The influence of oral cimetidine administration on creatinine clearance in chilren with chronic renal failure: A preliminary study

Rosalina D Roeslani, Partini P. Trihono, Sri Rezeki Harun

Research output: Contribution to journalArticlepeer-review

Abstract

Background 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 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 improves the accuracy of creatinine clearance.
Original languageEnglish
Pages (from-to)14-17
JournalPaediatrica Indonesiana
Volume45
Issue number1
DOIs
Publication statusPublished - 2016

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