{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:40:09Z","timestamp":1753879209078,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T00:00:00Z","timestamp":1735171200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric kidney transplant recipients experience creeping creatinine, which is a slow increase in serum creatinine over time. Distinguishing between normal growth\u2010related changes and possible allograft dysfunction becomes challenging when interpreting the increase in serum creatinine. We hypothesized that changes in BSA\u2010indexed measured glomerular filtration rate (mGFR) or creatinine\u2010estimated GFR (eGFR) might not be a true reflection of the renal function post\u2010transplant and that for longitudinal follow\u2010up a stable absolute mGFR is better.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 115 pediatric kidney transplant recipients transplanted between 2000 and 2021, with 319 measured GFR values (each subject had at least 2 values) were enrolled in this retrospective study. We analyzed after stratifying based on the height and BSA changes (&lt;\u20095% change, 5%\u201314.9% change, and &gt;\u200915% change in height and BSA) between measured GFR tests. The agreement between absolute mGFR and both BSA\u2010indexed mGFR or eGFR was analyzed by Bland and Altman analysis and nonparametric Spearman's rank order correlation analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The bias between absolute mGFR and either BSA\u2010indexed mGFR or eGFR increased as the % change in height and the BSA increased. Spearman's rank order correlation showed a strong correlation when the BSA and height changes were &lt;\u20095% and the correlation weakened as the % changes increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In children who grew more, the BSA\u2010indexed mGFR dropped more than the absolute mGFR. We propose that a stable absolute mGFR can be used to infer stable allograft function in the presence of height growth.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14883","type":"journal-article","created":{"date-parts":[[2024,12,27]],"date-time":"2024-12-27T03:04:26Z","timestamp":1735268666000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Creeping Creatinine in a Growing Child With a Kidney Transplant: Distinguishing Progressive Graft Dysfunction From Normal Growth in Pediatric Kidney Transplant Recipients"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5629-6520","authenticated-orcid":false,"given":"Raja S.","family":"Dandamudi","sequence":"first","affiliation":[{"name":"Division of Pediatric Nephrology, Hypertension and Apheresis Washington University School of Medicine &amp; St. Louis Children's Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Vyas","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Hypertension and Apheresis Washington University School of Medicine &amp; St. Louis Children's Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley P.","family":"Hmiel","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Hypertension and Apheresis Washington University School of Medicine &amp; St. Louis Children's Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8000-1385","authenticated-orcid":false,"given":"Vikas R.","family":"Dharnidharka","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, Hypertension and Apheresis Washington University School of Medicine &amp; St. Louis Children's Hospital  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_13_2_1","DOI":"10.1046\/j.1523-1755.1999.00611.x"},{"doi-asserted-by":"publisher","key":"e_1_2_13_3_1","DOI":"10.1034\/j.1399-3046.2002.1p067.x"},{"doi-asserted-by":"publisher","key":"e_1_2_13_4_1","DOI":"10.1016\/S0022-3476(05)83423-7"},{"doi-asserted-by":"publisher","key":"e_1_2_13_5_1","DOI":"10.6061\/clinics\/2014(Sup01)02"},{"doi-asserted-by":"publisher","key":"e_1_2_13_6_1","DOI":"10.1097\/TP.0000000000002727"},{"doi-asserted-by":"publisher","key":"e_1_2_13_7_1","DOI":"10.1016\/S0041-1345(98)00494-1"},{"doi-asserted-by":"publisher","key":"e_1_2_13_8_1","DOI":"10.1007\/s00467-008-0787-0"},{"doi-asserted-by":"publisher","key":"e_1_2_13_9_1","DOI":"10.1007\/s00467-009-1387-3"},{"key":"e_1_2_13_10_1","first-page":"S59","article-title":"Corticosteroids and Growth","volume":"43","author":"Fine R. 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