Prediction of the glomerular filtration rate using equations in kidney-pancreas transplant patients receiving cimetidine.
BACKGROUND
Current estimates of renal function in kidney transplant patients are frequently inaccurate compared to radionuclide GFR (rGFR) measurement. Cimetidine inhibits tubular secretion of creatinine and improves the accuracy of formulas to estimate GFR.


METHODS
We studied the effect of a cimetidine-aided (800 mg tid for 24 hr) serum creatinine on the correlation of creatinine clearance and three prediction formulas (Cockroft-Gault, Levey, and Nankivell) compared to rGFR in 15 kidney-pancreas transplant patients. Results were adjusted for body surface area.


RESULTS
Correlations with rGFR using cimetidine-aided creatinine were: Cockroft-Gault, r=0.710; Levey, r=0.752; Nankivell, r=0.676; creatinine clearance, r=0.643. By Bland and Altman analysis, agreement with rGFR was best with the Nankivell and Cockroft-Gault equations and worst with creatinine clearance. Cimetidine ($0.48 Canadian) costs substantially less than the rGFR test ($66.00 Canadian).


CONCLUSIONS
Using cimetidine, prediction equations give a stronger correlation with GFR than creatinine clearance.
Schiff
Jeffrey
J
Department of Medicine, Royal Victoria Hospital, McGill University Health Centre, Montréal, Québec, Canada.
Paraskevas
Steven
S
Keith
Douglas
D
Tchervenkov
Jean
J
Metrakos
Peter
P
Cantarovich
Marcelo
M
D002927:Cimetidine / Q000008:administration & dosage / Q000494:pharmacology*; D003404:Creatinine / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D011379:Prognosis
D002927:Cimetidine; D003404:Creatinine