MO190NORMATIVE DATA FOR GLOMERULAR FILTRATION RATE IN HEALTHY KIDNEY DONOR POPULATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ashish Bhoyar ◽  
Vinant Bhargava ◽  
Ashwani Gupta ◽  
Anurag Gupta ◽  
Vaibhav Tiwari ◽  
...  

Abstract Background and Aims Glomerular filtration rate (GFR) is estimated traditionally from 24-hour urinary creatinine clearance. Creatinine is mainly filtered by glomerulus. The collection of 24-hour urinary sample is a difficult task with many patients fail to collect all the urine samples. As measuring GFR is cumbersome, expensive, and not easily available in all centers, various equations are developed for estimating GFR from creatinine like MDRD, CKD EPI creatinine. GFR obtained from serum creatinine shows wide variation as muscle mass and dietary protein intake are important determinants of serum creatinine concentration. Literature shows very few studies with GFR estimation with reference to age in Indian population. Hence, this study is planned to develop age specific nomogram for GFR in healthy kidney donor population as well as to study agreement between GFR obtained by 99m Tc DTPA three sample method and GFR estimated by 24-hour urinary creatinine. The aim of this stidy was to develop age-specific nomogram GFR in healthy kidney donor population and to study the agreement between the GFR measured by Technetium-99m diethylene triamine pentaacetic acid (99m Tc DTPA) and 24-hour urinary creatinine method. Method This study was conducted at Sir Ganga Ram hospital, New Delhi. All healthy individuals aged more than 20 years and less than 65 years, undergoing evaluation as prospective kidney donor at our hospital were the part of this study. GFR was measured by 99m Tc DTPA clearance using 3 sample method. GFR measured by DTPA method was used to develop nomogram. Creatinine Clearance was calculated from 24-hour urinary creatinine by formula U x V/P where, U is urinary creatinine level, P is plasma creatinine level and V is total volume of urine. Nomogram was developed with respect to these 3 Age groups; namely, 20 to 40 years, 40 to 50 years and 50 to 65 years Results Total 100 kidney donors were included in this study. Enrolled subjects were divided into 3 age groups; 20 to 40 years (n=28), 40 to 50 years (n=46) and 50 to 65 years (n=26). Majority of the donors were females (n=80). The agreement between GFR obtained by 99m Tc DTPA and 24-hour urinary creatinine clearance methods was 92.6 vs. 94 ml/min, 80.4 vs. 76 ml/min and 76.3 vs. 70 ml/min in respective age groups. Conclusion In the younger age group (20 to 40 years), there is better agreement in GFR measured by 99m Tc DTPA method and 24-hour urinary creatinine clearance methods.

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Chee Keong Thye ◽  
Yee Wan Lee ◽  
Maisarah Jalalonmuhali ◽  
Soo Kun Lim ◽  
Kok Peng Ng

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.


2018 ◽  
Vol 58 (6) ◽  
pp. 305-11
Author(s):  
Indra Sandinirwan ◽  
Aris Primadi ◽  
Dany Hilmanto

Background The main parameter used to determine renal function in newborns is serum creatinine. Fetal growth restriction during pregnancy can cause the baby to be born small-for-gestational age. Serum creatinine levels in newborns are affected by muscle mass, gestational age, as well as the number of nephrons and kidney development. Objective To determine the usefulness of serum creatinine levels as an estimate of glomerular filtration rate in small-for-gestational age and appropriate-for-gestational age newborns. Methods This cross-sectional study was conducted in May-June 2018. The subjects were full term newborn infants consisting of small-for-gestational age and appropriate-for-gestational age groups (16 subjects each), born in Bandung City Regional Public Hospital. Serum creatinine level was tested by the Jaffe method. The estimated glomerular filtration rate was calculated based on serum creatinine, infant height, and a proportionality constant using the original Schwartz method, eGFR = [k * height]/SCr. Results Of 32 subjects, there were 17 spontaneous deliveries, 14 males, and 18 females. Mean serum creatinine levels in the small-for-gestational age and appropriate-for-gestational age groups were 0.94 (SD 0.36; 95%CI 0.75 to 1.14) mg/dL and 0.69 (SD 0.18; 95%CI 0.60 to 0.79) mg/dL (mean difference 0.25; 95%CI 0.05 to 0.46; P=0.009), respectively. The median estimated glomerular filtration rates (eGFR) in the small-for-gestational age and appropriate-for-gestational age groups were 25.69 mL/min/1.73m2 and 30.10 mL/min/1.73m2 (median difference 4.42; 95%CI 2.04 to 15.8; P=0.008), respectively. There was a weak negative correlation between serum creatinine and birth weight (r=–0.344; P=0.027). Conclusion Serum creatinine levels in small-for-gestational age newborns are significantly higher than in appropriate-for-gestational age newborns.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Lengnan Xu ◽  
Yonghui Mao ◽  
Aiqun Chen ◽  
Ban Zhao

Abstract Background and Aims The kidney is an important organ that removes metabolites and certain wastes and poisons from the body, and retains water and other useful substances through reabsorption. Its aging and function decline have a significant impact on the human health.Rather than simply depending on serum creatinine, glomerular filtration rate (GFR) assessment equation should be given priority in evaluating renal function. Different evaluated GFR (eGFR) equations sometimes have great differences in assessing the true value of GFR, especially for the elderly. The purpose of this study was to analyze the aging changes of renal function in normal people in Beijing and to compare the significance of different eGFR equations in evaluating renal function in Chinese population. Method The age, sex and serum creatinine were recorded in the population who underwent routine physical examination in our hospital from January 2012 to December 2014. Kidney function was assessed by CKD-EPI, MDRD, MDRDc, FAS and BIS equations, respectively. Results A total of 46 713 persons were enrolled in this study, of whom 27 249 (58.33%) were males. They were followed up for 3 years, ranging in age from 16 to 100 years. Both men and women showed age-related change in serum creatinine: serum creatinine and its standard deviation gradually increases parallel with age, indicating that the range of serum creatinine changes in the elderly was larger. Whether male or female, there were differences in eGFR change between different age groups (male: Χ2=141.28, P=0.000; female: Χ2=97.55, P=0.000). For male, eGFR decreased more in the elderly, and it was more common for young people to keep the eGFR constant or increase. However, in female, eGFR remained unchanged in most old people, and increased or decreased in the majority of the young. For all age groups, the ICC was very consistent among the equations, 0.849 for males and 0.817 for females. The whole population was divided into three groups according to serum creatinine < 1mg/dL, > 1mg/dL and < 1.5mg/dL, > 1.5mg/dL. The CKD-EPI equation gave higher stages of CKD than other equations. There was no clear age-related change trend in the 3-year average eGFR change rate of all age groups. For the elderly over 70 years of age, the MDRD and MDRDc equations had higher GFR evaluation results than the other three equations. The BIS equation had the lowest results of all equations. The ICC was very consistent among the equations, 0.966 for males and 0.957 for females. Conclusion we believed that the annual change of GFR varied from person to person and had little to do with age. GFR needed to be calculated more accurately in order to formulate corresponding medical strategies. Those eGFR equations the above-mentioned can be used to evaluate renal function, but the results were very different for different populations and serum creatinine levels. The use of different eGFR equations may lead to large differences in drug dose adjustment and the risk of serious adverse reactions. For the elderly in China, which equation was more suitable was inconclusive and further research was urgently needed.


1989 ◽  
Vol 35 (2) ◽  
pp. 312-314 ◽  
Author(s):  
F S Apple ◽  
P Benson ◽  
P A Abraham ◽  
T G Rosano ◽  
C E Halstenson

Abstract We compared creatinine clearances determined by enzymatic (Kodak Ektachem 700 single-slide, Boehringer Mannheim creatinine PAP) and nonenzymatic (Jaffé, HPLC) methods with glomerular filtration rate measured by inulin clearance in patients with varying degrees of renal function. The Kodak enzymatic assay gave values for creatinine 2 to 3 mg/L higher than the other methods. This resulted in significantly lower creatinine clearances than inulin clearances and creatinine clearances determined by the other methods. However, correlations between all methods for serum and urinary creatinine values and clearances were good. To avoid between assay (enzymatic vs nonenzymatic) discrepancies, manufacturers should agree to an acceptable standard of calibration under the usual conditions used with patients.


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