TABLE 8810 Estimation of Glomerular Filtration Rate GFR by Serum Creatinine

Knowledge of a patient's baseline creatinine becomes very important: small changes from low baseline levels of creatinine are much more clinically important than large changes from high basal creatinine. For emergency physicians, significant decrements in GFR can occur in the normal range of creatinine: a change of creatinine from 0.6 to 1.2 mg/dL represents a 50 percent decrease in gFr although both values are in the normal range for creatinine, yet a change in creatinine from 8 to 12 mg/dL represents only a 25 percent decline in GFR.

To investigate the possibility of myocardial ischemia and hyperkalemia, an electrocardiogram should be performed on all patients presenting with ARF. Serum electrolytes should be measured. A chest radiograph may also help detect infectious causes of ARF and fluid overload.

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