Creatininemia Versus Uremia

Diagnosis and Treatment1 December 1966Creatininemia Versus UremiaThe Relative Significance of Blood Urea Nitrogen and Serum Creatinine Concentrations in AzotemiaJOHN B. DOSSETOR, M.D., PH.D., F.A.C.P., F.R.C.P. (C)JOHN B. DOSSETOR, M.D., PH.D., F.A.C.P., F.R.C.P. (C)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-65-6-1287 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe terms uremia and azotemia are applied to acute or chronic conditions in which the blood concentration of nitrogenous end products rises. The terms are otherwise poorly defined. Nitrogen retention usually occurs when the renal function is less than 30% of normal. Recently, progressive renal dysfunction has been graded as [1] diminished renal reserve, [2] renal insufficiency, [3] renal failure, and [4] uremia (Strauss and Welt (1) 1963), but each grade overlaps others.Although urea is present in greatest amount, errors can occur when increased urea concentration is accepted as synonymous with the degree of renal dysfunction. Myers, Fine, and...References1. STRAUSSWELT MBLG (editors): Diseases of the Kidney. Little, Brown and Co., Boston, 1963. Google Scholar2. MYERSFINELOUGH VCMSEG: The significance of uric acid, urea and creatinine of blood in nephritis. Arch. Intern. Med. (Chicago) 17: 570, 1916. CrossrefGoogle Scholar3. MYERSKILLIAM VCJA: The prognostic value of the creatinine in the blood in nephritis. Proc. Soc. Exp. Biol. Med. 16: 41, 1918. CrossrefGoogle Scholar4. MÖLLERMCINTOSHVAN SLYKE EJFDD: Studies on urea excretion. Relationship between urine volume and the rate of urea excretion by normal adults. J. Clin. Invest. 6: 427, 1928. MedlineGoogle Scholar5. SHANNON JA: Glomerular filtration and urea excretion in relation to urine flow in the dog. Amer. J. Physiol. 117: 206, 1936. CrossrefGoogle Scholar6. SCHMIDT-NIELSEN B: Urea excretion in mammals. Physiol. Rev. 38: 138, 1958. CrossrefGoogle Scholar7. STEINMETZSMITH PRHW: Urea and the renal concentrating operation in man. Amer. J. Med. 35: 727, 1963. CrossrefMedlineGoogle Scholar8. GARDNERMAFFLY KDRH: An in vitro demonstration of increased collecting tubular permeability to urea in the presence of vasopressin. J. Clin. Invest. 42: 1968, 1965. Google Scholar9. JAENICKE JR: The relative rates of urea and water permeation in the distal nephron of the intact kidney. J. Clin. Invest. 43: 45, 1964. CrossrefMedlineGoogle Scholar10. BERLINERLEVINSKYDAVIDSONEDEN RWNGDGM: Dilution and concentration of the urine and action of antidiuretic hormone. Amer. J. Med. 24: 730, 1958. CrossrefMedlineGoogle Scholar11. BRICKER NS: Chronic progressive renal disease: pathologic physiology and relation to treatment. Progr. Cardiov. Dis. 4: 170, 1961. CrossrefGoogle Scholar12. PLATT R: Structure and functional adaptation in renal failure. Brit. Med. J. 1: 1313, 1952. CrossrefMedlineGoogle Scholar13. BLOCHSCHOENHEIMERRITTENBERG LRD: Rate of formation and disappearance of body creatinine in normal animals. J. Biol. Chem. 138: 155, 1941. CrossrefGoogle Scholar14. HUNTER A: Physiology of creatine and creatinine. Physiol. Rev. 2: 586, 1922. CrossrefGoogle Scholar15. BARRETTADDIS ET: The serum creatinine concentration of normal individuals. J. Clin. Invest. 26: 875, 1947. CrossrefMedlineGoogle Scholar16. BENEDICTOSTERBERG SRE: Studies in creatine and creatinine metabolism. V. The metabolism of creatine. J. Biol. Chem. 56: 229, 1923. CrossrefGoogle Scholar17. DOMINGUEZPOMERENE RE: Recovery of creatinine after intravenous injection in man. Proc. Soc. Exp. Biol. Med. 58: 26, 1945. CrossrefGoogle Scholar18. VAN PILSAMSELJESKOG JFG: Long term endogenous creatinine clearances in man. Proc. Soc. Exp. Biol. Med. 97: 270, 1958. CrossrefMedlineGoogle Scholar19. ROSEDIMMITT WCFW: Experimental studies on creatine and creatinine. VII. The fate of creatine and creatinine when administered to man. J. Biol. Chem. 26: 345, 1916. CrossrefGoogle Scholar20. BLEILERSCHEDL REHP: Creatinine excretion: variability and relationships to diet and body size. J. Lab. Clin. Med. 59: 945, 1962. MedlineGoogle Scholar21. FOLINDENIS OW: Protein metabolism from the standpoint of blood and tissue analysis. J. Biol. Chem. 17: 493, 1914. CrossrefGoogle Scholar22. HAREGOLDSTEINBARNETTMCNAMARAHARE KHHLHRS: Renal excretion of creatinine in man. Fed. Proc. 8: 67, 1949. Google Scholar23. MANDELJONESWILLISCARGILL EEFLMJWH: Renal excretion of creatinine and inulin in man. J. Lab. Clin. Med. 42: 621, 1953. MedlineGoogle Scholar24. MILLERLEAFMAMBYMILLER BJAARZ: Validity of the endogenous creatinine clearance as a measure of glomerular filtration rate in the diseased human kidney. J. Clin. Invest. 31: 309, 1952. CrossrefMedlineGoogle Scholar25. O'CONNELLROMEOMUDGE JMJAGH: Renal tubular secretion of creatinine in the dog. Amer. J. Physiol. 203: 985, 1962. CrossrefGoogle Scholar26. SWANSONHAKIM REAA: Stop-flow analysis of creatinine excretion in the dog. Ibid., p. 980. Google Scholar27. BRODSIROTA JJH: Renal clearances of endogenous "creatinine" in man. J. Clin. Invest. 27: 645, 1948. CrossrefMedlineGoogle Scholar28. HOBERMANSIMSPETERS HDEAJH: Creatine and creatinine metabolism in the normal adult studied with the aid of isotopic nitrogen. J. Biol. Chem. 172: 45, 1948. CrossrefMedlineGoogle Scholar29. DOOLANALPENTHEIL PDELGB: A clinical appraisal of the plasma concentration and endogenous clearance of creatinine. Amer. J. Med. 32: 65, 1962. CrossrefMedlineGoogle Scholar30. SCHREINERMAHER GEJF: Uremia: Biochemistry, Pathogenesis and Treatment. Charles C Thomas, Publisher, Springfield, Ill., 1961, p. 94. Google Scholar31. BALDUSFEICHTERSUMMERSKILL WPRNWH: The kidney in cirrhosis. I. Clinical and biochemical features of azotemia in hepatic failure. Ann. Intern. Med. 60: 353, 1964. LinkGoogle Scholar32. WINKLERPARRA AWJ: The measurement of glomerular filtration. The creatinine, sucrose and urea clearances in subjects with renal disease. J. Clin. Invest. 16: 869, 1937. CrossrefMedlineGoogle Scholar33. PATCHRABINOVITCH FSIM: Urea and creatinine contents of blood in renal disease. A statistical analysis of five thousand observations. JAMA 90: 1092, 1928. CrossrefGoogle Scholar34. MARSHALL S: Urea-creatinine ratio in obstructive uropathy and renal hypertension. JAMA 190: 719, 1964. CrossrefMedlineGoogle Scholar35. FOLINDENIS OW: Protein metabolism from the standpoint of blood and tissue analysis. J. Biol. Chem. 14: 29, 1913. CrossrefGoogle Scholar36. GABERMANATLASKAMMERLINGEHLICHISAACS PDHEMLJ: The relationship of creatinine to non-protein nitrogen in azotemic states. JAMA 144: 1246, 1950. CrossrefMedlineGoogle Scholar37. FISHBERG AM: Hypertension and Nephritis. Lea & Febiger, Philadelphia, 1954, pp. 50 and 72. Google Scholar38. GOODYER AV: Renal function and renal impairment in congestive heart failure. Progr. Cardiov. Dis. 3: 483, 1961. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JOHN B. DOSSETOR, M.D., PH.D., F.A.C.P., F.R.C.P. (C)Affiliations: Montreal, Quebec,From the Royal Victoria Hospital, Montreal, Quebec, Canada.Requests for reprints should be addressed to John B. Dossetor, M.D., Royal Victoria Hospital, Montreal, Quebec, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCNN-assisted SERS enables ultra-sensitive and simultaneous detection of Scr and BUN for rapid kidney function assessmentImpact of trimethoprim on serum creatinine, sodium, and potassium concentrations in patients taking trimethoprim‐sulfamethoxazole without changes in glomerular filtration rateShort-Term Treatment with Empagliflozin Resulted in Dehydration and Cardiac Arrest in an Elderly Patient with Specific Complications: A Case Report and Literature ReviewBlood Urea Nitrogen to Serum Albumin Ratio in the Prediction of Acute Kidney Injury of Patients with Rib Fracture in Intensive Care UnitThe biological roles of urea: A review of preclinical studiesHealthy and Chronic Kidney Disease (CKD) Dogs Have Differences in Serum Metabolomics and Renal Diet May Have Slowed Disease ProgressionAlgorithm for predicting cardiovascular events in low/moderate risk patients using traditional and new factors: data from 10-year follow-up studyAssociation between circulating microRNAs and changes in kidney function: A five-year prospective study among Japanese adults without CKDEffects of blood urea nitrogen independent of the estimated glomerular filtration rate on the development of anemia in non-dialysis chronic kidney disease: The results of the KNOW-CKD studyBlood urea nitrogen, blood urea nitrogen to creatinine ratio and incident stroke: The Dongfeng-Tongji cohortCurrent Status on Canine Foetal Fluid and Adnexa Derived Mesenchymal Stem CellsThe use of diuretics in chronic heart failure. Position paper of the Russian Heart Failure SocietyKidney DiseasesApproach to Electrolyte Abnormalities, Prerenal Azotemia, and Fluid BalanceThe effect of Ramadan fasting on kidney function in patients with chronic kidney diseaseThe kidney injury caused by the onset of acute graft-versus-host disease is associated with down-regulation of αKlothoPredictive Value of Matrix Metalloproteinases and Their Inhibitors for Mortality in Septic Patients: A Cohort StudyBlood urea nitrogen is independently associated with renal outcomes in Japanese patients with stage 3–5 chronic kidney disease: a prospective observational studyComparison of Risk Factors for Pediatric Kidney Stone Formation: The Effects of SexNon‐Specific SymptomsElectrolytes and DiureticsBlood urea nitrogen has additive value beyond estimated glomerular filtration rate for prediction of long-term mortality in patients with acute myocardial infarctionRenoprotective effect of oral rehydration solution III in exertional heatstroke ratsAnalysis of factors predicting the response to tolvaptan in patients with liver cirrhosis and hepatic edemaIssues of Acute Kidney Injury Staging and Management in Sepsis and Critical Illness: A Narrative ReviewAssessment of volume status and fluid responsiveness in the emergency department: a systematic approachNgal, cystatin c and interleukin-18 are detected Earlier than conventional biomarkers in Contrast induced nephropathyPerforming Anticoagulation: A Puzzling Case of Cholesterol Embolization SyndromeSalivary Urea Nitrogen as a Biomarker for Renal DysfunctionIn vitro concentration dependent detection of creatinine: a surface enhanced Raman scattering and fluorescence studyThe relationship between blood urea nitrogen levels and metabolic, biochemical, and histopathologic findings of nondiabetic, nonhypertensive patients with nonalcoholic fatty liver diseaseBlood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunctionRenal function overestimation in underweight and/or non-ambulatory patientsSalivary Urea Nitrogen as a Biomarker for Renal DysfunctionComparison of serum creatinine and serum cystatin C as biomarkers to detect sepsis-induced acute kidney injury and to predict mortality in CD-1 miceImpact of blood urea nitrogen for long-term risk stratification in patients with coronary artery disease undergoing percutaneous coronary interventionDevelopment and validation of a delirium predictive score in older peopleDehydration: Physiology, Assessment, and Performance EffectsBiochemical Parameters in Toxicological Studies in AfricaPrerenal AzotemiaElectrolytes and DiureticsThe meaning of the blood urea nitrogen/creatinine ratio in acute kidney injuryBenefits of ethyl gallate versus norepinephrine in the treatment of cardiovascular collapse in Pseudomonas aeruginosa septic shock in dogs*Biomarkers in Acute and Chronic Kidney DiseasesHematology and serum biochemistry in debilitated, free-ranging raccoon dogs (Nyctereutes procyonoides) infested with sarcoptic mangeReduced hydration status characterized by disproportionate elevation of blood urea nitrogen to serum creatinine among the patients with cerebral infarctionNRelation between renal function and response to cardiac resynchronization therapy in Multicenter Automatic Defibrillator Implantation Trial—Cardiac Resynchronization Therapy (MADIT-CRT)Risk Factors for Recurrent Heart Failure Events in the Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II)Estimating GFR using serum beta trace protein: accuracy and validation in kidney transplant and pediatric populationsSerum blood urea nitrogen and long-term mortality in acute ST-elevation myocardial infarctionClinical Laboratory Evaluation of the Syndrome of Inappropriate Secretion of Antidiuretic HormonePerformance of the Cockcroft-Gault and Modification of Diet in Renal Disease Equations in Estimating GFR in Ill Hospitalized PatientsSerum Blood Urea Nitrogen as an Independent Marker of Subsequent Mortality Among Patients With Acute Coronary Syndromes and Normal to Mildly Reduced Glomerular Filtration RatesElevated blood urea nitrogen level as a predictor of mortality in patients admitted for decompensated heart failureMeasurement of renal function during drug developmentObservations on urea kinetic modeling and adequacy of hemodialysisRegulatory mechanisms of fluid and electrolyte turnoverKidney FunctionStoffwechselüberwachungInitial laboratory studiesThe Risk of Rhabdomyolysis and Acute Renal Failure with the Patient in the Exaggerated Lithotomy PositionAssessment of Renal Function—Glomerular and TubularStoffwechselüberwachungIschemic Acute Renal FailureRaised urea clearance in cirrhotic patients with high uric acid clearance is related to low salt excretion.Alteration of renal function in hyperthyroidism: Increased tubular secretion of creatinine and decreased distal tubule delivery of chlorideClinical Laboratories for the Practicing Pharmacist: General Serum ChemistryRenal handling of urea in subjects with persistent azotemia and normal renal functionThe Effect of Vitamin B6 Deficiency on Food Intake, Growth, and Renal Function in Chronically Azotemic RatsOral Zinc Therapy Normalizes Serum Uric Acid Level in Wilson’s Disease PatientsBlood Urea Nitrogen and CreatinineHepatorenal syndrome without avid sodium retentionLaboratory InvestigationsAminoglycoside NephrotoxicityInvestigating renal function during lithium treatmentSeasonal changes of food and water consumption and urine production of the marmot, marmota flaviventrisMarked Azotemia and Increase in Serum Creatinine: Case Report of an Unusual Feature of Acute Ureteral Obstruction in a Renal Allograft RecipientNutrition in Renal DiseaseRhabdomyolysis and Acute Myoglobinuric Renal Failure Associated with Methadone IntoxicationHigh uric acid and urea clearance in cirrhosis secondary to increased “effective vascular volume”Ticarcillin associated hypokalemiaAssessment of nephrotoxicity.Renal dysfunctionFalsely-elevated serum creatinine values in diabetic ketoacidosis — clinical implicationsAcute Renal FailureBlood Pressure of Alloxan Diabetic Rats at Regular and High Salt IntakeSpurious Serum Creatinine Elevations in KetoacidosisMARK E. MOLITCH, M.D., ELISE RODMAN, M.D., CARL A. HIRSCH, M.D., ELI DUBINSKY, M.D.Comparative low-dose nephrotoxicities of gentamicin, tobramycin, and amikacinKidney FunctionHypouricemia in the Syndrome of Inappropriate Secretion of Antidiuretic HormoneChemical Profiles of DiseaseAn improved kinetic determination for creatinine using the Abbott ABA-100Steady state serum concentrations and renal clearance of digoxin in neonates, infants and childrenNephrotoxic and hepatotoxic effects of triclosan and chlorhexidine in ratsDietary management of children with uremiaBlood urea nitrogen and serum creatinineMyoglobinuria and renal failure in toluene poisoning.Enzymuria in Gentamicin-Induced Kidney DamageChemical profiles of diseaseDouble Atrial and Atrioventricular Junctional TachycardiaAcute Tubular Necrosis Caused by Exercise-Induced MyoglobinuriaROBERT W. HAMILTON, M.D., LAURENCE B. GARDNER, M.D., AUDREY S. PENN, M.D., MARTIN GOLDBERG, M.D., F.A.C.P.Current Concepts in the Diagnosis of Acute Renal FailureThe Conservative Management of Acute Oliguric Renal FailureMeasurement of Glomerular Filtration RateA Comparison of Renal Function in Spinal Cord Injury Patients with and Without RefluxThe Differential Diagnosis of Azotemia in the Surgical PatientSignificance of maternal creatinine clearance in assessing fetoplacental functionCase 40-1969Management of Renal Insufficiency Surgical PatientsEvaluation of Renal Function Without Collection of UrineM. H. GAULT, J. B. DOSSETORThe place of phenolsulfonphthalein (PSP) in the measurement of renal functionThe effect of potassium on the imparired glucose tolerance in chronic uremia 1 December 1966Volume 65, Issue 6Page: 1287-1299KeywordsAttentionBloodExcretionIngestionProteinsRenal failureUrea ePublished: 1 December 2008 Issue Published: 1 December 1966 PDF downloadLoading ...