Acute Kidney Injury in In Paediatrics

Serum Creatinine has many limitations:
• Differs with age, sex, dietary intake, muscle mass etc.
• Doesn’t reflect dynamic changes only increases when there is substantial
loss of renal function.
• 10 – 40% of creatinine is cleared by tubular secretion in the urine – therefore
has the potential to hide a considerable decline in GFR.
• Several drugs impair creatinine secretion, eg. Trimethoprim.
• Once a patient receives dialysis SCr easily dialysed can no longer be
used as a marker
• In neonates
• First few days reflect mother’s creatinine;
• Therafter, SCr improves at different rates depending on gestational age
(Bagshaw S, et al: Crit Care Med 2008; 36(4):S152-S158)
(Askenazi D; Curr Opin Pediatr 23: 201-207)