Indications for measurement of serum creatinine concentration (allowing estimation of GFR)

Indications for measurement of serum creatinine concentration

Serum creatinine concentration should be measured, allowing calculation of estimated GFR, at initial assessment and then at least annually in all adult patients with:

• previously diagnosed chronic kidney disease (CKD), including
  • polycystic kidney disease
  • reflux nephropathy
  • biopsy-proven chronic glomerulonephritis
  • persistent proteinuria
  • urologically unexplained persistent haematuria
• conditions associated with a high risk of obstructive nephropathy, including
  • known or suspected bladder outflow obstruction
  • neurogenic bladder caused by spina bifida or spinal cord injury (N.B. calculated GFR may overestimate true GFR in these patients because of decreased muscle mass)
  • urinary diversion surgery
  • urinary stone disease due to primary hyperoxaluria, cystinuria, Dent’s disease, infections (with struvite stones), anatomical abnormalities, or a stone episode rate of > 1/y
• conditions known to be associated with a high risk of silent development of CKD, including
  • hypertension
  • diabetes mellitus
  • heart failure
  • atherosclerotic coronary, cerebral, or peripheral vascular disease
• conditions requiring long-term treatment with potentially nephrotoxic drugs, including
  • ACEIs and ARBs
  • NSAIDs
  • Lithium carbonate
  • Mesalazine and other 5-aminosalicylic acid drugs
  • Calcineurin inhibitors (Cyclosporin, Tacrolimus)
• multisystem diseases that may involve the kidney, including systemic lupus erythematosus (SLE), vasculitis, myeloma, rheumatoid arthritis
• a first degree relative with stage 5 CKD

Reference:

1. The Renal Association (May 2006).UK CKD Guidelines.