Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors

Autor:	Ana González-Rinne, Laura Díaz Martín, Esteban Porrini, Patricia García, Federico González-Rinne, Sergio Luis-Lima, Alejandra Alvarez, Lourdes Pérez-Tamajón, Natalia Negrín-Mena, Ana Aldea-Perona, Nicanor Vega, María Del Carmen Abad, Alejandra González-Delgado, Domingo Marrero-Miranda, Ana Ramirez, Armando Torres, Adelaida Morales, Beatriz Escamilla, Elisa Cabello, Alejandro Jiménez-Sosa
Rok vydání:	2019
Předmět:	medicine.medical_specialty 030232 urology & nephrology Urology Renal function 030204 cardiovascular system & hematology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine living kidney donation measured GFR Transplantation Creatinine Plasma clearance Kidney Errata biology business.industry Confidence interval medicine.anatomical_structure chemistry Cystatin C Nephrology estimated GFR biology.protein Iohexol business Clearance medicine.drug
Zdroj:	Clin Kidney J Clinical Kidney Journal
ISSN:	2048-8513 2048-8505
DOI:	10.1093/ckj/sfz012
Popis:	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 ResultsNinety-three subjects (90.3%) had mGFR values above (donors) and 10 [9.7% (95% confidence interval 5.4–17)] below (non-donors) the cut-off. In non-donors, most of the equations gave eGFR values above the cut-off, so donation would have been allowed based on eGFR. All non-donors were female with reduced weight, height and body surface. In donors, up to 32 cases showed eGFR below the cut-off, while mGFR was actually higher. Therefore an important number of donors would not have donated based on eGFR alone.ConclusionThe misclassification of donors around the cut-off for donation is very common with eGFR, making eGFR unreliable for the evaluation of living kidney donors. Whenever possible, mGFR should be implemented in this setting.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::946f2c34cf33b6740868ddf89b5c548b https://doi.org/10.1093/ckj/sfz012 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.