![]() The most widely cited study of trimester-specific creatinine concentration includes only 29 healthy pregnant women. 7 Such data have limited generalizability without correction for factors known to cause variance in serum creatinine, including ethnicity, gestation, and the use of different creatinine assay methods. The upper limit (95th–97.5th centile) of creatinine concentration in healthy pregnancy varies between published cohorts. Serum creatinine concentration, therefore, remains the only standard, single-point assessment for kidney function in pregnant populations, yet a normal range for serum creatinine in pregnancy has not been established. 2 Even in women with preeclampsia and contracted maternal plasma volume, estimated GFR remains inaccurate when derived by both Modified Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration methods, compared with inulin and creatinine clearance. 1 Estimated GFR calculations based on Modified Diet in Renal Disease calculations underestimate GFR in pregnancy by up to 41 ml/min per 1.73 m 2 compared with inulin clearance. However, in pregnancy, estimated GFRs inconsistently underestimate renal function and should not be used. Such equations use demographic and clinical variables to correct for physiological factors that affect serum creatinine. Outside of pregnancy, glomerular filtration rates (GFRs) are routinely estimated from serum creatinine concentrations using standardized equations, facilitating the diagnosis of chronic kidney disease and grading of disease severity.
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