Drug-induced alterations in serum creatinine concentrations.
OBJECTIVE
To provide a comprehensive review of drug-induced alterations in serum creatinine concentrations (SCrs).


METHODS
Information was obtained from a MEDLINE search, reference lists from articles identified in the search, review articles, and abstracts.


METHODS
Emphasis was placed on clinical studies of direct relevance to clinical practitioners.


METHODS
Literature was assessed for its methodology, results, discussion, and conclusion.


RESULTS
Two analytical systems to assay SCr are commonly employed in clinical practice--the Jaffé-based and enzymatic methods. Several drugs have been reported to interfere with SCr results obtained with both analytical systems by producing assay interference. In addition, trimethoprim, cimetidine, and salicylates produce elevations in the SCr by altering the normal elimination pathways of creatinine. Phenacemide has been reported to increase creatinine elimination, but the mechanism of this effect is unknown.


CONCLUSIONS
Pharmacists should recognize the clinical significance of drug-induced interference with SCr and propose alternative methods of determining concentrations in selected patients.
Ducharme
M P
MP
Department of Pharmacy Practice, Wayne State University, Detroit, MI 48202.
Smythe
M
M
Strohs
G
G
D000619:Aminohydrolases; D002511:Cephalosporins / Q000494:pharmacology; D002927:Cimetidine / Q000494:pharmacology; D003124:Colorimetry; D003404:Creatinine / Q000097:blood*; D004347:Drug Interactions; D005919:Glomerular Filtration Rate; D006801:Humans; D012459:Salicylates / Q000494:pharmacology; D020156:Salicylic Acid; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology
D002511:Cephalosporins; D012459:Salicylates; D002927:Cimetidine; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003404:Creatinine; D000619:Aminohydrolases; D020156:Salicylic Acid