United States versus Australia: Is "Percentage Decline in Estimated Glomerular Filtration Rate" Truly a Surrogate Outcome in Graft Survival?
1Internal Medicine Division of Nephrology and Hypertension, East Carolina University, Greenville, NC
2Internal Medicine, Vidant Medical Center, Greenville, NC.
Meeting: 2016 American Transplant Congress
Abstract number: A270
Keywords: Glomerular filtration rate (GFR), Graft survival, Kidney transplantation, Outcome
Session Information
Session Name: Poster Session A: Poster Session III: Kidney Complications-Other
Session Type: Poster Session
Date: Saturday, June 11, 2016
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Halls C&D
Purpose: A previous study conducted in Australia and New Zealand examined the utility of estimated glomerular filtration rate (eGFR) decline as a surrogate marker for renal transplant outcomes in transplants performed 1995-2009. It was reported that a 30% or greater decline in eGFR between years 1 and 3 post- transplant was associated with death censored graft loss and patient death. Our aim was to test the validity of this model in a more diverse rural transplant population in the United States.
Methods: A retrospective chart review was performed on 82 renal transplant patients between 2006 and 2012. Data was obtained for eGFR at 1 and 3 years post-transplant, graft failure (return to dialysis or re-transplantation) and death. Patients were divided in cohorts by eGFR decline of greater than or less than 30%. Odds ratios for death censored graft loss and patient death were obtained by exact logistic regression using SAS 9.4.
Results: eGFR decline of >30% was seen in 17.1% (14) patients, 5% (4) experienced graft loss, and 3.7% (3) experienced death. Patient follow up represented 510 patient years. As compared to those with stable eGFR, a 30% decline in eGFR was associated with death censored graft loss (odds ratio [OR] 5.3, 95% CI 0.36-80.24) and patient death ([OR] 2.5, 95% CI 0.04-51.45). This represented 81% of the center's renal transplant patients between 2006 and 2012.
Conclusion: Our study results closely follow those of the previous study with the exception of death censored graph loss. Although our data spans a five year period, the sample size is considerably less and may explain the lack of significance. Realizing our limitations we consider the model validated. We feel the “percentage decline in eGFR” model is applicable to our US rural population and may be useful as a surrogate outcome in transplant centers globally.
CITATION INFORMATION: Parker K, Rice A, Kirby A, Pinion M, Parker K. United States versus Australia: Is "Percentage Decline in Estimated Glomerular Filtration Rate" Truly a Surrogate Outcome in Graft Survival? Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Parker K, Rice A, Kirby A, Pinion M, Parker K. United States versus Australia: Is "Percentage Decline in Estimated Glomerular Filtration Rate" Truly a Surrogate Outcome in Graft Survival? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/united-states-versus-australia-is-percentage-decline-in-estimated-glomerular-filtration-rate-truly-a-surrogate-outcome-in-graft-survival/. Accessed May 11, 2025.« Back to 2016 American Transplant Congress