Comparison Of Estimating Glomerular Filtration Equations In Living Kidney Donor Candidates Prior To Donation
1Nephrology, Hypertension and Transplantation, Houston Methodist Hospital, Houston, TX, 2Houston Methodist Research Institute, Houston, TX
Meeting: 2019 American Transplant Congress
Abstract number: B292
Keywords: Donation, Glomerular filtration rate (GFR), Kidney, Screening
Session Information
Session Name: Poster Session B: Kidney Living Donor: Selection
Session Type: Poster Session
Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Serum creatinine-based estimated glomerular filtration rate (eGFR) models have been shown to over- or underestimate measured iohexol GFR (mGFR), but it is unclear if combining these estimating equations could more accurately predict mGFR in living kidney donor candidates.
*Methods: Using 533 living kidney donors from August 2008 – November 2010, we compared the Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR models with mGFR by iohexol clearance. As the MDRD model was derived from a population with low mean GFR (40 mL/min), we incorporated a previously published refitted model (MDRD*), developed from a cohort with more similar mean GFR (123 mL/min) as our healthy kidney donors. We assessed the performance of these estimating models against mGFR in: bias, precision, and relative accuracy.
*Results: The mean measured GFR in our population was 110.3 ± 16.51 ml/min/1.73 m2 with a mean serum creatinine at donation of 0.83 ± 0.16 mg/dL. Analysis of the individual estimating models showed that eGFR(CG) underestimated mGFR by 4.93 ± 22.33 mL/min/1.73 m2 and eGFR(MDRD*) overestimated mGFR by 6.92 ± 15.87 mL/min/1.73 m2. Averaging eGFR (MDRD*) and eGFR (CG) provided the least bias model with the best accuracy. It overestimated mGFR by 1 ± 18.51 mL/min/1.73 m2 and was within 10% of mGFR 49.9% of the time. Moreover, this combined equation was within 30% of mGFR 91% of the time.
*Conclusions: Averaging the refitted MDRD* and CG equations provided the least biased and most accurate model for estimating GFR in kidney donors prior to transplantation.
To cite this abstract in AMA style:
Hebert S, Xu J, Ibrahim H. Comparison Of Estimating Glomerular Filtration Equations In Living Kidney Donor Candidates Prior To Donation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-estimating-glomerular-filtration-equations-in-living-kidney-donor-candidates-prior-to-donation/. Accessed December 11, 2024.« Back to 2019 American Transplant Congress