Fingernail creatinine as a predictor of prior renal function in children

ABSTRACT

It is often difficult to distinguish acute renal failure clinically from chronic renal failure, especially in children who do not have records of their medical history. The objective of this study was undertaken to re-examine the history the association between fingernail creatinine [NCr] and serum creatinine [SCr] in children with renal diseases as nephrotic syndrome, acute renal failure and chronic renal failure and the possibility of clinical use of this association. In this study, clipped fingernail specimen from 10 normal control children [mean age 9.5 +/- 2.57 years 6 males and 4 females], 8 children with nephrotic syndrome [mean age 9.93 +/- 2.2 years 5 males and 3 females], 7 children with acute renal failure [mean age 9.57 +/- 3.06 years 4 males and 3 females] and 10 children with chronic renal failure [mean age 10.15 +/- 2.44 years 6 males and 4 females] under regular hemodialyis were analysed for creatinine by autoanalyser using Jaffe's reaction. The results show that Ncr level of nephrotic syndrome [23.4 +/- 4.02 mg/100 mg nail] and Ncr of children with acute renal failure [22.05 +/- 4.27 mg/100 mg nail] were similar to that of NCr of normal control group [23.99 +/- 4.46 mg/100 mg nail] and significantly lower than NCr of the children with chronic renal failure [61.88 +/- 6.3 mg/100 gm nail]. Also, there were a strong positive correlations between NCr of children with chronic renal failure and SCr[r = 0.401] and duration of renal failure [r = 0.410]. This study confirms that the NCr measurement is of valid clinical value in differentiating acute from chronic renal failure