FP307IMPROVEMENT OF RENAL FUNCTION EVALUATION IN LIVING KIDNEY DONORS: ROLE OF RADIOISOTOPIC GLOMERULAR FILTRATION RATE AND OF RENAL FUNCTIONAL RESERVE

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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Unilateral nephrectomy causes an early abrupt decrease in plasma arginine and simultaneous reduction in glomerular filtration rate in living kidney donors

Clinical Biochemistry ◽

10.1016/j.clinbiochem.2013.04.031 ◽

2013 ◽

Vol 46 (15) ◽

pp. 1394-1398 ◽

Cited By ~ 5

Author(s):

Gordana Žunić ◽

Aleksandar Tomić ◽

Slavica Spasić

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Unilateral Nephrectomy ◽

Kidney Donors ◽

Abrupt Decrease ◽

Simultaneous Reduction ◽

Living Kidney Donors ◽

Plasma Arginine

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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

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p1718 ◽

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.

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

Nefrología (English Edition) ◽

10.1016/j.nefroe.2017.02.012 ◽

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

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The potential role of the eGFR in differentiating between true and pseudohyperkalaemia

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/0004563220966858 ◽

2020 ◽

Vol 57 (6) ◽

pp. 444-455

Author(s):

Thomas G Morris ◽

Sushmita Lamba ◽

Thomas Fitzgerald ◽

Gary Roulston ◽

Helen Johnstone ◽

...

Keyword(s):

Renal Function ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Blood Count ◽

Potential Role ◽

Estimated Glomerular Filtration Rate ◽

Full Blood Count ◽

Cut Points

Background Differentiating between true and pseudohyperkalaemia is essential for patient management. The common causes of pseudohyperkalaemia include haemolysis, blood cell dyscrasias and EDTA contamination. One approach to differentiate between them is by checking the renal function, as it is believed that true hyperkalaemia is rare with normal function. This is logical, but there is limited published evidence to support it. The aim of this study was to investigate the potential role of the estimated glomerular filtration rate in differentiating true from pseudohyperkalaemia. Methods GP serum potassium results >6.0 mmol/L from 1 January 2017 to 31 December 2017, with a repeat within seven days, were included. Entries were retrospectively classified as true or pseudohyperkalaemia based on the potassium reference change value and reference interval. If the initial sample had a full blood count, it was classified as normal/abnormal to remove blood cell dyscrasias. Different estimated glomerular filtration rate cut-points were used to determine the potential in differentiating true from pseudohyperkalaemia. Results A total of 272 patients were included with potassium results >6.0 mmol/L, with 145 classified as pseudohyperkalaemia. At an estimated glomerular filtration rate of 90 ml/min/1.73 m2, the negative predictive value was 81% (95% CI: 67–90%); this increased to 86% (95% CI: 66–95%) by removing patients with abnormal full blood counts. When only patients with an initial potassium ≥6.5 mmol/L were included (regardless of full blood count), at an estimated glomerular filtration rate of 90 ml/min/1.73 m2, the negative predictive value was 100%. Lower negative predictive values were seen with decreasing estimated glomerular filtration rate cut-points. Conclusion Normal renal function was not associated with true hyperkalaemia, making the estimated glomerular filtration rate a useful tool in predicting true from pseudohyperkalaemia, especially for potassium results ≥6.5 mmol/L.

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