Creatinine Increases Have Consistent and Differential Prognostic Impact Across Kidney Function

Clicks: 23
ID: 331850
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #94 of 228 articles by views in clinical kidney journal

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 228 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Within the current criteria for acute kidney injury (AKI), it remains debated whether small absolute creatinine increases are associated with higher mortality in patients with low baseline estimated glomerular filtration rates (eGFRs), and whether these changes carry prognostic value comparable to relative increases. We therefore examined the prognostic impact of rapid creatinine increases across baseline eGFRs in patients undergoing major elective surgery. Methods We pooled data on patients undergoing major elective surgery from Canada, Denmark, Scotland, and Wales. This clinical setting was chosen because creatinine levels in this group are routinely monitored both before and after an acute stress event, regardless of clinical status. We ascertained the highest relative creatinine increase within 7 days and the highest absolute creatinine increase within 2 days during the first 7 days after surgery. We used logistic regressions with splines and interaction terms to construct heatmaps depicting age-, sex-, year-, and surgery type-standardized 90-day mortality according to creatinine increases across baseline eGFRs. Results There were 311,975 surgical procedures performed in 279,554 patients, with 11,568 deaths. Compared to no change in creatinine, a 0.3 mg/dL (26.5 µmol/l) absolute increase was associated with a consistent 2.2-3.3 percentage point increase in mortality for eGFR between 15 and 90 mL/min/1.73 m2. However, while the excess mortality associated with a 0.3 mg/dL and a 50% creatinine increase was similar at baseline eGFR of 90 mL/min/1.73 m2, the excess mortality of a 50% creatinine increase was substantially greater among those with baseline eGFRs < 30 mL/min/1.73 m2. Conclusions A small absolute creatinine increase of 0.3 mg/dL is associated with a consistent increase in mortality across baseline eGFRs, indicating its relevance as a component of the AKI criteria. However, the higher excess mortality associated with a 50% increase at low eGFRs should be emphasized in future guidelines to improve clinical discussions.
Reference Key
openalex_W7221052681 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Philip Vestergaard Munch, Simon Kok Jensen, Uffe Heide‐Jørgensen, Samira Bell, David Yeung, Zhi Tan, Tim Scale, Matthew Thomas James, Christian Fynbo Christiansen
Are you one of these authors? Claim your profile
Journal clinical kidney journal
Year 2026
DOI
10.1093/ckj/sfag319
URL
https://doi.org/10.1093/ckj/sfag319
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.