The influence of oral cimetidine administration on creatinine clearance in chilren with chronic renal failure: A preliminary study
AbstractBackground Serum creatinine and creatinine clearance are used
to 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
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
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
Creatinine clearence following cimetidine for estima-
tion of glomerular filtration rate. Pediatr Nephrol
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