A rise in plasma creatinine that is not a sign of renal failure: which drugs can be responsible?
This is a review of the available information about drugs which cause an increase in plasma creatinine concentration without decreasing glomerular filtration rate (GFR). The GFR is the main, but not the single, determinant of the plasma creatinine levels. Several drugs, such as cimetidine, trimethoprim, corticosteroids, pyrimethamine, phenacemide, salicylates and active vitamin D metabolites, have been reported to increase plasma creatinine without influencing its glomerular filtration. Cimetidine, trimethoprim, pyrimethamine and salicylates can inhibit secretion of creatinine by the proximal tubule. Corticosteroids and vitamin D metabolites probably modify the production rate and the release of creatinine. The exact mechanism of phenacemide-creatinine interaction is not fully explained. These drug-induced alterations in plasma creatinine concentration have clinical significance when GFR is estimated by using plasma creatinine.
Andreev
E
E
Clinic of Nephrology, Medical University-Sofia, Bulgaria.
Koopman
M
M
Arisz
L
L
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000890:Anti-Infective Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000927:Anticonvulsants / Q000009:adverse effects; D044482:Benzeneacetamides; D002927:Cimetidine / Q000009:adverse effects; D003404:Creatinine / Q000097:blood*; D064420:Drug-Related Side Effects and Adverse Reactions; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006635:Histamine H2 Antagonists / Q000009:adverse effects; D006801:Humans; D011739:Pyrimethamine / Q000009:adverse effects; D051437:Renal Insufficiency / Q000097:blood / Q000175:diagnosis; D012459:Salicylates / Q000009:adverse effects; D014295:Trimethoprim / Q000009:adverse effects; D014508:Urea / Q000009:adverse effects / Q000031:analogs & derivatives; D014807:Vitamin D / Q000009:adverse effects
D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D044482:Benzeneacetamides; D006635:Histamine H2 Antagonists; D012459:Salicylates; D014807:Vitamin D; D002927:Cimetidine; D014508:Urea; D014295:Trimethoprim; D003404:Creatinine; C005396:phenacemide; D011739:Pyrimethamine