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Abstract
Serum creatinine elevation in a stable transplant recipient most often suggests rejection
of the transplant and requires further evaluation and management. In our series of
juvenile diabetic patients who have received kidney transplants, we frequently have
observed creatinine elevations in association with hyperglycemia. Correction of the
hyperglycemia resulted in return of serum creatinine to normal levels and no rejection
therapy was required. To better define this syndrome, 2,734 paired measurements of
blood glucose and serum creatinine were obtained in 52 stable post-transplant diabetic
patients. A mean increase in blood glucose of 100 mg. per 100 ml. was found to increase
serum creatinine by 0.5 mg. per 100 ml. in these patients (r = 0.93; p ≤ 0.001). Evidence
strongly suggests that the pathogenesis of this phenomenon is not a result of a laboratory
artifact due to the technique used to determine serum creatinine. The pathogenesis
may be due to the increased serum osmolarity and resulting intracellular dehydration
associated with hyperglycemia. Recognition of this syndrome is important to all centers
participating in the care and management of the diabetic transplant recipient.
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Article info
Footnotes
☆Supported by Grant No. AM 13083 from the United States Public Health Service.
☆☆Presented at the First Annual Meeting of the American Society of Transplant Surgeons, Chicago, Ill., May 23, 1975.
Identification
Copyright
© 1976 Published by Elsevier Inc.
