Spurious hypercreatininemia: 28 neonatal foals (2000-2008).

OBJECTIVES

To (1) determine the occurrence of spurious hypercreatininemia in a population of hospitalized foals<2 days old, (2) assess the resolution of the hypercreatininemia, and (3) determine its association with survival in these foals.

DESIGN

Retrospective case series.

SETTING

2 Referral hospitals.

ANIMALS

Foals<2 days old with an admission creatinine>442 micromol/L (>5.0 mg/dL) from 2 referral hospitals.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The medical records of 33 foals were reviewed. Twenty-eight had spurious hypercreatininemia and 5 had acute renal failure. Admission creatinine was not significantly different between the 2 groups (mean [standard deviation]). The creatinine was 1,202 micromol/L (663 micromol/L) (13.6 mg/dL [7.5 mg/dL]) versus 1,185 micromol/L (787 micromol/L) (13.4 mg/dL [8.9 mg/d]) (P=0.96) in each group, respectively, though BUN at the time of hospital admission was significantly higher for acute renal failure foals (P=0.009). In the spurious group, serum creatinine at admission decreased to 504 micromol/L (380 micromol/L) (5.7 mg/dL [4.3 mg/dL]) by 24 hours, and to 159 micromol/L (80 micromol/L) (1.8 mg/dL [0.9 mg/dL]) at 48 hours, and to 115 micromol/L (44 micromol/L) (1.3 mg/dL [0.5 mg/dL]) at 72 hours. Twenty-three of 28 foals with spurious hypercreatininemia survived to hospital discharge and there was no difference in mean admission creatinine between survivors (1176 micromol/L [628 micromol/L]) (13.3 mg/dL [7.1 mg/dL]) and nonsurvivors (1308 micromol/L [857 micromol/L]) (14.8 mg/dL [9.7 mg/dL]) (P=0.67). Twenty of 28 foals had clinical signs suggestive of neonatal encephalopathy.

CONCLUSION

Creatinine decreased by >50% within the initial 24 hours of standard neonatal therapy and was within the reference interval in all but 1 foal within 72 hours of hospitalization. The diagnosis of neonatal encephalopathy was common in these foals.