Creatinine

[Pharmacie]

Is it true to depend only on serum creatinine level for the assessment of the kidney functions rather than using cockcroft-gault equation or MDRD.

[laurabuk]

False. You can, and do, get patients with a "normal" creatinine who's renal function is severly impaired - particularly little old ladies with a low muscle mass.

[crit care]

i wouldn't just go on serum creatinin alone to assess renal function...need to look at urine output and urea as well. often cockroft-gault isn't accruate in the critically ill either, or those on a filter!

[Nik]

Also not practically useful in the acute setting because of changing CrCl - more useful in CKD.

[Pharmacie]

What are the necessary tests a patient with hypertension should do to evaluate the kidney functions (from a practical point of view)
Because if the patient has CKD, then the target blood pressure is 130/80

thanks

[crit care]

the main test to evaluate renal function is U&Es...i don't think you can ever accurately access someones renal function.....

not entirely sure where the question is heading....out in the community in someone who is otherwise well, thens erum creatinine can be used, but as Nik pointed out in the acute setting then using serum creatinine isn't that useful and can over estimate someones renal function

[Nik]

Because if the patient has CKD, then the target blood pressure is 130/80

Tight blood pressure control in renal patients is ideal but practically difficult to obtain. Same can probably be said for diabetics. CKD patients will probably have ongoing renal function tests while they are on anti-hypertensives, particularly if they're on ACEi's, ARB's or diuretics.