Need of a New Formula to Estimate Creatinine Clearance in Immediate Post Kidney Transplant Period with Functioning Allograft
1Surgery ( Transplant), Penn State Milton Hershey Medical Center, Hershey 17033, PA, 2Medicine( Neprhology), Penn State Milton Hershey Medical Center, Hershey, PA
Meeting: 2019 American Transplant Congress
Abstract number: B74
Keywords: Effector mechanisms, Kidney transplantation, Renal function, Urinalysis
Session Information
Session Name: Poster Session B: Biomarkers, Immune Monitoring and Outcomes
Session Type: Poster Session
Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Introduction: Post kidney transplant (KTx), with functioning renal allograft, serum creatinine continues to decrease at a variable rate until it stabilizes after a few days. Currently available formulae are based on single serum creatinine value. They are designed to estimate creatinine clearance in chronic kidney disease and do not take into account daily changes in the value. Currently there is not a single formula for immediate post KTx patient with functioning allograft where there is daily decrease in in creatinine hence certain medication which requires dose adjustment based on renal function are not adjusted appropriately. Purpose of the present study is to calculate the actual creatinine clearance by measuring urinary creatinine excretion every 12 hours post KTx with functioning allograft and compare with Cockcroft-Gault and MRDR-4 formulae.
*Methods: 25 consenting adults (mean age 53.3 +/- 17.2 years; 13 male), with primary allograft function, were prospectively studied after IRB approved protocol. Urine was collected every 12 hours post KTx until serum creatinine stabilized. Creatinine clearance was calculated {U (urinary creatinine) x V (urinary volume) / S (serum creatinine)}. This was compared with values obtained by Cockcroft- Gault and MDRD-4 formulae.
*Results: Mean urinary creatinine clearance was 43.3 and 59.9 mL/min on post-transplant day 1 and 2 respectively. This was much higher when compared with MDRD-4 formula (15.7 mL/min and 39.4 mL/min on day1 and 2 respectively) and Cockcroft-Gault (28.6 on and 51.3 on mL/min on day 1 and 2 respectively) formulae. The results are shown in figures below.
*Conclusions: At each time point, post KTx, actual measure creatinine clearance was much higher than calculated by both formulae. There is a need of a new formula which can estimate creatinine clearance in the immediate post KTx period to improve efficacy and avoid toxicity of medications which require dose adjustment based on renal function
$$MISSING OR BAD TABLE SPECIFICATION {F8D29377-DC98-40B2-9B59-64F40156DCD0}$$
To cite this abstract in AMA style:
Jain AB, Farooq U, Brooks A, Dohi T, Butt F, Kadry Z. Need of a New Formula to Estimate Creatinine Clearance in Immediate Post Kidney Transplant Period with Functioning Allograft [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/need-of-a-new-formula-to-estimate-creatinine-clearance-in-immediate-post-kidney-transplant-period-with-functioning-allograft/. Accessed May 11, 2025.« Back to 2019 American Transplant Congress