Calculating carboplatin doses using the 4-variable modification of diet in renal disease (4-v MDRD) estimate of glomerular filtration rate (GFR) in the Calvert formula

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 2521-2521 ◽  
Author(s):  
S. G. Poole ◽  
M. J. Dooley ◽  
D. Rischin
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Area Under The Curve ◽  
Oncology Patients ◽  
Calvert Formula ◽  
Mdrd Equation ◽  
Gault Formula ◽  
The Mean ◽  
Carboplatin Dose ◽  
Measured Gfr

2521 Background: The dose of carboplatin is usually calculated using the Calvert formula, with various bedside estimates utilized rather than directly measured GFR. The 4-v MDRD equation (Levey AS, et al. Ann Intern Med 2006; 145: 247–254) is now advocated as the routine method of estimating renal function from serum creatinine in all patients. Adoption in clinical practice is occurring despite lack of validation in oncology patients. The aim of this study was to compare carboplatin doses derived from the Calvert formula using measured GFR and the estimates of the 4-v MDRD equation and other established estimates. Methods: GFR was determined using technetium-99m diethyl triamine penta-acetic acid (Tc99mDTPA) clearance. Serum creatinine (Jaffe method) was measured and GFR estimates calculated using 4-v MDRD, Cockcroft and Gault formula (CGF), Wright, Martin, and Jelliffe (JF) formulae. Carboplatin doses were calculated using the Calvert formula, targeting an area under the curve of 7mg.ml- 1.min-1. Results: GFR was measured in 510 adult oncology patients (323 male, 187 female, mean age 63 years, range 17–87 years, mean GFR 84 mL/min, range 16–205 mL/min). The mean (range) carboplatin dose was 765 mg (287–1,610 mg), 681 mg (237–1,306 mg), 674 mg (249–2,044 mg), 721 mg (261–1,536mg), 741 mg (261–2,128mg), 620 mg (244- 1,329 mg) for measured GFR, 4-v MDRD, CGF, Wright, Martin, and JF formulas respectively. The accuracy (% within 20% of ‘true’ dose) was 58%, 63%, 73%, 72% and 49% for 4-v MDRD, CGF, Wright, Martin, and JF formulas respectively. Carboplatin doses derived using the 4-v MDRD estimate of GFR become increasingly less accurate with increasing GFR (see table ). All other formulas performed similarly. Conclusions: The 4-v MDRD equation resulted in an imprecise estimation of carboplatin doses with the degree of variability dependant on the level of renal function. [Table: see text] No significant financial relationships to disclose.

Comparison of bedside estimates of renal function and measured glomerular filtration rate (GFR) in 510 adult oncology patients

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19512-19512
Author(s):  
M. J. Dooley ◽  
S. G. Poole ◽  
D. Rischin
Keyword(s):  
Renal Function ◽  
Renal Disease ◽  
Clinical Utility ◽  
Chronic Renal Disease ◽  
Oncology Patients ◽  
Drug Dosing ◽  
Mdrd Equation ◽  
The Mean ◽  
And Gender ◽  
Measured Gfr

19512 Background: Various bedside formulae have been used in practice to estimate renal function to predict drug dosing. Recently the ‘4-variable Modification of Diet in Renal Disease’ (4-v MDRD) equation1 was derived in patients with chronic renal disease and has been advocated for application in oncology. The aim of this study was to compare measured GFR with estimates from formula based equations in adult oncology patients. Methods: GFR was determined using technetium-99m diethyl triamine penta-acetic acid (Tc99mDTPA) clearance, serum creatinine (Jaffe method) was measured and renal function estimates calculated using 4-v MDRD, Cockcroft and Gault (CGF), Wright, Martin, and Jelliffe (JF) formulae. Accuracy, bias (mean % error (MPE)) and precision were assessed for varying levels of GFR, body mass index (BMI), age and gender. Results: In 510 adult oncology patients (323 male, 187 female, mean age 63years, range 17–87years) GFR was determined using Tc99mDTPA clearance (mean 84mL/min, range 16–205mL/min). The mean (range) calculated GFR was 72mL/min/1.73m2(9–162mL/min/1.73m2), 71ml/min (11–267mL/min), 78mL/min (12- 195mL/min), 81mL/min (12–279mL/min), 64mL/min/1.73m2 (10–165mL/min/1.73m2) for 4-v MDRD, CGF, Wright, Martin, and JF formula respectively. Bias, precision and accuracy (%within 30% and 50% of true GFR) of estimates are shown in the table . The Wright and Martin formulae had greater bias relating to degree of renal function and gender respectively. The 4-v MDRD equation provided a less biased estimate compared to the CGF across all levels of renal function and BMI. Conclusions: When compared to measured GFR, the 4-v MDRD equation provides a less biased estimate compared to the other formulae evaluated across a range of variables including degree of renal function and BMI. The limitations of all the bedside estimates must be understood to allow appropriate clinical utility. 1. Levey AS, et al. Ann Intern Med 2006; 145: 247–254. [Table: see text] No significant financial relationships to disclose.

scholarly journals Relationship between severity of hypertension and renal impairment in preeclampsia

2018 ◽  
Vol 11 (3) ◽  
pp. 213
Author(s):  
Khairun Nahar ◽  
Ferdousi Islam ◽  
Naila Atik Khan
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Uric Acid ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Preeclamptic Patient ◽  
Blood Pressures ◽  
Mild Preeclampsia ◽  
The Mean ◽  
The Relationship

<p class="Abstract">The aim of this study was to determine the relationship between the severity of hypertension and renal impairment in preeclampsia. This study was conducted on 92 diagnosed cases of mild (n=42) and severe (n=50) preeclampsia patients from August 2010 to July 2011. All the patients were almost identical in terms of age and socioeconomic status. The results of the study showed that the mean serum creatinine and uric acid levels were significantly high in severe preeclampsia patient compared to mild preeclampsia and both systolic and diastolic blood pressures had the positive and significant effects on the serum creatinine and uric acid levels. In conclusion, impairment of renal function has the positive and significant relationship with the severity of blood pressure in the preeclamptic patient.</p>

THE CHANGES OF RENAL FUNCTION STATUS BASED ON PROTEINURIA AND GLOMERULUS FILTRATION RATE IN PATIENTS WITH HISTORY OF PREECLAMPSIA WITH SEVERE FEATURES

2021 ◽  
pp. 279-282
Author(s):  
Chairul Adilla Ardy ◽  
Muara Panusunan Lubis ◽  
Cut Adeya Adella ◽  
Hotma Partogi Pasaribu ◽  
Muhammad Rusda ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Late Onset ◽  
Case Series ◽  
Sampling Technique ◽  
Time Interval ◽  
History Of ◽  
The Mean

Background: Preeclampsia with severe features is an endothelial disease that causes renal system disorders during pregnancy. Preeclampsia is an important cause of acute kidney injury and risk for chronic kidney disease. Methods: This study was a case series conducted at the Department of Obstetrics and Gynecology, H. Adam Malik General Hospital Medan, Indonesia starting from December 2019 until January 2020. Total sampling technique was employed obtaining 31 subjects with a history of preeclampsia with severe features for at least 3 months to 2 years postpartum, without a history of chronic disease, diabetes mellitus, and congenital kidney disorders. Proteinuria, serum creatinine, and GFR calculations were performed. Results: There were 31 patients who met the inclusion and exclusion criteria. At a time interval of 4 - ≤13 months postpartum, 2 levels of proteinuria +1 (0-2), serum creatinine 0.81 ± 0.21 mg/dl, and levels of GFR 109.57 ± 25.13 (ml/min/1.73 m ). Whereas at the time interval of >13 - 24 months postpartum, levels of proteinuria +1 (0-3), serum creatinine 0.85 ± 0.23 mg/dl, and GFR 2 levels of 104. 41 ± 28.45 (ml/min/1.73 m ). The mean of serum creatinine before delivery was 0.69 ± 0.15 mg/dl and after delivery was 0.83 ± 0.22 mg/dl. The mean of GFR postpartum at group of history of early onset preeclampsia was 103.07 ± 25.23 2 2 (ml/min/1.73 m ) and group of history of late onset preeclampsia was 113.40 ± 28.24 (ml/min/1.73 m ). Conclusion: There was a tendency for a decrease in renal function among women with a history of preeclampsia with severe features with ndings of persistent proteinuria from more than 3 to 24 months postpartum, an increase in mean of serum creatinine levels from before and after delivery and a decrease in GFR, but it was not signicant. This was related to the slow course of chronic kidney disease, so it had to be followed up periodically.

scholarly journals P0657CHANGES IN CREATININE MAY NO REFLECT MEASURED RENAL FUNCTION CHANGES IN PREDIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Escamilla Cabrera Beatriz ◽  
Nuria Victoria Sánchez Dorta ◽  
Natalia Negrã­n Mena ◽  
Sergio Luis-Lima ◽  
Federico Gonzalez Rinne ◽  
...  
Keyword(s):  
Renal Function ◽  
Clinical Practice ◽  
Nutritional Status ◽  
Serum Creatinine ◽  
Outpatient Clinic ◽  
Intestinal Secretion ◽  
Repeated Measurement ◽  
Clinical Evolution ◽  
Measured Gfr

Abstract Background and Aims Serum creatinine is the most used biomarker of renal function in clinical practice. However, the correlation between creatinine and measured GFR is poor with a variability as wide as 200%. The causes of this phenomena are not clear. Some studies observed tubular handling (reabsorption and secretion) as well as intestinal secretion of creatinine, and depends of nutritional status . Importantly, these changes increased with the loss of renal function, masking changes in the evolution of real renal function. However, scarce evidence is available about the reliability of creatinine in reflecting the changes of renal function over the time in predialysis patients, compared to measured GFR. This information is relevant in the setting of clinical decisions. Method Spanish unicenter study developed at the Hospital Universitario de Canarias (Tenerife). In the pre-dialysis outpatient clinic, subjects are followed with measured GFR (clearance of iohexol by DBS). Measured GFR is performed at baseline and repeated as suggested by the clinical evolution. For this study we included all patients with repeated determinations of creatinine and measured GFR. The changes of creatinine in terms of increase (&gt;10%), decrease (&lt;10%) and stability (±10%) were compared with the changes in measured GFR. Results 89 cases with repeated measurement of GFR and creatinine were evaluated. In 61 cases (68.53%) discrepancies between changes in creatinine and measured GFR were evident. Graphic 1 shows differents discordancing cases with 39 cases (43.8%) overestimation, 7 (7.8%) of infraestimation and 15 cases (24.7%) not change of mGFR with changes on Cr. Conclusion Changes in creatinine do not reflect real changes in real renal function in about 70% of the cases. Whenever possible, the measurement of GFR by whichever method available should be considered in the renal care and follow-up of these patients.

The Epidemic of Chronic Kidney Disease in Patients Referred to a Hematologist for Anemia.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5521-5521
Author(s):  
Brian Zimmer ◽  
Dana Wentzel ◽  
James Reed ◽  
Sherrine Eid ◽  
Eliot Friedman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
General Population ◽  
Serum Creatinine ◽  
Strong Association ◽  
Chart Audit ◽  
Stage 4 ◽  
The Mean ◽  
Stage 1

Abstract NHANES survey estimates the prevalence of CKD to be approximately 11% in the general population and 25% in the population over 65 years of age, and the prevalence of Chronic Kidney Disease (CKD) associated anemia approaches 75% in Stage 5 CKD. Despite the high prevalence of CKD, and its strong association with anemia, many patients diagnosed with anemia and referred to a hematologist for evaluation frequently have the diagnosis of CKD overlooked, especially if one is using a serum creatinine to assess renal function. A more accurate method of assessing renal function and to appropriately stage CKD is the use of an estimated glomerular filtration rate (eGFR) utilizing the modified MDRD equation. With the realization that CKD clearly has become known as a significant magnifier of cardiovascular risk (CVR), the importance of making the diagnosis of CKD has become quite apparent. Hypothesis: Patients referred to a hematologist for evaluation of anemia represent a population enriched with CKD. A retrospective chart audit was performed on patients being referred to a hematology practice from community physicians for the evaluation of anemia from January 2004 through December 31, 2005. All patients with a prior knowledge of CKD and a history of malignancy or myelodysplastic process were excluded from the study. The cohort consisted of 256 patients (37.5 % male and 62.5 % female) with a mean age of 67.56 ± 15.9 years. The mean serum creatinine was 1.16 ± .74 mg/dL with a mean calculated GFR by the modified MDRD (4 variable) equation of 69.9 ± 34.2 ml/min/1.73 m2. The mean ± SEM serum creatinine by stage of CKD in our patient population is: Stage 1: 0.67 ± 0.14 mg/dL, Stage 2: 0.92 ± 0.15 mg/dL, Stage 3: 1.40 ± 0.29 mg/dL, Stage 4: 2.23 ± 0.53 mg/dL, and Stage 5: 5.2 ± 2.89 mg/dL. Conservatively, we defined CKD as GFR <60 as urinalysis, imaging, or biopsy data were not available. In conclusion, an astounding 42.2 % of patients referred to a hematologist for the evaluation of anemia have CKD as compared to an estimated prevalence of 11 % in the general population reported by K/DOQI. Not only were these patients not aware of their diagnosis of CKD, but, of note also is the fact that 5.1 % were not aware of the presence of advanced CKD (GFR < 30) and 4 patients had Stage 5 CKD without awareness. 55.8 % of the patients over the age of 65 with anemia have CKD as compared to an estimated 25 % of the general population over the age of 65. This information stresses the need to assess all anemia patients for CKD and to appropriately stage them. Given the well accepted association between CKD and CVR, physicians caring for these patients can then stress the need for aggressive pursuit of both traditional and non traditional risk factor reduction to circumvent the significant CVR that is present in this population. Prevalence of Abnormal Renal Function by GFR Frequency Percent *K/DOQI = National Kidney Foundation’s Kidney Disease Outcome Quality Initiative GFR > 90 (Normal /K/DOQI* Stage 1) 51 19.9 GFR 89 - 60 (K/DOQI Stage 2) 97 37.9 GFR 59 - 30 (K/DOQI Stage 3) 95 37.1 GFR 29 - 15 (K/DOQI Stage 4) 9 3.5 GFR < 15 (K/DOQI Stage 5) 4 1.6

scholarly journals Study of serum homocysteine level in patients with chronic kidney disease and its association with renal function and serum albumin

2020 ◽  
Vol 8 (6) ◽  
pp. 2195
Author(s):  
Vandana Yadav ◽  
Vivek Prakash ◽  
Bushra Fiza ◽  
Maheep Sinha
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Serum Albumin ◽  
Control Group ◽  
Serum Homocysteine ◽  
The Mean ◽  
Gandhi Medical College ◽  
And Control

 Background: Chronic kidney disease (CKD) includes irreversible destruction of nephrons leading to progressive decline in glomerular filtration rate. A preferential defect in Homocysteine disposal could hypothetically occur in CKD and subsequently lead to hyperhomocysteinemia. Understanding the status of Homocysteine and other parameters in CKD is useful in the management of the disease. Objective of the study is to estimate serum Homocysteine in CKD patients and its association with renal function and serum albumin in patients with CKD.Methods: The study design involves hospital based observational comparative study. The study was conducted in Department of Biochemistry in association with Department of Nephrology of Mahatma Gandhi Medical College and Hospital, Jaipur between May 2017 to June 2018. 100 diagnosed patients of CKD, visiting the Outpatient Department of Nephrology were enrolled as cases for the study. Patients having cardiovascular disease, Chronic liver disease, Age more than 60 years and pregnant females were excluded from study. The control group consists of 100 age and sex matched healthy individuals.Results: The mean serum creatinine levels of case and control group were 7.50±3.74 mg% and 0.83±0.22 mg% respectively. The mean of serum homocysteine levels of subject group was 27.35±12.52 µmol/L while the mean serum homocysteine levels of control group was 11.06±3.52 µmol/L. The serum homocysteine levels were significantly higher in the CKD patient group. The serum level of albumin in CKD patients and control group were 2.86±0.86 g/dl and 4.10±0.58 g/dl respectively. A positive correlation was found between serum creatinine and serum homocysteine levels. A negative correlation between serum homocysteine and serum albumin was found.Conclusions: Findings of the present study exhibit that serum homocysteine levels are elevated in CKD in comparison to healthy controls and it is positively correlated with serum creatinine level.

scholarly journals Renal function impairment in Hypothyroidism

2013 ◽  
Vol 6 (1) ◽  
pp. 19-25
Author(s):  
HS Chaudhury ◽  
KK Raihan ◽  
MN Uddin ◽  
SM Ansari ◽  
M Hasan ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Total Cholesterol ◽  
Impaired Renal Function ◽  
Ldl Cholesterol ◽  
Colorimetric Method ◽  
Group I ◽  
Increased Risk ◽  
The Mean ◽  
Group Ii

Background: Hypothyroidism is an important public health problem in Bangladesh. It is associated with increased risk for atherosclerosis and other complications. The frank development of hypothyroidism is associated with metabolic derangements including dyslipidemia- which is an etiopathologic factor for development of renal impairment. This study was to evaluate whether hypothyroidism is associated with impaired renal function. Methods: Using a cross sectional analytical study design, a total of 111 subjects attending Out Patient Department, Center for Nuclear Medicine and Ultrasound, Bogra Medical College during January 2007 to December 2007 were included purposively. Eighty newly diagnosed hypothyroid patients (Group I) and 31 healthy adults (Group II) were enrolled in this study. Serum thyroid stimulating hormone and serum free thyroxine were assayed by radioimmunoassay. Serum fasting lipid profile, serum creatinine and serum uric acid were estimated by enzymatic colorimetric method. Estimated GFR was calculated using MDRD equation. Results: The mean (±SD) age of in Group I and Group II were 35.59 (±6.91) and 37.35 (±2.78) years and were comparable. In Group I, there were 66 females and 14 males. In Group II, there were 16 females and 15 males. The mean BMI was 25.49 ±2.17 kg/m2 in Group I and 24.24 ±1.99 kg/m2 in Group II. The mean (±SD) Serum total-cholesterol, LDL- cholesterol and tryacylglycerol in Group I were significantly higher than that in Group II. Serum HDL cholesterol in Group I was significantly lower than that in Group II (p<0.001). The mean (±SD) serum creatinine was significantly higher in Group I than Group II (P<0.001). The estimated glomerular filtration rate (eGFR) was lower in Group I compared to Group II (p=0.011). In Group I (Hypothyroid), there were significant correlations of BMI, S Total-Cholesterol, S HDLCholesterol, S LDL-Cholesterol, S triglycerides and S creatinine with serum TSH level. In Group I (Hypothyroid), there were significant positive correlations of BMI and TSH with serum creatinine. Conclusions: Hypothyroidism is associated with dyslipidemia, hyperuricemia and impaired renal function. Therefore, patients presenting with these biochemical abnormalities are recommended to be investigated for hypothyroidism and vice versa. DOI: http://dx.doi.org/10.3329/bjmb.v6i1.13283 Bangladesh J Med Biochem 2013; 6(1): 19-25

scholarly journals Real-World Experience of Switching from Deferasirox Dispersible to Film-Coated Tablets: Impact on Adherence to Chelation Therapy, Iron Overload and Renal Function

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 1062-1062
Author(s):  
Simon Cheesman ◽  
Raakhee Shah ◽  
Sara Trompeter ◽  
Perla Eleftheriou ◽  
Bernadette Hylton ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Iron Overload ◽  
Serum Ferritin ◽  
Patient Adherence ◽  
Beta Thalassemia ◽  
Daily Dose ◽  
Baseline Values ◽  
The Mean ◽  
The Impact

Abstract Background Chronic iron overload is an important complication of long-term blood transfusions for severe beta-thalassemias, sickle cell disease and other blood disorders. Iron chelation therapy (ICT) is required to bind and excrete excess iron, which would otherwise accumulate and lead to organ damage or failure. Deferasirox is a once-daily, orally administered ICT approved for the treatment of chronic iron overload due to frequent blood transfusions in patients with beta-thalassemia major and other anaemias. A film-coated tablet (FCT) formulation was launched in the UK in 2016 and replaced the dispersible tablet (DT) formulation. In the context of a randomised clinical trial, the FCT formulation showed greater adherence and patient satisfaction, better palatability and fewer tolerability concerns than the DT. Furthermore, treatment compliance by pill count was higher with FCT (92.9%) than with DT (85.3%) (Taher et al, 2017). Little information exists however about compliance, efficacy and tolerability outside of a clinical trial setting. Objectives We wished to assess in a 'real world' situation, the effects of switching the deferasirox formulation from DT to FCT on patient adherence to ICT, iron overload and renal function. Methods Patients receiving ICT with deferasirox who were switched from the DT to FCT formulations were followed over a 12-month period and results audited using hospital dispensing and biochemistry records. The date of the first FCT prescription was defined as baseline. The initial daily dose used for switching from DT to FCT was as per manufacturer's recommendations: 70% of the DT daily dose. The impact on iron overload was assessed by comparing serum ferritin levels at 3, 6, 9 and 12 months post-switch with baseline values. The impact on renal function was assessed by comparing serum creatinine levels at 3, 6, 9 and 12 months post-switch with baseline values as well as the number of serum creatinine increases of 30% or greater above baseline. The changes in serum ferritin and creatinine were subsequently analysed by paired t-test. The Proportion of Days Covered (PDC) was calculated as a measure of patient adherence to ICT in the 12 months before and after switching formulations. Results 74 patients switched from deferasirox DT to FCT with the following diagnoses: beta-thalassemia (n = 45), sickle-cell disease (9), thalassemia-intermedia (6), HbE-thalassemia (5), other transfusion-dependent disorders (9). The median age was 36 (range: 1-78yo), mean baseline serum ferritin was 2767µg/L (range: 412-8742), mean baseline creatinine was 64.5 umol/L (range: 17-140) and the median prescribed daily dose of DT was 1250mg (range: 62.5 - 3500). The mean PDC in the 12 months prior to switching formulations was 0.80 (range: 0.31-1.00). This increased to 0.91 (range: 0.21-1.00) in the 12 months following the switch to FCT. The median prescribed daily dose of FCT was 900mg (range: 90 - 2520) The mean changes in ferritin and creatinine at 3, 6, 9 and 12 months post-switch are shown in the table. 6 out of 74 patients (8%) had a creatinine increase of >30% from baseline whilst receiving the FCT, occurring after an average of 120 days (range: 30-260). All 6 patients were managed by dose adjustment of FCT and creatinine returned to the normal range in 5 out of 6 cases. Conclusions The switch from deferasirox DT to FCT resulted in improved patient adherence to chelation, a reduction in mean serum ferritin and a modest rise in mean serum creatinine. Some patients showed a reversible rise in creatinine from baseline. The median daily dose of FCT prescribed was 72% of the DT formulation, approximately equivalent according to the known bioavailability of the different preparations and suggesting that improvements in serum ferritin were due to the more consistent daily administration of the FCT rather than an increased daily deferasirox dose. We suggest that when the fall in ferritin is abrupt and/or to levels <1000µg/L, serum creatinine should be followed particularly carefully to avoid over-exposure to deferasirox from the FCT. We further speculate that patients who may have over-reported adherence to the DT prior to switching may be most susceptible to this effect. Reference Taher, A. T., et al. (2017). "New film-coated tablet formulation of deferasirox is well tolerated in patients with thalassemia or lower-risk MDS: Results of the randomized, phase II ECLIPSE study." American journal of hematology 92(5): 420-428. Table Table. Disclosures Garbowski: Vifor: Consultancy. Porter:Novartis: Consultancy; Cerus: Honoraria; Agios: Honoraria.

scholarly journals Evaluation of Renal Function in Donar Following Kidney Donation

2020 ◽  
Vol 19 (1) ◽  
pp. 18-22
Author(s):  
Mohammed Mizanur Rahman ◽  
Md Waliul Islam ◽  
Probir Kumar Roy ◽  
Kartik Chandra Ghosh ◽  
Mohammad Al Amin
Keyword(s):  
Renal Function ◽  
Specific Gravity ◽  
Serum Creatinine ◽  
Kidney Donation ◽  
P Value ◽  
Female Ratio ◽  
The Mean ◽  
Medical University ◽  
Age Range

Objectives: To find out any changes in renal function in donor following kidney donation. Materials and Methods: A Hospital based prospective study was conducted in the Department of Urology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from April 2011 to September 2012, Investigations included specific gravity and urinary microalbumin, ultrasonogram of kidneys, serum creatinine, estimated glomerular filtration rate. According to inclusion and exclusion criteria a total of 37 donors were enrolled in this study. Subsequent follow up were taken at the end of three months, six months and nine months. Data were evaluated by Paired t-test, Significance was defined p value<0.05. Results: The age range varied from 25 to 39 years and almost a half (45.9%) of patients had age belonged to 25-30 years and male to female ratio was 1:2.4. The mean baseline specific gravity was 1016.97±8.03, serum creatinine 1.03±0.24. The baseline urinary microalbumin was found nil and subsequent 1st,2nd, and 3rd follow up were also nil. The mean difference of specific gravity, serum creatinine (mg/dl) and GFR estimated by cretainine clearance rate and DPTA were almost consistent between baseline and the subsequent follow-up, no statistical significant (P>0.05) was found between baseline and the subsequent follow-up. Conclusion: Renal function of the remaining kidney in living donors does not significantly change after donor nephrectomy. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.18-22

scholarly journals Factors that Influence Graft Function at 1-Year Posttransplantation and Correlation with Baseline Donated Kidney Function Measured with Radioisotopes

2016 ◽  
Vol 14 (1) ◽  
pp. 23-29
Author(s):  
Irena Rambabova Bushljetik ◽  
Jelka Masin Spasovska ◽  
Gjulsen Selim ◽  
Olivera Stojceva Taneva ◽  
Oliver Stankov ◽  
...  
Keyword(s):  
Renal Function ◽  
Graft Function ◽  
Calcineurin Inhibitors ◽  
Impact Factors ◽  
Donor Age ◽  
Estimated Gfr ◽  
Hemodialysis Treatment ◽  
Dialysis Vintage ◽  
The Mean ◽  
Measured Gfr

AbstractIntroduction. Assessment of renal function is a crucial component of donor evaluation. The higher measured donor GFR is independently associated with a better allograft outcomes in living donor kidney transplantation (LDKT). Monitoring graft function and estimation of GFR is a recommended method for patients’ follow-up in posttransplantation period. The aim of our study was to investigate the correlation of directly measured GFR of donated kidney with estimated GFR through creatininebased formulas and to detect impact factors on the graft function at 12 months posttransplantation. Methods. Fifty LDKT patients (related and nonrelated donors) with stable renal function in a period of 12 months after transplantation were included in our study. The mean recipient age was 30.7±9.6 years, and donor age 55.45±9.41 years. The mean directly measured donated kidney GFR was 47.61±5.72 ml/min. Graft function was estimated at 3, 6 and 12 months by 3 formulas: Cockcroft- Gault (C-G), MDRD 6 variables and Nankivell. Direct correlation of estimated with measured radiolabeled99mTc DTPA GFR was performed. Various impact factors such as donor age, dialysis vintage and different calcineurin inhibitors as a part of immunosupression were evaluated. Results. Estimated GFR at 12 months with MDRD, Cockroft Gault, and Nankivell formulas was 72.65±22.6, 94.25±36.42, and 81.78±17.89 ml/min, respectively. The highest estimated GFR was obtained with C-G formula at all three time points. The estimated allograft GFR did not correlate with directly measured GFR of donated kidney. Donor age well correlated with the graft function at 12 months. Allografts from standard criteria donors-SCD (<60 years) had better function than allografts form expanded criteria donors-ECD (>60 years). The highest GFR was estimated with C-G equation (106.08±39.26 ml/min), while GFR estimated with Nankivell was 86.86±15.30 ml/min, and with MDRD 79.67±20.28 ml/min, presenting patients in stage 2 of chronic kidney disease. Duration of hemodialysis treatment under 24 months showed better graft function estimated by C-G at 12 months (102.23±38.86 ml/min), compared to that above 24 months of HD (77.84±18.11 ml/ min). Different type of calcineurin inhibitors did not influence on the graft function at any time point. Conclusion. Creatinine-based formulas for estimation of the graft function did not correlate with directly measured function of the donated kidney with radiolabeled isotopes, nor between each other. Hence, the monitoring of the graft function should be done by a single formula in the posttransplantation period. Expectedly, a better graft function was observed in young donors (standard criteria) and in patients with shorter hemodialysis treatment.

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