title: Creatinine reduction ratio on post-transplant day two as criterion in defining delayed graft function.
abstract: Delayed graft function (DGF) is a common complication after renal transplant, affecting its outcome. A common definition of DGF is the need for dialysis within the first week of transplantation, but this criterion has its drawbacks. We tried to validate an earlier and better defined parameter of DGF based on the creatinine reduction ratio on post-transplant day 2 (CRR2). We analyzed the clinical charts of 291 cadaver kidney recipients to compare the outcome of patients with immediate graft function (IGF), dialyzed patients (D-DGF) and nondialyzed CRR2-defined DGF patients (ND-DGF) and to identify risk factors for D-DGF and ND-DGF. Creatinine reduction ratio on post-transplant day 2 correlates significantly with renal function during the first year. Patients with IGF have significantly better renal function throughout the first year and better graft survival than patients with D-DGF and ND-DGF, while we found no differences either in renal function from days 30-365 or in graft survival between D-DGF and ND-DGF patients. Defining DGF by CRR2 allows an objective and quantitative diagnosis after transplantation and can help to improve post-transplant management. Creatinine reduction ratio on post-transplant day 2 correlates with renal function throughout the first year. The worse survival in the ND-DGF group is an important finding and a major advantage of the CRR2 criterion.
authors.affiliation: Service of Nephrology, Hospital Valdecilla, University of Cantabria, Santander, Spain. erodrigoc@ono.com
authors.forename: Emilio
authors.initials: E
authors.lastname: Rodrigo
authors.forename: Juan C
authors.initials: JC
authors.lastname: Ruiz
authors.forename: Celestino
authors.initials: C
authors.lastname: Piñera
authors.forename: Gema
authors.initials: G
authors.lastname: Fernández-Fresnedo
authors.forename: Rafael
authors.initials: R
authors.lastname: Escallada
authors.forename: Rosa
authors.initials: R
authors.lastname: Palomar
authors.forename: Julio G
authors.initials: JG
authors.lastname: Cotorruelo
authors.forename: José A
authors.initials: JA
authors.lastname: Zubimendi
authors.forename: Angel L
authors.initials: AL
authors.lastname: Martín de Francisco
authors.forename: Manuel
authors.initials: M
authors.lastname: Arias
mesh_terms: D000328:Adult; D000367:Age Factors; D003404:Creatinine / Q000097:blood*; D003956:Dialysis; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007511:Ischemia; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D013223:Statistics as Topic; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D003404:Creatinine