The impairment of true glomerular filtration rate in long-term cyclosporine-treated pediatric allograft recipients

Journal Article · Mon Jan 01 00:00:00 EST 1990 · Transplantation; (USA)

DOI:https://doi.org/10.1097/00007890-199001000-00018· OSTI ID:6994197

McDiarmid, S V; Ettenger, R B; Hawkins, R A; Senguttvan, P; Busuttil, R W; Vargas, J; Berquist, W E; Ament, M E

We performed indium-111-DTPA plasma clearance studies in 61 pediatric kidney and liver recipients treated with cyclosporine to compare true glomerular filtration rate with calculated GFR (cGFR). The mean true GFR of 61.9 +/- 36.6 ml/min/1.73 m2 indicated renal impairment. The mean cGFR of 85.2 +/- 22.4 ml/min/1.73 m2 was significantly higher (P less than 0.001), and overestimated GFR by 38%. cGFR alone did not accurately reflect the degree of renal dysfunction. A group of 48 pediatric orthotopic liver transplant recipients was studied in more detail: 73% of these patients had a true GFR less than 70 ml/min/1.73 m2, while 85% had a true GFR below 90 ml/min/1.73 m2, the lower limit for normal GFR in children. The mean true GFR for patients treated more than 24 months with CsA was lower (P = 0.02) than patients treated with CsA for 12 to 24 months. OLT patients with normal true GFR (greater than 90 ml/min/1.73 m2) had significantly lower plasma CsA levels, and 50% of patients with a true GFR less than or equal to 50 ml/min/1.73 m2 had hypertension. There was no effect on true GFR of age, liver function, azathioprine use, or peritransplant treatment with other nephrotoxic drugs. We conclude that true GFR is significantly impaired in long-term CsA-treated allograft pediatric recipients. Calculations of GFR underestimate the degree of renal dysfunction. As patients treated greater than 24 months had the lowest true GFRs, the fall in GFR may be progressive.

• OSTI ID: 6994197
• Journal Information: Transplantation; (USA), Vol. 49:1; ISSN 0041-1337
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
KIDNEYS
TRANSPLANTS
LIVER
UROGENITAL SYSTEM DISEASES
DIAGNOSIS
CHILDREN
DTPA
DYNAMIC FUNCTION STUDIES
IMMUNOSUPPRESSIVE DRUGS
INDIUM 111
PATIENTS
AGE GROUPS
AMINO ACIDS
BETA DECAY RADIOISOTOPES
BODY
CARBOXYLIC ACIDS
CHELATING AGENTS
DAYS LIVING RADIOISOTOPES
DIGESTIVE SYSTEM
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
GLANDS
INDIUM ISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MINUTES LIVING RADIOISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANS
RADIOISOTOPES
RADIOPROTECTIVE SUBSTANCES
550601* - Medicine- Unsealed Radionuclides in Diagnostics