Creatinine Reduction Ratio on Post-Transplant Day Two as Criterion in Defining Delayed Graft Function
Article first published online: 21 APR 2004
American Journal of Transplantation
Volume 4, Issue 7, pages 1163–1169, July 2004
How to Cite
Rodrigo, E., Ruiz, J. C., Piñera, C., Fernández-Fresnedo, G., Escallada, R., Palomar, R., Cotorruelo, J. G., Zubimendi, J. A., Martín de Francisco, A. L. and Arias, M. (2004), Creatinine Reduction Ratio on Post-Transplant Day Two as Criterion in Defining Delayed Graft Function. American Journal of Transplantation, 4: 1163–1169. doi: 10.1111/j.1600-6143.2004.00488.x
- Issue published online: 21 APR 2004
- Article first published online: 21 APR 2004
- Received 25 November 2003, revised and accepted for publication 11 March 2004
- Acute rejection;
- delayed graft function;
- graft survival;
- kidney transplantation;
- serum creatinine
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.