Imprecision of Creatinine-Based GFR Estimates in Uninephric Kidney Donors
| Autor: | Jane C. Tan, Bryan D. Myers, Stephan Busque, Bing Ho, Geraldine C. Derby, Bradley Efron, Kristina Blouch |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Time Factors Epidemiology Estimating equations Kidney Critical Care and Intensive Care Medicine Nephrectomy Severity of Illness Index chemistry.chemical_compound Living Donors Age Factors Middle Aged medicine.anatomical_structure Nephrology Creatinine Female Kidney Diseases medicine.symptom Glomerular Filtration Rate Adult medicine.medical_specialty Adolescent Urinary system Urology Renal function Iothalamate Clearance Models Biological Young Adult Predictive Value of Tests Internal medicine medicine Humans Aged Transplantation urogenital system business.industry Reproducibility of Results Original Articles medicine.disease Kidney Transplantation Iothalamic Acid Endocrinology chemistry Chronic Disease Linear Models Albuminuria business Biomarkers Kidney disease |
| Zdroj: | Clinical Journal of the American Society of Nephrology. 5:497-502 |
| ISSN: | 1555-9041 |
| Popis: | 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. Design, setting, participants, & measurements: We compared urinary creatinine clearance, four-variable Modification of Diet in Renal Disease estimating equation (eGFR), and the recently reported CKD-EPI GFR estimating equation with true GFR measured by the urinary iothalamate clearance (iGFR) in 64 subjects after kidney donation. Results: Creatinine clearance overestimated iGFR. Both creatinine-based estimating equations were poorly correlated with and underestimated iGFR. More than half of kidney donors had eGFR 2 after donation, a level that categorized them as having stage 3 chronic kidney disease by our current laboratory reporting, whereas only 25% had iGFR 2 . This misclassification disproportionately affected older donors age ≥55 years, of whom 80% had eGFR 2 . Neither significant albuminuria nor hypertension was observed. Conclusions: The current practice of reporting eGFR after donation commonly leads to a misclassification of chronic kidney disease, particularly in older donors. To ensure long-term well-being of living kidney donors, more precise estimates of GFR are required, particularly among older potential donors. |
| Databáze: | OpenAIRE |
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