Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors

AbstractBackgroundReliable determination of glomerular filtration rate (GFR) is crucial in the evaluation of living kidney donors. Although some guidelines recommend the use of measured GFR (mGFR), many centres still rely on estimated GFR (eGFR) obtained through equations or 24-h creatinine clearance. However, eGFR is neither accurate nor precise in reflecting real renal function. We analysed the impact of eGFR errors on evaluation and decision making regarding potential donors.MethodsWe evaluated 103 consecutive living donors who underwent mGFR via iohexol plasma clearance and eGFR by 51 creatinine- and/or cystatin C–based equations. The cut-off for living donation in our centre is GFR > 80 mL/min for donors >35 years of age or 90 mL/min for those <35 years of age. We analysed the misclassification of donors based on the cut-off for donation-based eGFR.ResultsNinety-three subjects (90.3%) had mGFR values above (donors) and 10 [9.7% (95% confidence interval 5.4–17)] below (non-donors) the cut-off. In non-donors, most of the equations gave eGFR values above the cut-off, so donation would have been allowed based on eGFR. All non-donors were female with reduced weight, height and body surface. In donors, up to 32 cases showed eGFR below the cut-off, while mGFR was actually higher. Therefore an important number of donors would not have donated based on eGFR alone.ConclusionThe misclassification of donors around the cut-off for donation is very common with eGFR, making eGFR unreliable for the evaluation of living kidney donors. Whenever possible, mGFR should be implemented in this setting.

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SAT-329 CORRELATION BETWEEN ESTIMATED GFR AND MEASURED GFR WITH DTPA RENAL SCAN IN LIVING KIDNEY DONORS

Kidney International Reports ◽

10.1016/j.ekir.2020.02.349 ◽

2020 ◽

Vol 5 (3) ◽

pp. S138

Author(s):

S. Samavat ◽

M. Nafar ◽

S. Hoseinzadeh ◽

H. Masroor ◽

N. Dalili MD

Keyword(s):

Estimated Gfr ◽

Kidney Donors ◽

Living Kidney Donors ◽

Renal Scan ◽

Measured Gfr

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The evaluation of kidney function in living kidney donor candidates

Kidney360 ◽

10.34067/kid.0003052021 ◽

2021 ◽

pp. 10.34067/KID.0003052021

Author(s):

Neetika Garg ◽

Emilio D. Poggio ◽

Didier Mandelbrot

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Creatinine Clearance ◽

Kidney Function ◽

The United States ◽

Estimated Gfr ◽

Kidney Donors ◽

Living Kidney Donors ◽

Increased Risk ◽

Measured Gfr

Living kidney donors incur a small increased risk of end-stage kidney disease (ESKD), of which pre-donation glomerular filtration rate (GFR) is an important determinant. As a result, kidney function assessment is central to the donor candidate evaluation and selection process. This article reviews the different methods of GFR assessment including estimated GFR, creatinine clearance and measured GFR, and the current guidelines on GFR thresholds for donor acceptance. Estimated GFR obtained using the 2009 Chronic Kidney Disease Epidemiology Collaboration equation, while the best of estimating estimations, tends to underestimate and has limited accuracy, especially near normal GFR values. In the United States, the Organ Procurement and Transplantation Network policy on living donation mandates either measured GFR or creatinine clearance as part of evaluation. Measured GFR is considered the gold standard, although there is some variation in performance characteristics depending on the marker and technique used. Major limitations of creatinine clearance are dependency on accuracy of timed collection, and overestimation as a result of distal tubular creatinine secretion. GFR declines with healthy aging, and most international guidelines recommend use of age-adapted selection criteria. The 2017 Kidney Disease: Improving Global Outcomes Guideline for the Evaluation and Care of Living Kidney Donors diverges from other guidelines and recommends using absolute cut-off of <60 ml/min/1.73m2 for exclusion and of ≥90 ml/min/1.73m2 for acceptance, and determination of candidacy with intermediate GFR based on long-term ESKD risk. However, several concerns for this strategy exist, including inappropriate acceptance of younger candidates due to underestimation of risk, and exclusion of older candidates whose kidney function is in fact appropriate for age. Role of cystatin C and other newer biomarkers, as well as data on impact of pre-donation GFR on not just ESKD risk but also advanced chronic kidney disease risk and cardiovascular outcomes are needed.

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Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors

Clinical Kidney Journal ◽

10.1093/ckj/sfz052 ◽

2019 ◽

Vol 13 (5) ◽

pp. 910-910

Author(s):

Ana González-Rinne ◽

Sergio Luis-Lima ◽

Beatriz Escamilla ◽

Natalia Negrín-Mena ◽

Ana Ramírez ◽

...

Keyword(s):

Cystatin C ◽

Kidney Donors ◽

Living Kidney Donors ◽

Selection Of

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Comparison of estimated GFR and measured GFR in prospective living kidney donors

International Urology and Nephrology ◽

10.1007/s11255-014-0859-y ◽

2014 ◽

Vol 47 (1) ◽

pp. 201-208 ◽

Cited By ~ 8

Author(s):

Thakshyanee Bhuvanakrishna ◽

Glen M. Blake ◽

Rachel Hilton ◽

Lisa Burnapp ◽

Christopher Sibley-Allen ◽

...

Keyword(s):

Estimated Gfr ◽

Kidney Donors ◽

Living Kidney Donors ◽

Measured Gfr

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Determination of integral indicators characterizing the possibility of accommodating the evacuated population in the territory of the Republic of Kazakhstan

The Journal of Defense Modeling and Simulation Applications Methodology Technology ◽

10.1177/1548512920970288 ◽

2020 ◽

pp. 154851292097028

Author(s):

Yernar Zh Akimbayev ◽

Zhumabek Kh Akhmetov ◽

Murat S Kuanyshbaev ◽

Arman T Abdykalykov ◽

Rashid V Ibrayev

Keyword(s):

Statistical Data ◽

Armed Conflicts ◽

Security Issues ◽

Inaccurate Information ◽

The Subject ◽

The Republic ◽

The Impact ◽

Integrated Indicators ◽

Selection Of

Studying the historical facts of past wars and armed conflicts and natural and man-made emergencies, today in the Republic of Kazakhstan one of the most important security issues is the preparation and organization of the evacuation of the population from possible dangerous zones, taking into account the emergence of new threats to the country’s security. The paper presents an algorithm for constructing universal scales of the distribution function of opportunities by types of support and rebuilding them into subject scales using display functions. The purpose of the paper is to determine the integral indicators characterizing the possibility of accommodation of the evacuated population and the impact on resources during relocation. On the subject scales of cities and districts of the region, indicators of the possibility of relocation of a certain amount of the evacuated population by types of support and indicators characterizing the impact on the district’s resources during resettlement of a certain amount of the evacuated population are determined. It was concluded that the use of integrated indicators allows the selection of areas to accommodate the evacuated population without the use of statistical data, in conditions of incomplete and inaccurate information. The presented method does not replace traditional methods based on classical methods of territory assessment by the level of life sustenance, but also allows their reasonable combination with the experience of specialists in this field, taking into account the incompleteness, uncertainty, and inconsistency of the initial data of the study area, which does not allow the application of existing methods.

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Assessing glomerular filtration rate in healthy adult potential kidney donors in Bangladesh: A comparison of various prediction equations with measured glomerular filtration rate by diethylentriamine pentaacetic acid renogram

Bangladesh Medical Research Council Bulletin ◽

10.3329/bmrcb.v39i2.19646 ◽

2014 ◽

Vol 39 (2) ◽

pp. 74-79

Author(s):

F Jahan ◽

MNU Chowdhury ◽

T Mahbub ◽

SM Arafat ◽

S Jahan ◽

...

Keyword(s):

Renal Function ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Healthy Adult ◽

Healthy Population ◽

Prediction Equations ◽

Estimated Gfr ◽

Kidney Donors ◽

Measured Gfr

To ensure that potential kidney donors in Bangladesh have no renal impairment, it is extremely important to have accurate methods for evaluating the glomerular filtration rate (GFR). We evaluated the performance of serum creatinine based GFR in healthy adult potential kidney donors in Bangladesh to compare GFR determined by DTPA with that determined by various prediction equations. In this study GFR in 61 healthy adult potential kidney donors were measured with 99mTc-diethylenetriamine penta-acetic acid (DTPA) renogram. We also estimated GFR using a four variable equation modification of diet in renal disease (MDRD), Cockcroft-Gault creatinine clearance (CG CrCl), Cockcroft-Gault glomerular filtration rate (CG-GFR). The mean age of study population was 34.31±9.46 years and out of them 65.6% was male. In this study mean mGFR was 85.4±14.8. Correlation of estimated GFR calculated by CG-CrCl, CG-GFR and MDRD were done with measured GFR DTPA using quartile. Kappa values were also estimated which was found to be 0.104 for (p=0.151), 0.336 for (p=0.001) and 0.125 for (p=0.091) respectively. This indicates there is no association between estimated GFR calculated by CG-CrCl, CG-GFR, MDRD with measured GFR DTPA. These results show poor performance of these equations in evaluation of renal function among healthy population and also raise question regarding validity of these equations for assessment of renal function in chronic kidney disease in our population. DOI: http://dx.doi.org/10.3329/bmrcb.v39i2.19646 Bangladesh Med Res Counc Bull 2013; 39: 74-79

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Functional-semantic aspects of translation of psychological terminological phrases of English language

Филология научные исследования ◽

10.7256/2454-0749.2020.5.32967 ◽

2020 ◽

pp. 1-15 ◽

Cited By ~ 1

Author(s):

Elena Anatol'evna Balygina ◽

Yuliya Vladimirovna Yarovikova ◽

Tat'yana Viktorovna Ermolova ◽

Oksana Aleksandrovna Krukovskaya

Keyword(s):

English Language ◽

Translation Process ◽

Translation Strategy ◽

Semantic Development ◽

The Impact ◽

Selection Of ◽

The Way

Multiple scientific works are dedicated to studying the impact of linguistic factors upon the translation process. However, relevant remains the task of determining dependence of the translation strategy on the peculiarities of semantic development and functionality of terminological units. This article examines the functional-semantic aspects of translation of the adjective-substantive terminological phrases of English language that reflects the scientific notions of psychology. An attempt is made to develop the methods for translating terminological phrases that would consider syntagmatic aspects of interaction of the meanings of its components. Attention is focused on determination of the impact of peculiarities of terminological meaning of terminological phrase upon the choice of its conveying in translation. A conclusion is made that the translation process of terminological phrases from English to Russian are influenced by such factors, as the level of semantic closeness of terminological phrases and communicative significance of its adjective component. In conclusion, the author discusses strategies of selection of the way of translation of terminological phrases, taking into account the aforementioned factors.

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Morphometric analysis of myofibre development in the adductor femoris muscle of single and twin fetal lambs

Reproduction Fertility and Development ◽

10.1071/rd99067 ◽

2000 ◽

Vol 12 (6) ◽

pp. 329 ◽

Cited By ~ 6

Author(s):

S. A. McCoard ◽

W. C. McNabb ◽

S. W. Peterson ◽

S. N. McCutcheon ◽

P. M. Harris

Keyword(s):

Sampling Site ◽

Muscle Growth ◽

Morphological Characteristics ◽

Distal Region ◽

Fetal Life ◽

Cross Sectional ◽

The Impact ◽

Femoris Muscle ◽

Selection Of

Cellular development of the adductor femoris muscle from twin and single fetuses was studied at 140 days gestation to evaluate the effect of moderate fetal growth retardation on myofibre development. Twin fetuses had lower bodyweights (13%) and disproportionately small adductor femoris muscle weights (22%) compared with single fetuses. Reduced muscle mass was associated with smaller myofibre cross-sectional areas (CSA) and lower DNA content (22%), indicative of fewer myonuclei and retarded myofibre hypertrophy. Myofibre number and the phenotypic maturation of the myofibres were similar between twins and singletons. These results indicate that even modest growth restriction during fetal life can negatively influence myofibre hypertrophy, highlighting the importance of fetal nutrition for muscle growth. Large muscles, such as the adductor femoris, have intrafascicularly terminating myofibres, which necessitates accurate sampling of the muscle when investigating possible perturbations in morphological characteristics (e.g. between singletons and twins). The second objective of the present study was to investigate the impact of the sampling site on the morphological parameters of the adductor femoris muscle. The apparent total myofibre number decreased from the proximal to the distal region of the adductor femoris muscle. The apparent number of slow-twitch fibres also decreased from the proximal to the medial region, but was not different between the medial and distal regions of the muscle. Similarly, myofibre CSA differed between the medial and distal regions. These results indicate that, particularly with large muscles, such as the adductor femoris, which has intrafascicularly terminating myofibres, single site sampling for the determination of morphological fibre characteristics may generate misleading results and that careful selection of the sampling area may be necessary.

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