title: The relationship between the level of serum creatinine, modified diet and renal disease formula, Cockcroft-Gault formula, and renal tubulointerstitial lesion.
abstract: OBJECTIVE
  This study investigated the relationship between the levels of serum creatinine (SCr), the estimated glomerular filtration rate (eGFR), and the degree of tubulointerstitial injury.
  
  
  METHODS
  A total of 511 patients of Zhongshan hospital in China were hospitalized due to physical abnormalities and diagnosed with kidney disease by renal biopsy. The clinical and pathological data were retrospectively analyzed. The level of SCr was determined in all patients, and the eGFR was calculated with modification of diet in renal disease and Cockcroft-Gault formulae, whereas the renal histopathology was quantified according to the Katafuchi semi-quantitative standards.
  
  
  RESULTS
  With the aggravation of tubulointerstitial injury, SCr level increased and eGFR decreased gradually. The degree of tubulointerstitial lesion showed a positive correlation with SCr level and negative correlation with Cockcroft-Gault formula and modification of diet in renal disease (r = 0.627, -0.649, -0.626; p < 0.001). When the SCr was in the normal range, above 90% of the patients had various degrees of tubulointerstitial damage and 12.2% of the patients had moderate-to-severe tubulointerstitial lesions. The correlation between SCr level and tubulointerstitial damage became weak.
  
  
  CONCLUSIONS
  The morphologic changes of tubulointerstitium are closely linked with renal function, but incompletely parallel. SCr in the abnormal range could be used to diagnose tubulointerstitial injury well. However, when the level of SCr was in the so-called normal range, eGFR by the modification of diet in renal disease or Cockcroft-Gault formula may be preferred to assess renal tubulointerstitial injury.
authors.affiliation: Division of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, PR China.
authors.forename: Fengqing
authors.initials: F
authors.lastname: Cai
authors.forename: Li
authors.initials: L
authors.lastname: Ren
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Fang
authors.forename: Suhua
authors.initials: S
authors.lastname: Jiang
authors.forename: Xunhui
authors.initials: X
authors.lastname: Xu
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Ding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D003404:Creatinine / Q000097:blood*; D018450:Disease Progression; D005247:Feeding Behavior; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D007684:Kidney Tubules / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D003404:Creatinine