Abstract

Objective: To assess age- and sex-specific serum creatinine levels in a pediatric population using a hospital-based database in Taiwan.Study Design: Data on serum creatinine levels were obtained from the National Taiwan University Hospital-integrated Medical Database (NTUH-iMD). Due to the possibility of having acute kidney injury or chronic kidney disease, individuals with multiple serum creatinine measurements were excluded, and outliers in each age- and sex-specific group were also subsequently removed. The remaining creatinine measurements in each group were analyzed, and 95% reference limits were established.Results: Serum creatinine data of individuals aged between 1 month and 18 years from May 2011 to January 2018 were retrieved. After applying the exclusion criteria, 27,911 individuals with a single corresponding serum creatinine measurement were enrolled. Creatinine level reference limits for each age- and sex-specific group were generated. The upper reference limits (URLs), which are particularly useful in clinical practice, followed the natural trend of increasing serum creatinine with age.Conclusion: We generated serum creatinine reference limits from a single hospital-integrated medical database in Taiwan for different age- and sex-specific groups of children. Our results will aid physicians in clinical practice regarding renal function evaluation, especially for patients without a recent baseline serum creatinine level.

Highlights

  • Serum creatinine is an extremely useful index when it comes to assessing renal function [1]

  • Other than glomerular filtration rate (GFR), muscle mass has a strong influence on serum creatinine level [2]

  • A total of 151,859 serum creatinine measurements from 44,197 children aged from 1 month to 18 years of age were retrieved (Figure 1)

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Summary

Introduction

Serum creatinine is an extremely useful index when it comes to assessing renal function [1]. From 1 month of age, serum creatinine increases gradually with age in children because of an increase in muscle mass, and the level differs every year. The reference cited by the Nelson Textbook of Pediatrics, which most general pediatricians use, states that the serum creatinine URL is 0.50 mg/dL for children under 4 years of age [3, 4]. Using this can lead to underestimation of abnormal renal function in infants and toddlers

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