title: Diabetic Nephropathy and CKD-Analysis of Individual Patient Serum Creatinine Trajectories: A Forgotten Diagnostic Methodology for Diabetic CKD Prognostication and Prediction.
abstract: Creatinine is produced in muscle metabolism as the end-product of creatine phosphate and is subsequently excreted principally by way of the kidneys, predominantly by glomerular filtration. Blood creatinine assays constitute the most common clinically relevant measure of renal function. The use of individual patient-level real-time serum creatinine trajectories provides a very attractive and tantalizing methodology in nephrology practice. Topics covered in this review include acute kidney injury (AKI) with its multifarious rainbow spectrum of renal outcomes; the stimulating vicissitudes of the diverse patterns of chronic kidney disease (CKD) to end-stage renal disease (ESRD) progression, including the syndrome of rapid onset end stage renal disease (SORO-ESRD); the syndrome of late onset renal failure from angiotensin blockade (LORFFAB); and post-operative AKI linked with the role of intra-operative hypotension in patients with diabetes mellitus and suspected diabetic nephropathy with CKD. We conclude that the study of individual patient-level serum creatinine trajectories, albeit a neglected and forgotten diagnostic methodology for diabetic CKD prognostication and prediction, is a most useful diagnostic tool, both in the short-term and in the long-term practice of nephrology. The analysis of serum creatinine trajectories, both in real time and retrospectively, indeed provides supplementary superior diagnostic and prognostic insights in the management of the nephrology patient.
authors.affiliation: Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. onuigbo.macaulay@mayo.edu.|Department of Nephrology, Mayo Clinic Health System, MCHS Eau Claire, 1221 Whipple Street, Eau Claire, WI 54702, USA. onuigbo.macaulay@mayo.edu.
authors.forename: Macaulay Amechi Chukwukadibia
authors.initials: MA
authors.lastname: Onuigbo
authors.affiliation: North East London National Health Service Foundation Trust, Barley Lane, Ilford, Essex, 1G3 8XJ, UK. nnoms@aol.com.
authors.forename: Nneoma
authors.initials: N
authors.lastname: Agbasi
keywords: acute kidney injury (AKI); chronic kidney disease (CKD); creatinine; end stage renal disease (ESRD); national kidney foundation kidney disease outcomes quality initiative (NKF KDOQI); renoprevention; serum creatinine trajectory; syndrome of late onset renal failure from angiotensin blockade (LORFFAB); syndrome of rapid onset end stage renal disease (SORO-ESRD)