Paving the Way for Personalized Medicine in First Kidney Transplantation: Interest of a Creatininemia Latent Class Analysis in Early Post-transplantation.

Plasma creatinine is a marker of interest in renal transplantation but data on its kinetics in the first days following transplantation are scarce. The aim of this study was to identify clinically relevant subgroups of creatinine trajectories following renal transplantation and to test their association with graft outcome. Among 496 patients with a first kidney transplant included in the French ASTRE cohort at the Poitiers University hospital, 435 patients from donation after brain death were considered in a latent class modeling. Four distinct classes of creatinine trajectories were identified: "" (6% of patients), "" (47%), "good recovery" (10%) and "" (37%). Cold ischemia time was significantly lower in the "" class. Delayed graft function was more frequent and the number of hemodialysis sessions was higher in the "" class. Incidence of graft loss was significantly lower in "" patients with an adjusted risk of graft loss 2.42 and 4.06 times higher in "" and "" patients, respectively. Our study highlights substantial heterogeneity in creatinine trajectories following renal transplantation that may help to identify patients who are more likely to experience a graft loss.