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.