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Patients with lupus nephritis in remission have wide fluctuations in serum creatinine

WASHINGTON — Researchers of a poster presented at ASN Kidney Week observed wide fluctuations in serum creatinine in patients with lupus nephritis in remission.

“Clinical trials in lupus nephritis typically base remission on proteinuria and the relative change in serum creatinine compared to baseline,” Salem Almaani, MD, MS, of the division of nephrology at the Ohio State University Wexner Medical Center, and colleagues wrote. “These serum creatinine cutoffs have been arbitrary; however, we observe considerable fluctuation of serum creatinine levels in day-to-day clinical practice.”

To assess the variability of serum creatinine in patients with stable, non-flaring lupus nephritis, researchers included those who had at least three consecutive serum creatinine measurements while in stable proteinuric remission. Patients were categorized as either fluctuators (at least one serum creatinine measurement >115% of baseline) or non-fluctuators (no measurement >115% of baseline).

Researchers found that, in the fluctuator group, 33%, 20% and 12% of each patient’s creatinine measurements were more than 115%, 120% and 125% above their baseline, respectively. They noted that fluctuation occurred more frequently in those with low serum creatinine.

Results led researchers to conclude that “the typically used 115% cutoff is too restrictive, and a 125% cutoff might be more reasonable.” – by Melissa J. Webb

Reference:

Almaani S, et al. Abstract FR-PO880. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington, D.C.

Disclosure: Almaani reports no relevant financial disclosures.

WASHINGTON — Researchers of a poster presented at ASN Kidney Week observed wide fluctuations in serum creatinine in patients with lupus nephritis in remission.

“Clinical trials in lupus nephritis typically base remission on proteinuria and the relative change in serum creatinine compared to baseline,” Salem Almaani, MD, MS, of the division of nephrology at the Ohio State University Wexner Medical Center, and colleagues wrote. “These serum creatinine cutoffs have been arbitrary; however, we observe considerable fluctuation of serum creatinine levels in day-to-day clinical practice.”

To assess the variability of serum creatinine in patients with stable, non-flaring lupus nephritis, researchers included those who had at least three consecutive serum creatinine measurements while in stable proteinuric remission. Patients were categorized as either fluctuators (at least one serum creatinine measurement >115% of baseline) or non-fluctuators (no measurement >115% of baseline).

Researchers found that, in the fluctuator group, 33%, 20% and 12% of each patient’s creatinine measurements were more than 115%, 120% and 125% above their baseline, respectively. They noted that fluctuation occurred more frequently in those with low serum creatinine.

Results led researchers to conclude that “the typically used 115% cutoff is too restrictive, and a 125% cutoff might be more reasonable.” – by Melissa J. Webb

Reference:

Almaani S, et al. Abstract FR-PO880. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington, D.C.

Disclosure: Almaani reports no relevant financial disclosures.

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