Elsevier

Transplantation Proceedings

Volume 47, Issue 9, November 2015, Pages 2603-2607
Transplantation Proceedings

9th Congress of the Andalucian Transplantation Society
Kidney transplantation
Assessment of the Renal Function in Potential Donors of Living Kidney Transplants: Expanded Study

https://doi.org/10.1016/j.transproceed.2015.09.029Get rights and content

Highlights

  • We compared the direct measurement of GFR using EDTA-Cr51 and the estimations based on creatinine (eGFR).

  • We have evaluated 105 potential living kidney donors from April 2011 to December 2014 in the Virgen del Rocio University Hospital.

  • eGFR using MDRD-4 and MDRD-6 formulas reveal the best adjustment to the measure by EDTA-Cr51.

Abstract

Introduction

It is very important to determine as accurately as possible the renal function in potential living renal transplant donors, especially those with limited renal function (CrCl <90 mL/m/1.73 m2), age older than 50 years, and cardiovascular risk factors that might favor the development of long-term kidney diseases.

Objective

The objective of this study was to compare the direct measurement of glomerular filtration rate (GFR) using EDTA-Cr51 and the estimations based on creatinine (eGFR): Cr clearance (CCr) with 24-hour urine and estimated using Cockroft-Gault (adjusted by using body surface area–Mosteller formula-SC), MDRD-4, MDRD-6, and CKD-EPI to determine the usefulness of different methods from EDTA-Cr51to evaluate the kidney function.

Patients and Methods

The kidney function evaluation has been made to 105 potential kidney donors using the EDTA-Cr51 method. The GFR obtained through the EDTA-Cr51 is compared with the CCr values in 24-hour urine and eGFR based on creatinine (Cockcroft-Gault, MDRD4, MDRD6, and CKD-EPI).

Results

Using the Bland Altman graphic we have observed that the most dispersed results are obtained with the eGFR using CCr in 24-hour urine and CKD-EPI. By means of Pasing & Bablock, we realized that MDRD-4 and MDRD-6 show the highest approximation to the reference method proposed to be substituted, whereas CCr shows a high dispersion.

Conclusions

eGFR using MDRD-4 and MDRD-6 formulas reveal the best adjustment to the measure by EDTA-Cr51. This might represent the best option if a direct eGFR measure is not available.

Section snippets

Materials and Methods

We have evaluated 105 potential living kidney donors from April 2011 to December 2014 in the Virgen del Rocio University Hospital. The mGFR has been done by the clearance of Cr-51-EDTA and the eGFR by CCr in 24-hour urine and serum creatinine–based formulas before donation as part of the screening program.

Results

From the 105 potential living kidney donors studied, 69 were females (65.7%), with an average age of 47.65 ± 10.94 years. Mean body area 2.04 ± 0.54 m2, urinary volume in 24-hours for the CCr was 1804.34 ± 767.6 mL/min with 92 (87.6%) valid samples to determine and average CCr of 130.78 ± 49.07 mL/min/1.73 m2. The mGFR mean was 96.22 ± 16.44 mL/min/1.73 m2 by EDTA-Cr51. eGFR mean according to the Cr-based formulas was: Cockcroft-Gault, 106.57 ± 22.42 mL/min/1.73 m2; MDRD-4, 100.14 ± 18.51;

Discussion

In the last decades both the average age of living donors and their cardiovascular comorbidity (advanced age, prehypertension, blood hypertension, obesity level I, and hydrocarbonated intolerance) have constantly increased due to new requirements for the inclusion criteria. These potential donors present more long-term risk of progressively losing their renal function after donation. Therefore, a more precise and rigorous evaluation of their kidney function is recommended, although nowadays no

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