[Background] Recently the number of renal transplantation has increased in Japan. To know how to assess renal function accurately for Japanese renal transplant recipients is required.
[Methods] 73 patients were included in this study at Nagoya Daini Red Cross Hospital. All of them were underwent renal transplantation before at least 6 months at our hospital and had stable renal function for more than 3 months. Glomerular filtration rate (GFR) was measured by inulin clearance (mGFR) and compared with estimated cystatin C-based GFR (eGFRcys), creatinine-based GFR (eGFRcre) and their averaged value (eGFRave).
eGFRcre was as follows by theJapanese Society of Nephrology.
194×(age)-0.287 ×(serum creatinine)-1.094
, including a correction factor of 0.739 for women
eGFRcys was as follows by theJapanese Society of Nephrology.
For men :(104×Cys-C-1.019×0.996age)-8
For women: (104×0.929×Cys-C-1.019×0.996age)-8
[Results] Measured GFR was 43.3 ± 14.1 mL/min/1.73 m2 and, estimated GFR was 39.6 ± 11.7 in eGFRcre, 56.0 ± 17.1 in eGFRcys, and 47.8 ± 13.7 mL/min/1.73 m2 in eGFRave, respectively. Serum cystatin C was 1.39±0.37 mg/L and serum creatinine was 1.58±0.51 mg/dL. In the relationships between measured GFR values and estimated GFR values, correlation coefficient for eGFRcre, eGFRcys, and eGFRave was 0.77x, 0.83 x, and 0.84 x (p <0.001, all). Intraclass correlation coefficient was 0.75, 0.82, and 0.84 (p <0.001, all). The mean difference between measured and estimated GFR values was – 3.74 mL/min/1.73 m2 with a root-mean square error (RMSE) of 9.06 in eGFRcre, + 12.64 with a RMSE of 9.48 in eGFRcys, and + 4.45 with a RMSE of 7.86 in eGFRave. BlandAltman plots showed that eGFRcys overestimated GFR values against mGFR values in most cases and eGFRave also overestimated in 53 of 73 cases, whereas eGFRcre underestimated in 53 of 73 cases. Results are shown in Figure 1.
[Conclusion] In this study, eGFRave may be the best marker to estimate kidney function in Japanese renal transplant recipients. In most cases eGFRcys overestimated GFR values and eGFRcre underestimated in patients with mild reduced or normal kidney function.
To cite this abstract in AMA style:Tsujita M. How To Estimate Kidney Function in Kidney Transplant Recipients with Mild to Moderate Kidney Impairment. – Comparison of eGFR Values between Creatinine-Based GFR Equation and Cystatin C-Based Equation for Japanese [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/how-to-estimate-kidney-function-in-kidney-transplant-recipients-with-mild-to-moderate-kidney-impairment-comparison-of-egfr-values-between-creatinine-based-gfr-equation-and-cystatin-c-based-eq/. Accessed September 24, 2017.
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