Impact of estimation versus direct measurement of predonation glomerular filtration rate on the eligibility of potential living kidney donors

Kidney International
François GaillardChristophe Mariat

Abstract

While direct measurements of glomerular filtration rate (GFR) provide the most accurate evaluation of pre-donation kidney function, guidelines do not systematically require the use of a reference method. We evaluated whether and to what extent relying upon creatinine-based estimating equations (eGFR) rather than direct measurement of GFR (mGFR) alters the selection of potential living donors. We compared the impact of 4 equations (the MDRD study equation, the CKD-EPI equation, the revised Lund-Malmö equation, and the full age spectrum [FAS] equation) on the evaluation of 2733 potential donors with GFR measured by reference methods. We also considered the impact of using either absolute or age-adapted GFR thresholds. The CKD-EPI and FAS equations had the best performances (P10 of 50.6% and 47.8%; P30 of 94.4% and 93.1%, respectively) and led to the lowest proportion of improperly evaluated candidates. Misclassification was more frequent when GFR adequacy was defined as an absolute threshold of 90 ml/min/1.73m2 as compared to an age-adapted definition (26% and 5%, respectively). Interpretation of eGFR according to an absolute threshold of 90 ml/min/1.73m2 identified 1804 candidates eligible to donate, compared to 2648 when mGFR w...Continue Reading

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Citations

Apr 2, 2020·Transplantation·Guillaume ClaisseChristophe Mariat
Jan 12, 2021·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·J BranchereauM-O Timsit
Dec 20, 2020·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Pablo LujánWalter Douthat
Mar 25, 2019·Kidney International·Richard J Glassock
Apr 26, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Mathilde GrapinFrank Bienaimé
Mar 29, 2021·Transplant International : Official Journal of the European Society for Organ Transplantation·François GaillardChristophe Mariat
Jun 26, 2021·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Pablo LujánWalter Douthat
Aug 5, 2021·Clinical Kidney Journal·Natalie EbertElke Schaeffner
Sep 15, 2021·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Christophe MariatUmberto Maggiore
Dec 14, 2021·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·François Gaillard, Christophe Mariat
Jan 23, 2022·Journal of Nephrology·Shunsuke GotoShinichi Nishi

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