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Pediatr Nephrol (2010) 25:21072113 DOI 10.1007/s00467-010-1533-y
ORIGINAL ARTICLE
Reference values for serum creatinine in children younger than 1 year of age
Dirk P. Boer & Yolanda B. de Rijke & Wim C. Hop &
Karlien Cransberg & Eiske M. Dorresteijn
Received: 15 February 2010 /Revised: 22 March 2010 /Accepted: 30 March 2010 /Published online: 27 May 2010 # The Author(s) 2010. This article is published with open access at Springerlink.com
Abstract Reliable reference values of enzymatically assayed serum creatinine categorized in small age intervals are lacking in young children. The aim of this study was to determine reference values for serum creatinine during the first year of life and study the influence of gender, weight and height on these values. Serum creatinine determinations between 2003 and 2008 were retrieved from the hospital database. Strict exclusion criteria ensured the selection of patients without kidney damage. Correlation analysis was performed to evaluate the relation between height, weight and serum creatinine; the MannWhitney test was used to evaluate the relation between gender and serum creatinine. A broken stick model was designed to predict normal serum creatinine values. Mean serum creatinine values were found to decrease rapidly from 55 mol/L on day 1 to 22 mol/L in the second month of life; they then stabilized at 20 mol/L until the seventh month, followed by a slight
increase. No significant relation was found between serum creatinine and gender, weight and height. We present here reference values of serum creatinine in infants not at risk of decreased renal function. The absence of a relationship with gender, weight and height confirms that height-based equations to estimate glomerular filtration rate are less useful in patients of this age group.
Keywords Creatinine . Enzymatic . Infants .
Reference values
Introduction
Screening for renal disease or monitoring of renal function should be based on an adequate estimation of the glomerular filtration rate (GFR). The most commonly used marker to estimate GFR is serum creatinine. Creatinine is a break-down product of creatine phosphate in muscle and is freely filtered by the glomerulus. Although estimation of the GFR using creatinine is not as specific and sensitive as, for example, an inulin clearance assay, the method is inexpensive, fast, and minimally invasive. The Jaff reaction, based on a...