The plasma creatinine concentration is not an accurate reflection of the glomerular filtration rate in stable renal transplant patients receiving cyclosporine

Am J Kidney Dis. 1987 Aug;10(2):113-7. doi: 10.1016/s0272-6386(87)80042-2.

Abstract

We studied 31 stable renal cadaver kidney transplant patients receiving cyclosporine (CyA) and prednisone for immunosuppression to determine what reduction in true glomerular filtration rate (GFR) was reflected by their mild elevation in plasma creatinine concentration (1.8 +/- 0.11 mg/dL). We measured both the creatinine clearance (60 +/- 4.32 mL/min/1.73 m2) and the true GFR using Technetium 99m-DTPA (44 +/- 2.72 mL/min/1.73 m2). The creatinine clearance overestimated true GRF by a mean of 38%, indicating that this percentage of creatinine reached the urine by tubular secretion rather than glomerular filtration. A similar degree of overestimation was found in a separate group of 14 patients receiving imuran for immunosuppression. In 23 patients receiving CyA in whom the serum creatinine concentration was less than 2.0 mg/dL, the mean DTPA clearance was 49.5 +/- 2.83 mL/min/1.73 m2. In stable renal transplant patients receiving CyA, a serum creatinine concentration at, or close to, the upper limit of the normal range may reflect markedly impaired renal function.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Azathioprine / therapeutic use
  • Creatinine / blood*
  • Creatinine / urine
  • Cyclosporins / therapeutic use*
  • Glomerular Filtration Rate / drug effects*
  • Humans
  • Immunosuppression
  • Kidney / physiopathology
  • Kidney Transplantation*
  • Pentetic Acid
  • Prednisone / therapeutic use

Substances

  • Cyclosporins
  • Pentetic Acid
  • Creatinine
  • Azathioprine
  • Prednisone