Using Creatinine Reduction Ratio To Evaluate Renal Function Recovery Of Kindey Transplant Recipients From Donor Of Cardiac Death:A Retrospective Study

Objective To explore the relationship between creatinine reduction ratio and renal function recovery among kidney transplant recipients of donor of cardiac death(DCD).To define the value of creatinine reduction ratio to predict delayed graft function(DGF)in early post-transplant period.Method We selected 86 patients who received renal transplantation from donor of cardiac death during Jan 1st 2011 to Jun 30 th 2016.We performed a retrospective study and collected creatinine data within 3 days after the surgery.We marked them with Cr1,Cr2 and Cr3,and then calculated creatinine reduction ratio day-2(CRR 2)=(Cr1-Cr2)/Cr1×100% and creatinine reduction ratio day-3(CRR 3)= [(Cr1-Cr2)/Cr1+(Cr2-Cr3)/Cr2]/2×100%.Patients were divided into two groups by DGF or not.We compared the difference between DGF group and no DGF group,and drew the receiver operating characteristic curve(ROC curve),and found out the cutoff value to predict the recovery condition of transplant kidneys.Results Among 86 patients,DGF appeared in 17 patients.The incidence of DGF was 19.8%.The CRR 2 of patients without DGF was 37.5%±17.4% while patients with DGF was 2.0%±24.8%,P<0.0001.The CRR 3 of patients without DGF was 32.5%±13.1% while patients with DGF was 6.8%±17.1%,P<0.0001.Then,we drew ROC curve.When the cutoff value of CRR 2 was defined as <20.7%,the prediction value of DGF,sensitivity was 85.5%,specificity was 76.5%,area under the curve was 0.876.In the same way,when CRR 3 was defined as <17.6%,sensitivity is 89.9%,specificity is 76.5%,area under the curve is 0.872.Conclusion It was reliable to predict DGF using creatinine reduction ratio during early postoperative period.CRR showed high sensitivity and specificity and it was simple.It could guide the adjustion of immunosuppressive regimen,prevent early rejection and improve prognosis of the patients.