Estimated Glomerular Filtration Rate in Renal Transplantation
| Autor: | Eduardo Salido, Sergio Luis-Lima, Alejandro Jiménez-Sosa, Hugo Jiménez-Hernández, Federico González-Rinne, José Manuel González-Posada, Ana Aldea-Perona, Aurelio Rodríguez, Lourdes Pérez-Tamajón, Esteban Porrini, Armando Torres, Ana González-Rinne, Flavio Gaspari, Juan A. Gómez-Gerique, Fabiola Carrara, Domingo Marrero-Miranda, Natalia Negrín-Mena |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Coverage probability Urology Renal function Kidney Function Tests urologic and male genital diseases chemistry.chemical_compound Internal medicine medicine Humans Renal Insufficiency Chronic Kidney transplantation Transplantation Creatinine business.industry Graft Survival Middle Aged Prognosis medicine.disease Kidney Transplantation Transplant Recipients Surgery Cross-Sectional Studies Concordance correlation coefficient chemistry Female business Follow-Up Studies Glomerular Filtration Rate Kidney disease |
| Zdroj: | Transplantation. 99:2625-2633 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/tp.0000000000000786 |
| Popis: | Background Formulas do not estimate renal function with acceptable precision and accuracy. Methods We compared 51 creatinine-based and/or cystatin c-based formulas with a gold standard (iohexol plasma clearance) in 193 renal transplant recipients using concordance correlation coefficient, total deviation index, coverage probability and the error in chronic kidney disease (CKD) stage classification. Results No formula showed a concordance correlation coefficient greater than 0.90 (average for creatinine-based formulas: ∼0.70 and for cystatin c-based formulas: ∼0.85). A wide total deviation index was observed: approximately 70% (creatinine-based) and approximately 50% (cystatin c-based), indicating that 90% of the estimations showed bounds of error of ±70% or ±50%, respectively, compared with the gold standard. No formula included 90% of the estimations within a coverage probability of ±10%. Half the CKD stages classified by creatinine-based formulas were incorrect, mainly due to overestimation of renal function. One of 3 CKD stages diagnosed by cystatin c-based formulas was incorrect, with both overestimation and underestimation. Overall, the formulas showed very low precision and accuracy and a high degree of error in reflecting real renal function. Conclusions In conclusion, formulas do not properly reflect renal function in kidney transplantation, which makes their use in clinical practice unreliable. Moreover, their use in clinical trials should be avoided. |
| Databáze: | OpenAIRE |
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