A patient had recurrent acute nocturnal pulmonary oedema following an anterior myocardial infarction despite a normal maximal stress electrocardiogram. He had a history of chronic heavy snoring and other symptoms to suggest a diagnosis of obstructive sleep apnoea (OSA) which was supported by an overnight sleep study. The recurrent acute pulmonary oedema was most likely due to a combination of poor left ventricular function and obstructive sleep apnoea.
Creatinine clearance is calculated from 24 hour urine creatinine excretion. This method of measuring creatinine clearance is cumbersome. Many formulae have been proposed as an alternative method of obtaining predicted creatinine clearance and they have all shown satisfactory results. From our study using 4 formulae, the correlation coefficient using these formulae rangedfrom 0.71 - 0.75. The correlation clearance was even better at > 0.90. We therefore advocate the routine use of these formulae for predicting creatinine clearance by clinicians.
Study site: Nephrology clinic, Universiti Kebangsaan Malaysia unit at Hospital Kuala Lumpur, Malaysia