Predicting the ideal serum creatinine level following kidney transplantation

This Practice Point commentary reviews a study by Sberro et al. that evaluated formulae to predict the lowest measured serum creatinine concentration in kidney transplant recipients following surgery. The objective of the study was to ascertain a simple means of identifying patients with inappropriately high serum creatinine concentrations, who are in need of further investigation. A prediction formula based on the recipient's age and weight and the donor's preoperative estimated creatinine clearance, as calculated from the Cockcroft-Gault equation, showed the strongest correlation, the greatest precision, the lowest positive bias, and the second highest 30% accuracy with the lowest observed serum creatinine concentration in the recipient. This study provides a simple means of predicting the lowest serum creatinine concentration following kidney transplantation. However, the sensitivity, specificity and other diagnostic characteristics of the equation need to be determined in a prospective study before this approach can be recommended in routine clinical practice.