Assessment Of Glomerular Filtration Rate Among Lung Transplant Candidates
1Loyola University Medical Center, Maywood, IL, 2Medicine, Loyola University Medical Center, Maywood, IL
Meeting: 2019 American Transplant Congress
Abstract number: C334
Keywords: Glomerular filtration rate (GFR), Lung transplantation
Session Information
Session Name: Poster Session C: Lung: All Topics
Session Type: Poster Session
Date: Monday, June 3, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Assessment of kidney function in lung transplant candidates is difficult due to cachexia prior to transplant. Measured glomerular filtration rate (GFR) studies are useful in assessing kidney function but they are resource intensive and may not be easily available. The purpose of this study is to assess the accuracy of the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft-Gault equations in lung transplant candidates using serum creatinine.
*Methods: A retrospective chart review was done for patients who underwent a lung transplant evaluation. Candidates over the age of 18 that underwent a measured GFR (mGFR) assessment by plasma clearance of 99mTc-DTPA and were not on dialysis or had a functioning kidney transplant were included in the study cohort. Serum creatinine within 2 weeks of the mGFR was used in the GFR estimating equations and they were standardized to a body surface area of 1.73m2. The median difference between the mGFR and estimated GFR (eGFR) along with the percentage of participants with an eGFR within 30% of the mGFR (P30) were used to assess accuracy.
*Results: Among 537 patients evaluated for lung transplant, 30 individuals met the criteria listed above. The cohort was 57% male, 80% white, and the mean age was 61.4 (+/- 12.3) years old. The native lung disease was 30% chronic obstructive pulmonary disease (COPD), 17% idiopathic pulmonary fibrosis (IPF), 10% cystic fibrosis (CF), and 47% other. Among the entire cohort, CKD-EPI was the most accurate with a P30 of 79% and a median difference of 0.02 (interquartile range -7.2 – 5.2) mL/min/1.73m2 (see Table). Accuracy was worst in the CF group.
| MDRD | CKD-EPI | Cockcroft-Gault | ||||
| P30 | Median Difference | P30 | Median Difference | P30 | Median Difference | |
| All
(n-30)
|
71% | -1.4 (-10.2 – 5.0) | 79% | 0.02 (-7.2 – 5.2) | 76% | -0.9 (-5.1 – 3.1) |
| COPD
(n=9)
|
89% | -1.3 (-8.2 – 4.3) | 100% | 0.3 (-6.8 – 5.2) | 100% | -1.5 (-5.2 – 5.7) |
| IPF
(n=5)
|
100% | -1.5 (-7.8 – 0.24) | 100% | 0.7 (-8.9 – 4.0) | 80% | -2.6 (-4.7 – 4.9) |
| CF
(n=3)
|
33% | -19.2 (-109 – -1.7) | 67% | -5.5 (-22.2 – -3.2) | 33% | -21.7 (-100.3- -4.1) |
| Other
(n=13)
|
62% | -2.2 (-11.7 – 7.2) | 69% | -0.7 (-7.9 – 7.4) | 69% | -0.1 (-4.7 – 8.6) |
*Conclusions: Estimating equations based on serum creatinine appear to be accurate in estimating GFR in most lung transplant candidates. Further study is needed to validate these results in a larger cohort, especially CF patients where mGFR may be the preferred approach for assessing kidney function.
To cite this abstract in AMA style:
Akkina S, Hou S, Arwindekar DJain, Desai A. Assessment Of Glomerular Filtration Rate Among Lung Transplant Candidates [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/assessment-of-glomerular-filtration-rate-among-lung-transplant-candidates/. Accessed November 22, 2024.« Back to 2019 American Transplant Congress