Abstract
Serum creatinine is a commonly used laboratory marker to assess kidney function; however, there has not been an established level of serum creatinine to predict mortality. After extensive literature review, we present a case of the highest recorded serum creatinine of 73.8 mg/dL in a 23-year-old male with the history of pediatric deceased donor kidney transplant (DDKT). He initially presented with uremia and signs of acute renal allograft failure after two months of immunosuppressive medication nonadherence, ultimately requiring emergent hemodialysis, which was complicated by new onset seizures. This was the patient's fourth episode of late acute rejection and emphasizes the need for education of immunosuppressant adherence and periodic monitoring of renal function in high-risk patients. Though there is no known creatinine level incompatible with life, this patient appears to have the highest known serum creatinine in a uremic patient on record.
Highlights
Serum creatinine is a commonly used laboratory measurement to gauge renal function in clinical practice
Creatinine is a byproduct of the metabolism of creatine in skeletal muscle and dietary meat intake [1]
It is freely filtered across the glomerulus, and there is additional creatinine secretion in the proximal tubule of the nephron via organic cation secretory pathways [2]. erefore, serum creatinine is a reflection of glomerular filtration rate, creatinine secretion in the renal tubule, creatine intake, and baseline skeletal muscle mass
Summary
Christine Persaud ,1 Uttsav Sandesara, Victor Hoang, Joshua Tate ,1 Wayne Latack, and David Dado. Serum creatinine is a commonly used laboratory marker to assess kidney function; there has not been an established level of serum creatinine to predict mortality. We present a case of the highest recorded serum creatinine of 73.8 mg/dL in a 23-year-old male with the history of pediatric deceased donor kidney transplant (DDKT). He initially presented with uremia and signs of acute renal allograft failure after two months of immunosuppressive medication nonadherence, requiring emergent hemodialysis, which was complicated by new onset seizures. Ough there is no known creatinine level incompatible with life, this patient appears to have the highest known serum creatinine in a uremic patient on record He initially presented with uremia and signs of acute renal allograft failure after two months of immunosuppressive medication nonadherence, requiring emergent hemodialysis, which was complicated by new onset seizures. is was the patient’s fourth episode of late acute rejection and emphasizes the need for education of immunosuppressant adherence and periodic monitoring of renal function in high-risk patients. ough there is no known creatinine level incompatible with life, this patient appears to have the highest known serum creatinine in a uremic patient on record
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