PMID- 20335274
OWN - NLM
STAT- MEDLINE
DCOM- 20101223
LR  - 20181201
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Linking)
VI  - 25
IP  - 9
DP  - 2010 Sep
TI  - Creatinine-based GFR predicting equations in renal transplantation: reassessing 
      the tubular secretion effect.
PG  - 3076-82
LID - 10.1093/ndt/gfq123 [doi]
AB  - BACKGROUND: The real utility of blocking the tubular secretion of creatinine with 
      cimetidine in order to ameliorate the prediction of renal graft function is 
      questionable, particularly in the context of an increasing diffusion of the 
      Modification of Diet in Renal Disease (MDRD) study equation. We have compared the 
      impact of cimetidine on the performances of the Cockcroft-Gault (C-G) and MDRD 
      equations in 56 renal transplant patients with an estimated glomerular filter 
      rate (GFR) >30 mL/min/1.73 m(2) for whom true GFR was directly measured by inulin 
      clearance. METHODS: Serum creatinine concentration (SCr) was measured [isotope 
      dilution mass spectrometry (IDMS) traceable enzymatic assay] at the beginning of 
      the inulin clearance procedure and 2 days later, after three oral cimetidine 
      doses of 800 mg every 12 h. Predictive and diagnostic performances of the 
      re-expressed MDRD and C-G formulas were compared before and after cimetidine 
      intake. RESULTS: Mean SCr (+/-SD) increased from 120 micromol/L (+/-34) before to 
      154 micromol/L (+/-47) after cimetidine. The beneficial effect of cimetidine was 
      significant only on the accuracy of the C-G formula (accuracy 30% post-cimetidine 
      of 93 and 79% for the C-G and MDRD equations, respectively). Likewise, while a 
      higher proportion of patients were correctly staged using the chronic kidney 
      disease classification after cimetidine with the C-G equation (59% before and 68% 
      after), no improvement was seen with the MDRD formula (59 vs 57%). For both 
      equations, receiver operating characteristic curves analysis showed only a 
      marginal gain in GFR prediction. CONCLUSION: Our data do not support the use of a 
      cimetidine-based strategy for the evaluation of renal graft function in the 
      clinic, particularly when the GFR is estimated by the MDRD equation.
FAU - Maillard, Nicolas
AU  - Maillard N
AD  - Service de Nephrologie, Dialyse, Transplantation Renale, Laboratoires 
      d'Explorations Fonctionnelles Renales, EA 3065 Hopital NORD, CHU de 
      Saint-Etienne, Universite Jean MONNET, Saint-Etienne, France.
FAU - Mehdi, Manolie
AU  - Mehdi M
FAU - Thibaudin, Lise
AU  - Thibaudin L
FAU - Berthoux, Francois
AU  - Berthoux F
FAU - Alamartine, Eric
AU  - Alamartine E
FAU - Mariat, Christophe
AU  - Mariat C
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20100324
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
RN  - 0 (Anti-Ulcer Agents)
RN  - 80061L1WGD (Cimetidine)
RN  - 9005-80-5 (Inulin)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anti-Ulcer Agents/pharmacology
MH  - Cimetidine/pharmacology
MH  - Creatinine/*metabolism
MH  - *Diet
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Humans
MH  - Inulin/*metabolism
MH  - Kidney Diseases/*therapy
MH  - Kidney Function Tests
MH  - *Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - ROC Curve
MH  - Survival Rate
EDAT- 2010/03/26 06:00
MHDA- 2010/12/25 06:00
CRDT- 2010/03/26 06:00
PHST- 2010/03/26 06:00 [entrez]
PHST- 2010/03/26 06:00 [pubmed]
PHST- 2010/12/25 06:00 [medline]
AID - gfq123 [pii]
AID - 10.1093/ndt/gfq123 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2010 Sep;25(9):3076-82. doi: 10.1093/ndt/gfq123. Epub 
      2010 Mar 24.