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Comparison of Estimated and Measured Glomerular FiltrationRate in Longitudinal Follow-up after Living Kidney Donation

(2017) Vries, J. de (Jannieta)

Comparison of Estimated and Measured Glomerular Filtration Rate in Longitudinal Follow-up after Living Kidney Donation
Introduction: Living donor kidney transplantation is the optimal treatment for patients with end stage renal disease (ESRD). Because of the rising demand for donor organs, selection criteria for living kidney donation have been liberalized, possibly increasing donor risks. Detection of renal function decline is important for living kidney donors safety. It is not known whether the estimated glomerular filtration rate (eGFR) equations are able to detect renal function changes in living kidney donors.
Aim: To compare eGFR and mGFR slopes in longitudinal follow-up after living kidney donation and to examine which serum creatinine-based formula can be used best to assess long term GFR decline.
Materials and methods: In 284 donors we compared eGFR (CKD-EPI, MDRD, Cockcroft-Gault (CG)) and mGFR (continuous 125I-iothalamate) slopes for donors with declining (n = 72), stable (n = 136), and rising (n = 76) mGFR.
Results: Mean age at donation was 50.2±10.3 years, 55.0% were female and mean mGFR was 116.0±22.5 mL/min. After donation mGFR was 73.7±13.9, 79.2±16.1 and 77.4±16.1 at 3 months, 5 years and 10 years, respectively. All eGFR equations underestimated the slopes of donors with declining mGFR. CG had the lowest bias.
Conclusion: Renal function decline in living kidney donors with severe mGFR loss is underestimated by eGFR equations. This emphasizes the importance of mGFR in long term follow-up.






 
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