji Cheol ; Ahn, Kwang Ho ; Cho, Kye Hee ; Cho, Su Hyun ; IM, Sang Hee</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3379-c6bd1c78a241ee4260a9cc67da397cebc255d90239a7909c5f3bfd168a463c8b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>24‐h urine creatinine clearance</topic><topic>Body composition</topic><topic>Body mass index</topic><topic>Comorbidity</topic><topic>Creatinine</topic><topic>effective renal plasma flow</topic><topic>Feasibility Studies</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney - physiology</topic><topic>Kidney Function Tests</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Renal function</topic><topic>Scintigraphy</topic><topic>Spinal Cord Injuries</topic><topic>spinal cord injury</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shin, Ji Cheol</creatorcontrib><creatorcontrib>Ahn, Kwang Ho</creatorcontrib><creatorcontrib>Cho, Kye Hee</creatorcontrib><creatorcontrib>Cho, Su Hyun</creatorcontrib><creatorcontrib>IM, Sang Hee</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shin, Ji Cheol</au><au>Ahn, Kwang Ho</au><au>Cho, Kye Hee</au><au>Cho, Su Hyun</au><au>IM, Sang Hee</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility of 24‐h urine creatinine clearance as a renal function monitoring tool in spinal cord injury patients</atitle><jtitle>International journal of urology</jtitle><addtitle>Int J Urol</addtitle><date>2023-01</date><risdate>2023</risdate><volume>30</volume><issue>1</issue><spage>100</spage><epage>106</epage><pages>100-106</pages><issn>0919-8172</issn><eissn>1442-2042</eissn><abstract>Objective
Renal dysfunction is a major cause of morbidity in patients with spinal cord injury (SCI). A 24‐h urine creatinine (Cr) clearance (24‐h urine CCr) is cost‐effective and easy to implement compared to renal scintigraphy in the evaluation of renal function. This study aimed to verify the feasibility of 24‐h urine CCr in the SCI population by assessing the correlation with effective renal plasma flow (ERPF) on renal scintigraphy.
Methods
Data from 245 SCI patients (189 males, mean age: 50.2 years) were used in this retrospective review. Clinical characteristics, 24‐h urine CCr, serum Cr, comorbidities, and body composition analyses were assessed for correlation with laboratory parameters including renal scintigraphy. Strong predictors of ERPF were determined by multivariate linear regression analysis. Areas under receiver‐operating characteristic curves were calculated to evaluate the discriminating power of 24‐h urine CCr to predict ERPF <250 ml/min.
Results
Spinal cord injury patients showed tubular dysfunction despite normal serum Cr and 24‐h urine CCr. There was a significant correlation between 24‐h urine CCr and ERPF, and 24‐h urine CCr was one of the strongest predictors for ERPF (area under the curve 0.72, 95% CI 0.64–0.80, p < 0.000) among other parameters such as age, appendicular lean mass index, and body mass index. 24‐h urine CCr was an independent predictor of ERPF in subacute (R2 = 0.497, p < 0.001) and chronic SCI patients (R2 = 0.664, p < 0.0001). The optimized 24‐h urine CCr cut‐off was 139.4 ml/min/1.72 m2 for predicting decreased ERPF <250 ml/min (sensitivity 67.6% and specificity 64.0%).
Conclusion
24‐h urine CCr is a sensitive indicator for renal function deterioration of SCI patients. Further longitudinal studies with larger numbers of SCI patients are needed to confirm the feasibility of 24‐h urine CCr for monitoring this population.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36305675</pmid><doi>10.1111/iju.15069</doi><tpages>106</tpages><orcidid>https://orcid.org/0000-0001-5128-5526</orcidid></addata></record> |
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| ispartof | International journal of urology, 2023-01, Vol.30 (1), p.100-106 |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | 24‐h urine creatinine clearance Body composition Body mass index Comorbidity Creatinine effective renal plasma flow Feasibility Studies Glomerular Filtration Rate Humans Kidney - diagnostic imaging Kidney - physiology Kidney Function Tests Male Middle Aged Morbidity Renal function Scintigraphy Spinal Cord Injuries spinal cord injury Urine |
| title | Feasibility of 24‐h urine creatinine clearance as a renal function monitoring tool in spinal cord injury patients |
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