P1718COMPARISON OF MEASURED GLOMERULAR FILTRATION RATE USING 24-HOUR URINE CREATININE CLEARANCE WITH 51-CHROMIUM EDTA IN A MALAYSIAN COHORT OF LIVING KIDNEY DONOR CANDIDATES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Chee Keong Thye ◽  
Yee Wan Lee ◽  
Maisarah Jalalonmuhali ◽  
Soo Kun Lim ◽  
Kok Peng Ng
Keyword(s):  
Glomerular Filtration Rate ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Urine Volume ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
51Cr Edta

Abstract Background and Aims All living kidney donors undergo assessment of renal function by evaluation of Glomerular Filtration Rate (GFR). 51Cr-EDTA is one of the most widely used marker for measuring GFR but it is hampered by cost and laboriousness as well as not being widely available in Malaysia. Measuring 24-hour urine for creatinine clearance (Ccr) is a common alternative when exogenous filtration markers are not available. Ccr suffers from over/underestimation of measured GFR (mGFR) due to errors in urine collection and tubular secretion of creatinine. This is a study to compare the correlation of Ccr against 51Cr-EDTA in measuring GFR among the living donors in Malaysian population. Method This is a cross-sectional, single-centre study of a cohort of living kidney donor candidates from January 2007 to March 2019. All candidates who had mGFR done with both 51Cr-EDTA and Ccr in University Malaya Medical Centre were enrolled. Special consideration was taken to account for adequate urine sampling for Ccr. Clinical data was analysed for correlation, bias, precision and accuracy between Ccr and 51Cr-EDTA. Results A total of 83 living kidney donors with a mean age of 45.60 ± 11.06 years and body mass index (BMI) of 24.36 ± 4.03 were enrolled. Female comprised 74.7% of the donors while Chinese, Malay and Indian accounted for 67.5%, 20.5% and 7.2% of the donors respectively. The study group had a mean serum creatinine of 63.37 ± 16.00 umol/L with a urine volume of 2.03 ± 0.81 L (range 0.70 – 3.82). mGFR from 51Cr-EDTA was 125.56 ± 27.64 ml/min/1.73m2 (range 77.0 – 194.3) whereas calculated Ccr was 136.05 ± 36.15 ml/min/1.73m2 (range 75.32 – 280.06). The correlation coefficient between Ccr and 51Cr-EDTA is moderate (r = 0.43) (p < 0.01). Mean absolute bias between Ccr and 51Cr-EDTA was 10.59 ± 37.99 ml/min/1.73m2 (p < 0.05). The accuracy of Ccr within 30% of 51Cr-EDTA was 77.11%. Conclusion Our study showed that Ccr significantly overestimates mGFR compared to 51Cr-EDTA. However, there is a significantly moderate positive correlation between Ccr and 51Cr-EDTA. Thus, in the absence of 51Cr-EDTA, Ccr is a clinically acceptable alternative if utilized with care and understanding its limitations.

scholarly journals MDRD or CKD-EPI for glomerular filtration rate estimation in living kidney donors

2018 ◽  
Vol 38 (2) ◽  
pp. 207-212
Author(s):  
Carla Burballa ◽  
Marta Crespo ◽  
Dolores Redondo-Pachón ◽  
María José Pérez-Sáez ◽  
Marisa Mir ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Rate Estimation ◽  
Glomerular Filtration Rate Estimation

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

2019 ◽  
Vol 95 (4) ◽  
pp. 896-904 ◽  
Author(s):  
François Gaillard ◽  
Marie Courbebaisse ◽  
Nassim Kamar ◽  
Lionel Rostaing ◽  
Lola Jacquemont ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Direct Measurement ◽  
Filtration Rate ◽  
Kidney Donors ◽  
Living Kidney Donors

scholarly journals Cardiovascular rEmodelling in living kidNey donorS with reduced glomerular filtration rate: rationale and design of the CENS study

2019 ◽  
Vol 29 (2) ◽  
pp. 123-134 ◽  
Author(s):  
Kjersti Benedicte Blom ◽  
Kaja Knudsen Bergo ◽  
Emil Knut Stenersen Espe ◽  
Vigdis Rosseland ◽  
Ole Jørgen Grøtta ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Kidney Donors ◽  
Living Kidney Donors

Living kidney donor estimated glomerular filtration rate and recipient graft survival

2013 ◽  
Vol 29 (1) ◽  
pp. 188-195 ◽  
Author(s):  
Ann Young ◽  
S. Joseph Kim ◽  
Amit X. Garg ◽  
Anjie Huang ◽  
Greg Knoll ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Graft Survival ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Kidney Donor ◽  
Living Kidney Donor

scholarly journals Renal Transplantation from Elderly Living Donors

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Jacob A. Akoh ◽  
Umasankar Mathuram Thiyagarajan
Keyword(s):  
Glomerular Filtration Rate ◽  
Renal Transplantation ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
English Language ◽  
Graft Function ◽  
Living Donors ◽  
Living Kidney Donor ◽  
Living Kidney Donors ◽  
Elderly Living

Acceptance of elderly living kidney donors remains controversial due to the higher incidence of comorbidity and greater risk of postoperative complications. This is a review of publications in the English language between 2000 and 2013 about renal transplantation from elderly living donors to determine trends and effects of donation, and the outcomes of such transplantation. The last decade witnessed a 50% increase in living kidney donor transplants, with a disproportionate increase in donors >60 years. There is no accelerated loss of kidney function following donation, and the incidence of established renal failure (ERF) and hypertension among donors is similar to that of the general population. The overall incidence of ERF in living donors is about 0.134 per 1000 years. Elderly donors require rigorous assessment and should have a predicted glomerular filtration rate of at least 37.5 mL/min/1.73 m2at the age of 80. Though elderly donors had lower glomerular filtration rate before donation, proportionate decline after donation was similar in both young and elderly groups. The risks of delayed graft function, acute rejection, and graft failure in transplants from living donors >65 years are significantly higher than transplants from younger donors. A multicentred, long-term, and prospective database addressing the outcomes of kidneys from elderly living donors is recommended.

Abstract P047: Relation of Body Mass Index to Creatinine Clearance and Glomerular Filtration Rate in Japanese Population Samples in Japan and Hawaii

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Naomi Kitano ◽  
Katsuyuki Miura ◽  
Akira Okayama ◽  
Hideaki Nakagawa ◽  
Kiyomi Sakata ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Glomerular Filtration Rate ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Body Mass ◽  
Filtration Rate ◽  
Urine Volume ◽  
Total Serum ◽  
Central Laboratory

Background: Obesity is an established risk factor for hypertension and end stage kidney disease. There is little information on how obesity relates to risk of impaired renal function in apparently healthy individuals. We investigated associations of body mass index (BMI) with timed 24-hour creatinine clearance (Ccr) and glomerular filtration rate (GFR) in the cross-sectional population-based INTERLIPID Study, ancillary study of the International Study on Macro- and Micro-Nutrients and Blood Pressure (INTERMAP). Methods: INTERLIPID participants ages 40-59 y from 5 INTERMAP research samples (4 Japanese and 1 Hawaiian) were investigated. Participants were ethnically all Japanese. Two timed 24-hour urine specimens were collected by each participant and analyses were performed in a central laboratory. Values of serum creatinine (Scr) were assayed by Jaffe’s method in a Japanese central laboratory. Data were analyzed from 1,338 Japanese, 570 men and 563 women in Japan, 100 men and 105 women in Hawaii. Measures of kidney function were 24-hour Ccr (ml/min) and GFR (ml/min/1.73m 2 ). Ccr was calculated by equation (urine creatinine х urine volume)/(Scr х 1440); GFR was calculated as Ccr х (1.73/body surface area (BSA)). BSA was estimated by the DuBois formula. In addition, estimated GFR (eGFR) was calculated by use of the Modification of Diet in Renal Disease (MDRD) Study equation, 186 х Scr -1.154 х age -0.203 х 0.742 (if female). All statistical analyses were stratified by gender. Adjusted mean values of Ccr, GFR, and eGFR in quartiles of BMI were estimated using analysis of covariance. Model 1 was adjusted for age; model 2, for age and urine volume; model 3 for variables in model 2 plus blood pressure, pulse rate, physical activity, smoking habit, alcohol consumption, urinary sodium excretion, HbA1c, and total serum cholesterol. Results: Ccr (mean (SD)) were 107.5 (18.9) in men in Japan, 91.9 (17.0) in women in Japan, 123.4 (25.1) in men in Hawaii, and 98.5 (20.3) in women in Hawaii. BMI quartile ranges were in men Q1 16.8-22.3, Q2 22.3-24.1, Q3 24.1-26.1, and Q4 26.1-42.9; in women Q1 15.9-21.2, Q2 21.2-23.0, Q3 23.0-25.1, and Q4 25.1-47.0. In men, BMI was positively related to multivariate-adjusted Ccr and GFR ( P for trend across BMI quartiles <0.001 and <0.001, respectively), however, multivariate-adjusted eGFR was inversely associated with BMI ( P for trend 0.001). In women, BMI was positively related to multivariate-adjusted Ccr ( P for trend across BMI quartiles <0.001); multivariate-adjusted GFR and eGFR were not significantly associated with BMI. Interactions between age and BMI were not significant in men or women. Conclusions: These results indicate that excess BMI may lead to higher Ccr, and that the MDRD equation may underestimate GFR in middle-aged overweight or obese Japanese men.

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