Serum Creatinine Levels May Not Necessarily Reflect a True Renal Function to Adjust Amikacin Dose in Paraplegic Patient: A Case Report and Literature ReviewHundie Tesfaye1*, Blanka Jedlickova1, Richard Prusa1, Renata Hakova2 and Jiri Kriz2
- *Corresponding Author:
- Hundie Tesfaye, MD, PhD
Department of Medical Chemistry and Clinical Biochemistry
Division of Clinical Pharmacology
University Hospital Motol
Prague, Czech Republic
E-mail: [email protected]
Received date: May 24, 2016; Accepted date: June 05, 2016; Published date: June 15, 2016
Citation: Tesfaye H (2016) Serum Creatinine Levels May Not Necessarily Reflect a True Renal Function to Adjust Amikacin Dose in Paraplegic Patient: A Case Report and Literature Review. J Drug Metab Toxicol 7:209. doi:10.4172/2157-7609.1000209
Copyright: © 2016 Tesfaye H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
rate as an indicator of kidney function, clearance of endogenous creatinine is usually used despite its unreliability due to influence of several factors including age, gender, muscle mass and interferences within methods. Although there is emergence of better markers like serum cystatin-C, creatinine clearance continues to be used routinely as a marker of renal function to date. In the present case study we describe only slightly elevation of serum creatinine associated with high serum drug concentration 27 mg/L “trough” and 41 mg/L “peak”, respectively in a paraplegic patient treated with initially reduced dose (500 mg/day) of an aminoglycoside antibacterial drug (amikacin). The relatively little increment of serum creatinine in this case might be related to underlying pathology resulting in low production of creatinine, which does not essentially reflect the true renal function. Methodological challenges during GFR estimation and risk of renal impairment in
(SCI) patents are also discussed in context with literature review.