Background incidence of serum creatinine threshold rises in a predominantly female clinical trial population without underlying renal disease.
OBJECTIVE
Serum creatinine (Cr) is used to monitor renal function during pre-marketing clinical trials. Standard thresholds for a serum creatinine (Cr) increase predictive of renal injury remain to be established in this setting.


METHODS
Aggregated clinical trial data were utilized to evaluate the background frequency of Cr increases of ≥ 0.3 mg/dl and ≥ 0.5 mg/dl from baseline.


RESULTS
Ten thousand and eighteen subjects who participated in 15 clinical trials were included: 311 (4%) male, 7521 (96%) female, mean age of 48.1 years. Mean follow-up time was 6 months. The incidence of Cr increase ≥ 0.3 mg/dl from baseline was 7.5 per 1000 person-months (95%CI 6.81-8.24) and 1.2 per 1000 person-months (95%CI 0.94-1.52) for ≥ 0.5 mg/dl. The Cr increase was sustained at the following visit in 15.9% of subjects with a Cr increase of 0.3 mg/dl, and in 8.9% of those with a 0.5 mg/dl increase from baseline.


CONCLUSIONS
A sustained increase in Cr of 0.5 mg/dl from baseline as a stopping criteria for potential nephrotoxicity would have resulted in study drug cessation in approximately 1 in 1000 participants in this selected clinical trial population and would not have caused undue clinical trial attrition.
Liu
Yanfang
Y
Department of Worldwide Epidemiology, Research and Development, GlaxoSmithKline, Harlow, Essex, UK.
Hunt
Christine
C
Bains
Chanchal
C
Weil
John G
JG
D000328:Adult; D002986:Clinical Trials as Topic / Q000379:methods; D003404:Creatinine / Q000097:blood*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged
D003404:Creatinine