The influence of oral cimetidine administration on creatinine clearance in children with chronic renal failure: A preliminary study
ABSTRACT: 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 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 administration was
27.4 (SD 14.6) ml/minute/1.73 m2 BSA, and decreased after cimetidine to 21.1
(SD 13,1) ml/minute/1.73 m2 BSA (p=0.015).
Conclusion Oral cimetidine was effective in inhibiting creatinine tubular
secretion. This study could not prove that cimetidine improves the accuracy of
creatinine clearance.
Author: Rosalina D Roeslani,
MD; Partini P Trihono, MD, MM (Paed); Sri Rezeki Harun, MD, PhD
Journal Code: jpkedokterangg050055
