Key result
Several drugs, including trimethoprim, cimetidine, and salicylates, can alter serum creatinine concentrations by interfering with assays or altering normal elimination pathways.
Why the study?
How do specific drugs alter serum creatinine concentrations through assay interference or elimination pathways?
How do specific drugs alter serum creatinine concentrations through assay interference or elimination pathways?
Clinicians must recognize drug-induced interference with serum creatinine assays and elimination pathways to avoid misinterpreting renal function.
Clinicians should account for drug effects when interpreting creatinine; extends known interferences but leaves open questions on assay-specific impacts in current practice.
OBJECTIVE: To provide a comprehensive review of drug-induced alterations in serum creatinine concentrations (SCrs). DATA SOURCES: Information was obtained from a MEDLINE search, reference lists from articles identified in the search, review articles, and abstracts. STUDY SELECTION: Emphasis was placed on clinical studies of direct relevance to clinical practitioners. DATA EXTRACTION: Literature was assessed for its methodology, results, discussion, and conclusion. DATA SYNTHESIS: Two analytical systems to assay SCr are commonly employed in clinical practice--the Jaffé-based and enzymatic methods. Several drugs have been reported to interfere with SCr results obtained with both analytical systems by producing assay interference. In addition, trimethoprim, cimetidine, and salicylates produce elevations in the SCr by altering the normal elimination pathways of creatinine. Phenacemide has been reported to increase creatinine elimination, but the mechanism of this effect is unknown. CONCLUSIONS: Pharmacists should recognize the clinical significance of drug-induced interference with SCr and propose alternative methods of determining concentrations in selected patients.
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Hartshorn et al. (1993) conducted a review in Drug-induced alterations in serum creatinine concentrations. Drugs (trimethoprim, cimetidine, salicylates, phenacemide) was evaluated on Alterations in serum creatinine concentrations. Several drugs, including trimethoprim, cimetidine, and salicylates, can alter serum creatinine concentrations by interfering with assays or altering normal elimination pathways.
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