This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
In Reply—We are appreciative of Matz' comments on our study concerning abnormally low serum creatinine levels and increased creatinine clearance values in severe hepatic disease. He observed similar kinds of constellations of low serum levels of creatinine and uric acid, low serum urea nitrogen levels, and increased creatinine clearance values in patients with alcoholic liver disease, although the levels of creatinine were in the low range of normal. However, the background of the patients is somewhat different. Their patients were almost invariably suffering from acute alcoholic hepatitis, and some of them recovered, in contrast to our patients with severe liver disease. He suggested a causative role of increased effective vascular volume without giving an explanation as to how the body fluid volume could increase in their alcoholic patients. He also had no data regarding the glomerular filtration rate measured by a reliable method.
TAKABATAKE T. Low Serum Creatinine Levels in Severe Hepatic Disease-Reply. Arch Intern Med. 1989;149(6):1471. doi:10.1001/archinte.1989.00390060173052
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: