SAN DIEGO—Recipients of kidneys from expanded criteria donors (ECDs) with elevated terminal creatinine may be at higher risk for delayed graft function (DGF) and primary nonfunction (PNF), according to researchers at Mount Sinai School of Medicine in New York.

Researchers led by Anita Mehrotra, MD, a clinical fellow, analyzed data from 69 ECD transplant recipients. Of these, 44 experienced DGF and 25 did not. In univariate analysis, the mean donor terminal serum creatinine level was 1.36 mg/dL in the DGF group compared with 1.02 mg/dL in the patients without DGF. The difference remained significant after adjusting for recipient age, race, gender, donor age, donor cause of death, and donor hypertension.

The study also showed that PNF was more likely to occur in black than white patients, Dr. Mehrotra reported here at the 2010 American Transplant Congress.

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Of the 28 black patients, 20 had a functioning graft and eight had PNF. Of the 41 non-blacks, 38 had a functioning graft and only three had PNF. In multivariate analysis, black race was associated with a nearly 10-fold increased risk of PNF. Black race also was associated with a low six-month estimated glomerular filtration rate. Each 1 mg/dL increment in terminal creatinine was associated with a fivefold increased risk, Dr. Mehrotra said.