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Tytuł pozycji:

Performance of Creatinine Clearance and Estimated GFR in Assessing Kidney Function in Living Donor Candidates.

Tytuł :
Performance of Creatinine Clearance and Estimated GFR in Assessing Kidney Function in Living Donor Candidates.
Autorzy :
Garg N; Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Snyder G; Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.
Li J; Qualitative Health Sciences, Cleveland Clinic, Cleveland, OH.
Mandelbrot D; Division of Nephrology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Poggio ED; Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.
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Źródło :
Transplantation [Transplantation] 2020 Mar; Vol. 104 (3), pp. 575-582.
Typ publikacji :
Comparative Study; Journal Article
Język :
English
Imprint Name(s) :
Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore, Williams & Wilkins.
MeSH Terms :
Living Donors*
Creatinine/*metabolism
Donor Selection/*methods
Glomerular Filtration Rate/*physiology
Kidney Function Tests/*methods
Adolescent ; Adult ; Aged ; Body Weight/physiology ; Contrast Media/administration & dosage ; Contrast Media/metabolism ; Creatinine/blood ; Creatinine/urine ; Female ; Humans ; Iodine Radioisotopes/administration & dosage ; Iodine Radioisotopes/metabolism ; Iothalamic Acid/administration & dosage ; Iothalamic Acid/metabolism ; Male ; Middle Aged ; Renal Elimination/physiology ; Retrospective Studies ; Sex Factors ; Young Adult
Substance Nomenclature :
0 (Contrast Media)
0 (Iodine Radioisotopes)
16CHD79MIX (Iothalamic Acid)
AYI8EX34EU (Creatinine)
GVO776611R (Iodine-125)
Entry Date(s) :
Date Created: 20190618 Date Completed: 20200930 Latest Revision: 20200930
Update Code :
20201023
DOI :
10.1097/TP.0000000000002797
PMID :
31205262
Czasopismo naukowe
Background: Glomerular filtration rate (GFR) assessment is a key aspect in the evaluation of living kidney donor candidates; however, data on performance of commonly used methods are limited.
Methods: We examined 769 living kidney donor candidates with 24-hour urine collections assessed as accurate by comparing measured creatinine excretion rate (CER) to CER estimated using a 4-variable equation previously developed and validated using robust methodology.
Results: Of all collections, 42.6% would have been deemed inaccurate, mostly under-collections, using the conventional weight- and gender-based CER estimation. Creatinine clearance (CrCl) overestimated I-iothalamate GFR (iGFR), estimated GFR (eGFR), underestimated iGFR, and their average [Avg (CrCl and eGFR)] essentially eliminated the GFR bias (median bias = +2.2, -5.4, and -1.0 mL/min/1.73 m, respectively; P < 0.001). This held true for all subgroups except blacks, where all 3 measures overestimated iGFR. Avg (CrCl and eGFR) also offered modestly improved accuracy compared with CrCl alone, as measured by the proportion of values falling within 10% (50.7% versus 45.3%; P = 0.009) and 30% of iGFR (94.5% versus 89.3%; P < 0.001).
Conclusions: When measured GFR is unavailable, the Avg (CrCl and eGFR) provides a better estimate of kidney function in kidney donor candidates than either measure alone, although in blacks the estimates are neither better nor worse.

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