Donor renal function (original) (raw)
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The Performance of Three Serum Creatinine-Based Formulas in Estimating GFR in Former Kidney Donors
American Journal of Transplantation, 2006
Studies addressing long-term consequences of living with one kidney have used serum creatinine-based formulas that have not been validated in former kidney donors. Therefore, we evaluated the performance of Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD) and Mayo Clinic formulas in predicting iohexol glomerular filtration rate (iGFR) after donation in 112 randomly selected former kidney donors. Mean time from donation was 12.2 ± 8.5 years. Serum creatinine was 1.1 ± 0.2 mg/dL and iohexol GFR was 72 ± 12 mL/min/1.73 m 2. The majority, 83.9%, of donors had a GFR >60 mL/min. CG formula overestimated GFR by 3.35 ± 13.6 mL/min and was within 10% of iohexol GFR in only 43.7% of cases. MDRD formula underestimated iohexol GFR by 6.45 ± 9.5 mL/min and was within 10% of actual GFR in half of the cases. In contrast, the Mayo Clinic equation was the most biased at 14.71 ± 12.3 mL/min and was within 10% of measured GFR in only a fifth of the cases. Only MDRD and CG formulas provide estimates of GFR in former kidney donors that are within a clinically acceptable range of actual GFR. In conclusion, the majority of former kidney donors have excellent kidney function and the MDRD formula should be the recommended GFR estimating model in this population.
Nuclear Medicine Communications, 2008
Objective This study was planned to determine the efficacies of single plasma sample methods (SPSMs) in indicating glomerular filtration rate (GFR) by taking two plasma sample method (TPSM) as reference in the determination of the GFR in cases with clinically stable renal transplantation. Methods Ninety-six renal transplantation cases (33 female, 63 male; age interval 18-67, mean age 37.46 ± 11.81 years) progressing stably clinically and as laboratory, with minimum 6 months after transplantation were included in the study. The GFR values of the cases were measured with SPSM and TPSM. Results It is observed that all SPSMs have a strong correlation with TPSM. Highest correlation was observed between Groth&Aasted SPSM and TPSM GFR (intraclass correlation coefficient: 0.965). In the analyses performed by using the Bland-Altman analysis, GFR values calculated by all SPSMs were concordant to the TPSM which is the gold standard method in 95 % confidence interval (average ± 1.96 standard deviation) and were within the clinically acceptable limits. The narrowest concordance interval was obtained between Groth&Aasted Tc-99 m DTPA SPSM and Tc-99 m DTPA TPSM..Besides, we have obtained the minimum bias and precision value by the Groth&Aasted method. Conclusions As a result; we can see that all the SPSMs give reliable results in measuring GFR in cases with renal transplantation; besides, we suggest Groth&Aasted method as the first option.
Imprecision of Creatinine-Based GFR Estimates in Uninephric Kidney Donors
Clinical Journal of the American Society of Nephrology, 2010
Background and objectives: To ensure long-term safety of living kidney donors, it is now recommended that they be followed for at least 2 years after donation and that serum creatinine levels be monitored. Such levels are often subjected by clinical laboratories to estimating equations and are reported as estimated GFR (eGFR). The accuracy of such equations in uninephric living donors has yet to be validated. This is especially important in older living donors, who often have senescence-related depression of GFR.
Creatinine Clearance in Selection of Living Kidney Donor: is It Safe?
Research Square (Research Square), 2022
Background: Assessment of donor renal function is made by the measurement of Glomerular Filtration Rate (GFR). Exogenous markers are preferred over creatinine clearance and are widely used for measuring GFR. However, they are di cult to obtain, costly and laborious. This is a study to look into the safety and accuracy of creatinine clearance for renal assessment among the living kidney donors in the Malaysian population. Methods: This is a retrospective, single-centre study comprising 105 living kidney donor candidates from the year 2007 to 2020. By comparing against 51-Chromium ethylenediamine-tetraacetic acid (51 Cr-EDTA), we analysed creatinine clearance for correlation, bias, precision and accuracy. Results: The study group had a mean age of 45.68 ± 10.97 years with a mean serum creatinine of 64.43 ± 17.68 mmol/L and a urine volume of 2.06 ± 0.83 L. Mean measured GFR from 51 Cr-EDTA was 124.37 ± 26.83 ml/min/1.73m 2 whereas mean creatinine clearance was 132.35 ± 38.18 ml/min/1.73m 2. Creatinine clearance overestimated 51 Cr-EDTA signi cantly with a correlation coe cient of 0.48 (p <
Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors
Clinical Kidney Journal, 2019
BackgroundReliable determination of glomerular filtration rate (GFR) is crucial in the evaluation of living kidney donors. Although some guidelines recommend the use of measured GFR (mGFR), many centres still rely on estimated GFR (eGFR) obtained through equations or 24-h creatinine clearance. However, eGFR is neither accurate nor precise in reflecting real renal function. We analysed the impact of eGFR errors on evaluation and decision making regarding potential donors.MethodsWe evaluated 103 consecutive living donors who underwent mGFR via iohexol plasma clearance and eGFR by 51 creatinine- and/or cystatin C–based equations. The cut-off for living donation in our centre is GFR > 80 mL/min for donors >35 years of age or 90 mL/min for those <35 years of age. We analysed the misclassification of donors based on the cut-off for donation-based eGFR.ResultsNinety-three subjects (90.3%) had mGFR values above (donors) and 10 [9.7% (95% confidence interval 5.4–17)] below (non-dono...
Appraisal of GFR-Estimating Equations Following Kidney Donation
American Journal of Kidney Diseases, 2009
Background-It is not clear which serum creatinine-based glomerular filtration rate (GFR) estimating model performs best in kidney donors. Study Design-Study of diagnostic accuracy. Setting and Participants-From a population of 3,698 kidney donors, 255 donors underwent iohexol GFR measurement (mGFR). Index Test (Intervention)-mGFR by the plasma disappearance of iohexol. Reference Test or Outcome-eGFR was estimated using the Cockcroft-Gault equation, (eGFR CG), the Mayo Clinic equation (eGFR MC), and the MDRD Study equation (eGFR MDRD). Results-Mean mGFR was 71.8±11.8 mL/min/1.73m 2 and 85.5% had mGFR > 60 mL/min/ 1.73m 2. eGFR CG underestimated mGFR by 3.96±13.3 mL/min/1.73m2 and was within 30% of mGFR in 89.4% of the time. eGFR MC overestimated mGFR by 8.44±11.9 mL/min/1.73m 2 and was within 30% of mGFR in 83.1% of cases. eGFR MDRD underestimated mGFR by only 0.43±11.7 mL/ min/1.73m 2 and the proportion within 30% of mGFR was the highest amongst the tested model; 94.1% of the time. The eGFR MC , however, was most accurate in classifying donors according to having eGFR < 60 mL/min/1.73m 2. Limitations-Lack of ethnic diversity and response bias.
Glomerular filtration rate in prospective living kidney donors
International Urology and Nephrology, 2013
Purpose Measurements of glomerular filtration rate (GFR) are frequently interpreted assuming a linear variation with age. Nonlinear relationships may give a better representation of the changes associated with normal ageing. Methods This was a retrospective study of 904 subjects (468 women, 436 men; age range 18-84 years) undergoing assessment as prospective living kidney donors. GFR was evaluated from 51 Cr-EDTA plasma clearance using blood samples taken at 2, 3 and 4 h. The slope-intercept GFR was corrected for body surface area (BSA) using the Haycock formula and for the fast exponential using the Brochner-Mortensen equation. The relationship between age, gender and GFR was examined using best-fit curve analysis. Nonlinear relationships with age were explored using fractional polynomials.
Debate: CON Position. Formal Assessment of Donor Kidney Function Should Be Mandatory
American Journal of Nephrology, 2011
To prevent some suitable donors being turned down due to borderline CrCl, there is a push to standardize the technique of measuring renal function in potential living kidney donors. One technique is a nuclear scan using iothalamate as an exogenous marker. We present three lines of argument why nuclear scan GFR may not be used routinely for this purpose. Iothalamate GFR: Technique and Variability For urinary clearance of 125 I-iothalamate, a radioactive exogenous filtration marker is used in the measurement of glomerular filtration rate (GFR). Since an adequate (5 ml/min) urine flow is important and necessary to calculate clearance, hydration with a water load of 20 ml/kg is a prerequisite. A bolus subcutaneous injection of iothalamate is then given. To block the uptake of the radioactive tracer by the thyroid gland, 'cold' iodine is administered at the time of the 125 I-iothalamate administration. This requirement precludes its use in subjects with allergy to iodine, shellfish or iodinated contrast material. After equilibration for an hour, four consecutive urine collections are obtained by voluntary voiding. Water intake to replace the volume voided is necessary, which in some patients could lead to nausea or in rare
LOW ABSOLUTE GLOMERULAR FILTRATION RATE IN THE LIVING KIDNEY DONOR
Transplantation, 2000
Background. There is no defined lower acceptable level of glomerular filtration rate (GFR) in potential living kidney donors. Considerations focus on the risk for the donor. We wanted to evaluate the outcome in the recipient in relation to the GFR of the living donor.