A short-term rise in (serum) creatinine may reflect a beneficial effect in chronic kidney disease. …further complicating the AKI definition is the finding that short-term rise in creatinine may reflect a beneficial effect in chronic kidney disease. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers slow the progression of proteinuric kidney disease, but initiation of these medications often lead to an acute rise in creatinine. In the RENAAL study, this initial rise in creatinine predicted a slower long-term loss of kidney function (4). Unfortunately, this concern about the rise in creatinine can lead to underdosing or discontinuation of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. When Increase in Serum Creatinine Doesn’t Imply Kidney Damage | American Society of Nephrology. When Increase in Serum Creatinine Doesn’t Imply Kidney Damage | American Society of Nephrology (asnjournals.org)