Accuracy and variability of equations to estimate glomerular filtration rates in renal transplant patients receiving sirolimus and/or calcineurin inhibitor immunosuppression

Transplant International : Official Journal of the European Society for Organ Transplantation
James T BurkeJohn F Neylan

Abstract

Measured glomerular filtration rates (mGFRs) were obtained by (99)mTc-DPTA, (125)I-iothalamate, iohexol, (51)Cr-EDTA, non-radiolabeled iothalamate, or inulin clearance from centers agreeing to perform mGFR in six completed and one ongoing Wyeth Research multicenter trials evaluating sirolimus (SRL) in regimens with or without a calcineurin inhibitor (CNI). Estimated GFRs (eGFRs) were calculated by the Cockcroft-Gault (eGFR(CG)), Nankivell (eGFR(NK)), and simplified Modification of Diet in Renal Disease (eGFR(MDRD)) equations. Bias, precision, and accuracy for each of these equations were estimated by tertiles and by regimen. For the Rapamune Maintenance Regimen (RMR) trial, eGFR outcomes were also compared between treatments {[SRL-cyclosporine (CsA) versus SRL]} using the three eGFR formulas. In the lowest mGFR tertile (6-40 ml/min), eGFR(MDRD) gave the best accuracy with the least bias whereas eGFR(NK) and eGFR(CG) performed better in the highest mGFR tertile (58-139 ml/min). At 24 months in the RMR study, mean differences in eGFR between treatments were 13.6, 14.2, and 13.5 ml/min/1.73 m(2) for eGFR(CG), eGFR(NK), and eGFR(MDRD), respectively, favoring CsA withdrawal (P-values for all <0.001). The accuracy of the three eGFR e...Continue Reading

References

Jan 1, 1976·Nephron·D W Cockcroft, M H Gault
Jun 26, 2002·Kidney International·Sundaram HariharanChristopher P Johnson
Dec 20, 2002·Transplantation·Thomas A GonwaUNKNOWN Sirolimus Renal Function Study Group
Mar 3, 2005·Clinical Transplantation·Dharmapaul L RajuAhmed Shoker
Aug 13, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Renate J BosmaGerjan Navis
Jan 24, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·O OyenI B Brekke
Jan 26, 2006·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·E D PoggioP M Hall

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Citations

Sep 4, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Nicolas MaillardChristophe Mariat
Dec 6, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Flávia Silva Reis MedeirosElias David-Neto
Apr 2, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Rossini BotevOtto Schück
Jul 8, 2011·Clinical Journal of the American Society of Nephrology : CJASN·Michelle A Josephson

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