Most studies evaluating renal function post-renal transplantation in children have used serum creatinine (SCr) or estimates of its clearance (CSCH). When renal function is impaired both SCr and the CSCH overestimate glomerular filtration rate (GFR), especially during cyclosporine therapy. This study measured GFR in 64 children (age range: 4-19 years) with stable renal function who received renal allografts at the Childrens Medical Center of Dallas, 31 from live related donors (LRD) and 33 from cadaveric donors (CAD). 125I- iothalamate clearance (CIO) was used as the reference standard for measuring GFR. Data from 100 CIO studies, were analyzed and results reported as mean ± S.E.M. CIO performed during the first year after renal transplantation in 23 children who received allografts from LRD was 72.4±5.5 ml/min per 1.73 m2 compared to 50.4±7.4 ml/min per 1.73m2 in 18 children who received allografts from CAD (p<0.05). Beyond the first year post-renal transplantation there was no difference in CIO between LRD and CAD allografts. When SCr was compared to CIO, the relationship was nonlinear. CIO was also compared to the simultaneous estimation of creatinine clearance by CSCH. The overestimation of GFR by CSCH was inversely proportional to the level of renal function. When renal function was normal or mildly reduced (CIO>50 ml/min per 1.73 m2), CSCH closely approximated CIO. When renal function was moderately to severely curtailed (CIO < 50 ml/min per 1.73 m2), CSCH overestimated CIO by 43.6±5.6%. The study concludes that in children with renal transplant: 1) CIO is higher in allografts from LRD compared to CAD kidneys only in the first 12 months following renal transplantation; 2) SCr is a poor predictor of CIO; and 3) CSCH consistently overestimates GFR children following renal transplantation unless renal function is normal or only mildly decreased.
|Original language||English (US)|
|Number of pages||5|
|State||Published - Aug 1 1998|
- Glomerular filtration rate
- Iothalamate clearance
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health