Wijninga, A. (Anthony) (2017) Comparison of change in estimated and measured Glomerular Filtration Rate in living kidney donors Anthony Wijninga. thesis, Medicine.
Full text available on request.Abstract
Introduction: Living kidney transplantation is the best treatment for patients with End Stage Renal Disease (ESRD). Due to the rising demand of donor kidneys, many transplant centers have liberalized their selection criteria for kidney donating, possibly increasing donor risks of ESRD. Early detection of declining kidney function is critical for these donors. Whether estimated Glomerular Filtration Rate (eGFR) accurately depicts changes in GFR in donors is unknown. Aim: To compare the mGFR slope with eGFR slopes in a longitudinal cohort study in living kidney donors and evaluate which equation can be used to assess long-term kidney function in this population. Materials and methods: In 349 donors, we compared eGFR (MDRD-, CKD-Epi, Cockcroft-Gault (CG/BSA) and CKD-EPI-Cystatin C) and mGFR (125I-iothalamate) slopes assessing changes in renal function from 3 months until 5 years after donation. We calculated the bias of eGFR slopes to test accuracy and IQR and RMSE to test precision. Results: Mean age at donation was 51±10 years, 46% were male and mean mGFR was 116±23 mL/min. mGFR at short-term follow-up was 73±14, 79±16 at long-term follow-up and 78±16 at extended follow-up. Of all eGFR equations, CG/BSA has the lowest bias (-0.08±2.06), followed by CKD-EPI (0.13±2.16), MDRD (0.19±2.10) and CKD-EPI-CysC (-0.45±2.70). All eGFR equations underestimated the mGFR slope in donors with a declining mGFR. Conclusion: eGFR equations are unable to reliably determine kidney function decline in living kidney donors with declining mGFR. These results highlight the need of mGFR in the follow-up of living kidney donors.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider : and Borst, dr. M.H. de and Tweede begeleider : and Londen, M. van and Universitair Medisch Centrum Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2442 |
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