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World J Hepatol. Oct 27, 2014; 6(10): 696-703
Published online Oct 27, 2014. doi: 10.4254/wjh.v6.i10.696
Published online Oct 27, 2014. doi: 10.4254/wjh.v6.i10.696
Difficulties in diagnosing acute kidney injury post liver transplantation using serum creatinine based diagnostic criteria
Banwari Agarwal, Intensive Care Unit, The Royal Free Hospital, NW32QG London, United Kingdom
Andrew Davenport, UCL Centre for Nephrology, The Royal Free Hospital, NW32QG London, United Kingdom
Author contributions: Both of the authors both contributed to this paper.
Supported by Royal Free Hospital
Correspondence to: Dr. Andrew Davenport, UCL Centre for Nephrology, The Royal Free Hospital, Pond Street, NW32QG London, United Kingdom. andrewdavenport@nhs.net
Telephone: +44-20-74726457 Fax: +44-20-73178591
Received: May 22, 2014
Revised: June 16, 2014
Accepted: September 6, 2014
Published online: October 27, 2014
Revised: June 16, 2014
Accepted: September 6, 2014
Published online: October 27, 2014
Core Tip
Core tip: Acute kidney injury is defined and severity graded based on changes in serum creatinine. Increasing concentrations of bilirubin interefere with laboratory determination of creatinine and reduce creatinine estimations. Post transplantation serum creatinine increases due to a combination of fall bilirubin and the loading doses of calcineurin inhibitor immunosupressants. This combination leads to an over estimation of the lesser grades of acute kidney injury post liver transplantation.