The influence of oral cimetidine administration on creatinine clearance in chilren with chronic renal failure: A preliminary study
Keywords:
chronic renal failure, creatinine clearance, cimetidine, cystatin C
Abstract
Background Serum creatinine and creatinine clearance are usedto assess glomerular filtration rate but have a major disadvantage
since a variable amount of creatinine is secreted in the proximal
tubule. This may cause an unpredictable overestimation of GFR.
Tubular creatinine secretion can be blocked by cimetidine through
competitive inhibition of cation transport in the proximal tubular
luminal membrane.
Objective Cimetidine administration might improve the reliability
of creatinine as a marker of glomerular filtration.
Methods A preliminary study with a one-group pretest-posttest
design in 11 children with chronic renal failure. Serum cystatin C
level as reference value was compared with creatinine clearance
measured before and after oral ingestion of cimetidine. The dose
of cimetidine was adjusted with the GFR using Schwartz formula.
Statistical evaluation was done with the Wilcoxon signed ranks
test.
Result The mean creatinine clearance before cimetidine adminis-
tration was 27.4 (SD 14.6) ml/minute/1.73 m 2 BSA, and decreased
after cimetidine to 21.1 (SD 13,1) ml/minute/1.73 m 2 BSA (p=0.015).
Conclusion Oral cimetidine was effective in inhibiting creatinine
tubular secretion. This study could not prove that cimetidine im-
proves the accuracy of creatinine clearance
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M, Kouri T. Reference intervals for cystatin-C in pre-
and full-term infants and children. Pediatr Nephrol
2000;15:105-8.
Creatinine clearence following cimetidine for estima-
tion of glomerular filtration rate. Pediatr Nephrol
1998;12:49-54.
2. Levey A. Clinical evaluation of renal function. In:
Greenberg A, Cheung AK, Falk RJ, Coffman TM,
Jennete JC, eds. Primer on Kidney diseases. San Di-
ego: Academic Press Limited; 1994. p. 17-23.
3. Hilbrands LB, Artz MA, Wetzels JFM, Koene RAP.
Cimetidine improves the realiability of creatinine as
a marker of glomerular filtration. Kidney Int
1991;40:1171-6.
4. Kemperman FAV, Silberbusch J, Slaats EH, Prins AM,
Weber JA, Krediet RT, et al. Estimation of glomerular
filtration rate in NIDDM patients from plasma
creatinin concentration after cimetidine administra-
tion. Diabetes Care 1998; 21: 216-20.
5. Zaltzman J, Whiteside C, Cattran DC, Lopez FM, Lo-
gan AG. Accurate measurement of impaired glomeru-
lar filtration using single-dose oral cimetidine. Am J
Kidney Dis 1996; 27:504-11.
6. Van Acker BAC, Koomen GCM, Koopman MG, De
Waart DR, Arisz L. Creatinine clearance during
cimetidine administration for measurement of glom-
erular filtration rate. Lancet 1992; 340:1326-9.
7. Serdar MA, Kurtz I, Urhan M, Ilgan S, Yenicesu M,
Kenar L, et al. A practical approach to glomerular fil-
tration rate measurements: creatinine clearance esti-
mation using cimetidine. Ann Clin Lab Sci 2001;
31:265-73.
8. Ylinen EA, Hauhala MA, Harmoinem APT, Knip M.
Cystatin-C as a marker for glomerular filtration rate in
pediatric patients. Pediatr Nephrol 1999; 13:506-9.
9. Bökenkamp A, Domanetzki M, Zinck R, Schumann
G, Byrd D, Brodehl J. Cystatin C serum concentrations
underestimate glomerular filtration rate in renal trans-
plant recipients. Clin Chem 1999;45:1866-8.
10. Bricon TL. Cystatin C in renal transplantation. Pre-
sented at International Expert Meeting on Cystatin C
and GFR Assessment, Marburg; 2002 April 15-16;
Marburg, Germany.
11. Stoves J, Bosomworth M, Newstead CG. Cystatin C as
aguide to glomerular filtration rate in renal transplant
recipients with chronic allograft nephropathy. Clin
Chem 2002; 32:1467.
12. Bokenkamp A, Damonetzki M, Zinck R, Schumann G,
Brodehl J. Reference values for cystatin-C serum concen-
trations in children. Pediatr Nephrol 1998; 12:125-9.
13. Filler G, Priem F, Vollmer I, Gellermann J, Jung K.
Diagnostic sensitivity of serum cystatin for impaired
glomerular filtration rate. Pediatr Nephrol 1999;
13:501-5.
14. Harmoinen A, Ylinen E, Houhala MA, Janas M, Kaila
M, Kouri T. Reference intervals for cystatin-C in pre-
and full-term infants and children. Pediatr Nephrol
2000;15:105-8.
Published
2016-10-10
How to Cite
1.
Roeslani R, Trihono P, Harun S. The influence of oral cimetidine administration on creatinine clearance in chilren with chronic renal failure: A preliminary study. PI [Internet]. 10Oct.2016 [cited 23Apr.2024];45(1):14-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/791
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Received 2016-10-05
Accepted 2016-10-05
Published 2016-10-10
Accepted 2016-10-05
Published 2016-10-10
