Creatinine increase in elderly means increased renal disease, mortality

Apr 15, 2008

Even small increases in serum creatinine levels during hospitalization raise the risk of end stage renal disease and mortality of elderly patients over the long term, according to a University of Alabama at Birmingham (UAB) study in the Archives of Internal Medicine.

The 10-year retrospective study, led by UAB nephrologist Britt Newsome, M.D, is the first systematic description of creatinine increase and longer-term end stage renal disease and mortality risk. Previous studies showed a relationship between reductions in kidney function during hospitalization and higher mortality rates.

“Previous studies have shown that a rise in serum creatinine level of 0.3 milligrams per deciliter or more during hospitalization is associated with higher in-hospital mortality, longer stays and higher costs,” Newsome said. “However, little was known about the long-term risks of subsequent end-stage renal disease and mortality in this population. The long-term risks we observed suggest that even the least severe category of kidney injury may indicate a worse prognosis.”

The study looked at 87,094 Medicare beneficiaries admitted to 4,473 hospitals across the country suffering from a heart attack, or acute myocardial infarction. They studied changes in creatinine levels of those patients from 0.1 to 3.0 milligrams per deciliter. The mean age of the patients was 77.1 years old.

Incidences of end stage renal disease and death were greatest among patients with larger changes in creatinine level, and all levels of serum creatinine increase were associated with a greater risk of end stage renal disease and death.

“We chose to examine a population of Medicare beneficiaries because the incidence of acute kidney injury has been increasing in this population for the past 10 years,” Newsome said. “Further, patients with cardiovascular disease are at a particularly high risk of chronic kidney disease as well as acute kidney injury. In future studies we will want to determine if this relationship exists in patients admitted to the hospital for other conditions.”

With these findings, the study calls for clinicians to closely monitor and aggressively treat patients experiencing increases in creatinine levels.

“The study also shows that giving patients beta blockers and aspirin can help treat these patients and possibly prevent death in the long term, regardless of creatinine change during hospitalization,” Newsome said.

Source: University of Alabama at Birmingham

Explore further: Growing a blood vessel in a week

add to favorites email to friend print save as pdf

Related Stories

Tablets, cars drive AT&T wireless gains—not phones

4 hours ago

AT&T says it gained 2 million wireless subscribers in the latest quarter, but most were from non-phone services such as tablets and Internet-connected cars. The company is facing pricing pressure from smaller rivals T-Mobile ...

Twitter looks to weave into more mobile apps

5 hours ago

Twitter on Wednesday set out to weave itself into mobile applications with a free "Fabric" platform to help developers build better programs and make more money.

Recommended for you

Growing a blood vessel in a week

Oct 24, 2014

The technology for creating new tissues from stem cells has taken a giant leap forward. Three tablespoons of blood are all that is needed to grow a brand new blood vessel in just seven days. This is shown ...

Testing time for stem cells

Oct 24, 2014

DefiniGEN is one of the first commercial opportunities to arise from Cambridge's expertise in stem cell research. Here, we look at some of the fundamental research that enables it to supply liver and pancreatic ...

Team finds key signaling pathway in cause of preeclampsia

Oct 23, 2014

A team of researchers led by a Wayne State University School of Medicine associate professor of obstetrics and gynecology has published findings that provide novel insight into the cause of preeclampsia, the leading cause ...

Rapid test to diagnose severe sepsis

Oct 23, 2014

A new test, developed by University of British Columbia researchers, could help physicians predict within an hour if a patient will develop severe sepsis so they can begin treatment immediately.

User comments : 0