Serum Creatinine Back-Estimation in Cardiac Surgery Patients: Misclassification of AKI Using Existing Formulae and a Data-Driven Model

Clinical Journal of the American Society of Nephrology : CJASN
Martin Hermann BernardiA Lassnigg

Abstract

A knowledge of baseline serum creatinine (bSCr) is mandatory for diagnosing and staging AKI. With often missing values, bSCr is estimated by back-calculation using several equations designed for the estimation of GFR, assuming a "true" GFR of 75 ml/min per 1.73 m(2). Using a data set from a large cardiac surgery cohort, we tested the appropriateness of such an approach and compared estimated and measured bSCr. Moreover, we designed a novel data-driven model (estimated serum creatinine [eSCr]) for estimating bSCr. Finally, we analyzed the extent of AKI and mortality rate misclassifications. Data for 8024 patients (2833 women) in our cardiac surgery center were included from 1997 to 2008. Measured and estimated bSCr were plotted against age for men and women. Patients were classified to AKI stages defined by the Kidney Disease Improving Global Outcomes (KDIGO) group. Results were compared with data from another cardiac surgery center in Zurich, Switzerland. The Modification of Diet in Renal Disease and the Chronic Kidney Disease Epidemiology Collaboration formulae describe higher estimated bSCr values in younger patients, but lower values in older patients compared with the measured bSCr values in both centers. The Pittsburgh Lin...Continue Reading

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Citations

Dec 21, 2016·Critical Care : the Official Journal of the Critical Care Forum·Junichi IzawaTakashi Kawamura
May 20, 2017·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Erin HesseyMichael Zappitelli
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May 29, 2021·Scientific Reports·Jill VanmassenhoveWim Van Biesen
Jun 12, 2021·The Journal of Thoracic and Cardiovascular Surgery·Zhongli ChenLiang Chen

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