scholarly journals Monitoring of Renal Allograft Function with Different Equations: What are the Differences?

2017 ◽  
Vol 15 (1) ◽  
pp. 24-28
Author(s):  
Irena Rambabova Bushljetikj ◽  
Gjulsen Selim ◽  
Olivera Stojcheva Taneva ◽  
Sasho Dohchev ◽  
Oliver Stankov ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Renal Allograft ◽  
Graft Function ◽  
Mean Value ◽  
Post Transplantation ◽  
Transplant Patients ◽  
Mdrd Equation ◽  
Transplant Center ◽  
Mathematical Equations ◽  
The Mean

AbstractIntroduction. Monitoring of graft function by creatinine concentrations in serum and calculated glomerular filtration rate (GFR) is recommended after kidney transplantation. KDIGO recommendations on the treatment of transplant patients advocate usage of one of the existing mathematical equations based on serum creatinine. We compared clinical application of three equations based on serum creatinine in monitoring the function of transplanted kidney. Methods. A total number of 55 adult patients who received their first renal allograft from living donors at our transplant center in between 2011-2014 were included into the study. Renal allograft GFR was estimated by the Cockroft-Gault, Nankivell and MDRD formula, and correlated with clinical parameters of donors and recipients. Results. The mean age of recipients was 35.7±9.5 (range 16-58), and the mean age of donors was 55.5±9.0 (34- 77) years. Out of this group of 55 transplant patients, 50(90.91%) were on hemodialysis (HD) prior to transplantation. HD treatment was shorter than 24 months in 37(74%) transplant patients. The calculated GFR with MDRD equation showed the highest mean value at 6 and 12 months (68.46±21.5; 68.39±24.6, respectively) and the lowest at 48 months (42.79±12.9). According to the Cockroft&Gault equation GFR was the highest at 12 months (88.91±24.9) and the lowest at 48 months (66.53±18.1 ml/min). The highest mean level (80.53±17.7) of the calculated GFR with the Nankivell equation was obtained at 12 months and the lowest (67.81±16.7 ml/min) at 48 months. The values of Pearson’s correlation coefficient between the calculated GFR and the MDRD at 2 years after transplantation according to donor’s age of r=-0.3224, correlation between GFR and the Cockfroft & Gault at 6 and 12 months and donor’s age (r=-0.2735 and r=-0.2818), and correlation between GFR and the Nankivell at 2 years and donor’s age of r=-0.2681, suggested a conclusion that calculated GFR was lower in recipients who had an older donors. Conclusion. Our analysis showed difference in the calculated GFR with different equations at the same time points. Using one mathematical equation during the total post-transplantation period would be a recommended method in order to eliminate the discrepancy in determining the stage of kidney failure.

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.

Change in Glomerular Filtration Rate with Febuxostat in Patients with Advanced Chronic Renal Failure

2021 ◽  
Vol 15 (11) ◽  
pp. 3293-3295
Author(s):  
Ishtiaq Alam ◽  
Faheem Usman Sulehri ◽  
Muhammad Abdul Azim Baig ◽  
Maira Bhatti ◽  
Fouzia Perveen ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Mean Value ◽  
Kidney Dysfunction ◽  
The Mean

Background: Chronic kidney disease (CKD), is defined as progressive loss in kidney function. The study evaluated the mean change in estimated glomerular filtration rate (eGFR) with febuxostat in patients of advanced chronic kidney dysfunction with hyperuricemia. Methodology: A prospective observational study was conducted at the department of Nephrology, Sheikh Zayed Hospital, Lahore for 6 months, from January 2019 to October 2019. At baselines, the blood sample was obtained and sent to the laboratory for assessment of serum creatinine level. The eGFR was calculated by using the MDRD formula. Patients were then advised to take one oral Febuxostat 40 mg daily for 6 months. After 6 months, the blood sample was obtained for assessment of serum creatinine level. Results: The mean age of the patients was 40.72±14.90 years, male to female ratio was 1:1. The mean value of eGFR at baseline was 23.53±11.09 and its mean value at 6th month was 34.28+12.31, which was significant (p<0.001). Conclusion: Febuxostat effectively improved estimated glomerular filtration rate (eGFR) in patients presenting with advanced chronic kidney dysfunction with hyperuricemia. Keywords: Hyperuricemia, Kidney, Disease, Febuxostat, Dysfunction, Glomerular, Filtration

scholarly journals Serum Cystatin C in Patients with Delayed Graft Function

2016 ◽  
Vol 43 (1) ◽  
pp. 14-22
Author(s):  
M. Boncheva ◽  
T. Gruev ◽  
G. Nikolov
Keyword(s):  
Cystatin C ◽  
Graft Function ◽  
High Sensitivity ◽  
Acute Rejection Episode ◽  
Serum Cystatin C ◽  
Post Transplantation ◽  
Creatinine Concentration ◽  
Serum Cystatin ◽  
The Mean ◽  
Kinetics Of

SummaryDespite recent studies showing that serum Cystatin C (CysC) is a better marker for glomerular filtration rate (GFR) than the ubiquitously used creatinine, the clinical utility of these findings remains to be evaluated. This marker is very sensitive for allograft function after renal transplantation. The concentration of CysC was compared with that of the creatinine. Decreased renal function was followed in 64 transplanted patients. Serum CysC significantly correlated with creatinine in healthy controls (r = 0.625, p < 0.0001), whereas in the transplanted patients the mean serum creatinine and CysC concentrations were: 81 ± 13 mmol/L and 0.90 ± 0.22 mg/L, respectively. Serum CysC and creatinine significantly correlated throughout the post transplantation period (r = 0.686, p < 0.001), but we confirmed differences between kinetics of these parameters. In the first four days after transplantation the CysC concentration was normalized faster than the creatinine concentration. Development of acute rejection episode (between 5 and 7 days) showed high sensitivity and specificity of the changes of CysC compared with those of creatinine.

scholarly journals 1336. Outcomes of COVID-19 in Recent Kidney Transplants Recipients at a Large Transplant Center in Miami

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S756-S756
Author(s):  
Maria A Mendoza ◽  
Ana Coro ◽  
Yoichiro Natori ◽  
Shweta Anjan ◽  
Giselle Guerra ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Graft Function ◽  
Deceased Donor ◽  
Lower Survival Rate ◽  
Transplant Patients ◽  
Deceased Donor Kidney ◽  
Transplant Center ◽  
Polymerase Chain ◽  
Deceased Donor Kidney Transplant

Abstract Background Outcomes of COVID-19 have been reported in deceased donor kidney transplant (DDKT) recipients. However, data is limited in patients that underwent recent DDKT. Methods This single-center retrospective study evaluated the differences in demographics and post-transplant outcomes between those who tested positive and negative for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) by polymerase chain reaction, after undergoing recent DDKT. The treatments and outcomes for the SARS-CoV-2-positive patients were assessed. Patients who underwent DDKT from 3/2020 to 8/2020 were included and followed until 9/2020. Results 201 DDKT recipients were analyzed [14(7%) SARS-CoV-2-positive and 187(93%) negative]. There was no difference in delayed graft function and biopsy-proven rejection between both groups. The patient survival at the end of the study follow-up was lower among SARS-CoV-2-positive patients (Table 1). The median time from DDKT to COVID-19 diagnosis was 45 (range: 8-90) days; 5(36%) patients required intensive care unit and 4(29%) required mechanical ventilation; steroids were used in all the patients, therapeutic plasma exchange (TPE) and convalescent plasma (CP) in 7(50%) patients each, remdesivir in 6(43%) and tocilizumab in 1(7%); 9(64%) patients recovered, 3(21%) died and two were still requiring mechanical ventilation at the end of the follow-up. Conclusion Our cohort demonstrated a lower survival rate among SARS-CoV-2-positive patients, which highlights the vulnerability of the transplant population. Transplant patients must comply with the CDC recommendations to prevent COVID-19. Disclosures All Authors: No reported disclosures

scholarly journals Evaluation the performance of serum neutrophil gelatinase associated lipocalin as a biomarker of allograft dysfunction in kidney recipients from living donors

2021 ◽  
Vol 10 (4) ◽  
pp. e30-e30
Author(s):  
Elham Adlravan ◽  
Farid Javandoust Gharehbagh ◽  
Ali Taghizadeh Afshari ◽  
Behzad Baradaran ◽  
Jaffar Nourooz-Zadeh
Keyword(s):  
Renal Transplant ◽  
Graft Function ◽  
Living Donors ◽  
Post Transplantation ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Allograft Dysfunction ◽  
Transplant Patients ◽  
Kidney Recipients ◽  
Renal Transplant Patients ◽  
Neutrophil Gelatinase

Introduction: Serum neutrophil gelatinase-associated lipocalin (sNGAL) has been proposed as an early biomarker for the prediction of delayed graft function (DGF) from cadaveric donors. Objectives: The purposes of this investigation were to explore the time-based trend for sNGAL in kidney recipients from living donors and to evaluate its correlation with graft function recovery during a one-year follow-up. Patients and Methods: Kidney recipients (n=39) were consecutively enrolled. Sample collection was performed before transplantation and at 2, 16, 24, 36, 48 hours after surgery. Kidney recipients were split into immediate graft function (IGF) and DGF based on estimated glomerular filtration rate (eGFR) on day 5 post-surgery. eGFRs >60 mL/min/1.73 m2 on day 5 post-transplantation were considered as IGF. sNGAL was assessed by ELISA. Serum creatinine (sCr) was measured by the Jaffe method. Results: Rates of participants with IGF or DGF were 25 and 14, respectively. Pre-surgery, sNGAL levels in the DGF subset were 21% higher than that of the IGF group. At 2-hours checkpoint, area under curve, sensitivity, specificity and cut-off (ng/mL) for sNGAL were 0.73, 100%, 52% and 151.8. sNGAL levels correlated with allograft function at 6, 9 and 12 months post-transplantation (r=0.66; P=0.007; r=0.836; P=0.031 and r=0.93; P=0.016). Conclusion: We have uncovered that monitoring sNGAL in kidney recipients is a useful biomarker for the evaluation of short- and long postoperative outcome in renal transplant patients from living donors. However, multicenter study with large samples-size is required to ascertain the usefulness of sNGAL as diagnostic tool for the evaluation of allograft dysfunction in renal transplant patients from living donors.

scholarly journals Delayed Graft Function and Acute Rejection in Kidney Transplant Patients with Positive Panel-Reactive Antibody and Negative Donor-Specific Antibodies

2020 ◽  
Vol 12 (4) ◽  
Author(s):  
Ha Nguyen Thi Thu ◽  
Manh Bui Van ◽  
Dung Nguyen Thi Thuy ◽  
Kien Truong Quy ◽  
Duc Nguyen Van ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Graft Function ◽  
Post Transplantation ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Group 2 ◽  
Reactive Antibody ◽  
Group 1

Background: Delayed graft function (DGF) and acute rejection (AR) are common complications in kidney transplant patients. Objectives: The study evaluated DGF and AR in highly sensitized patients and their effects on kidney function for six months post-transplantation. Methods: We enrolled 95 patients with kidney transplants from living donors who were divided into two groups. Group 1 included 47 highly sensitized patients with panel reactive antibody (PRA) < 20.0% and negative donor-specific antigen, and group 2 included 48 patients with negative PRA. All patients were followed for the state of DGF, AR, and kidney function for six months. Results: Group 1 showed a significantly higher proportion of DGF and AR than group 2 (27.7% versus 2.1%, P < 0.001 and 14.9% versus 2.1%, P = 0.031, respectively). The rates of positive PRA in DGF and AR patients were significantly higher than those in non-DGF and non-AR patients (92.9% versus 42.0%, P < 0.001 and 87.5% versus 46.0%, P = 0.031, respectively). Transplanted kidney function was significantly worse in patients with PRA and DGF and/or AR than in patients with negative PRA and non-DGF and non-AR only in the seventh-day post-transplantation. Conclusions: Kidney transplant in highly sensitized patients with positive PRA was related to the increased ratio of DGF and AR.

MO999COMPARISON OF BASILIXIMAB VS NO INDUCTION ON 12-MONTHS RENAL FUNCTION IN KIDNEY TRANSPLANT RECIPIENTS IN THE TACROLIMUS ERA

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Zdenek Lys ◽  
Ivo Valkovsky ◽  
Pavel Havranek ◽  
Jarmila Dedochova ◽  
Jana Polaskova ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Serum Creatinine ◽  
Kidney Transplant ◽  
Interleukin 2 ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Median Serum ◽  
Transplant Center

Abstract Background and Aims IL2-RA (Interleukin 2 receptor antagonist) are recommended for the induction immunosuppression of kidney transplant recipients in patients with low/standard immunological risk. Studies showing the effectiveness of these substances have often been performed in patients taking cyclosporine. We aimed to find out whether the same results would be obtained with the more effective tacrolimus in an immunosuppressive regimen. Method Induction immunosuppression using IL2-RA basiliximab in all patients undergoing kidney transplantation has been routinely used in our transplant center since April 1, 2018. We retrospectively compared outcomes of kidney transplantation of the last 40 patients before introduction of induction and the first 40 patients after the induction (monitored period of analysis is June 2017 to January 2019). All patients in each group received baseline immunosuppression of tacrolimus, corticosteroid and mycophenolate. We selected patients with low immunological risk (1st transplant, panel reactive antibodies up to 20%, without donor specific antibodies, donation after brain death) in both groups and evaluated their renal outcomes (serum creatinine and estimated glomerular filtration rate/eGFR) at 12 months after transplantation. Results Patients in the groups withnout and with basiliximab induction were of comparable age (51.9 years vs. 54.7) and with similar retransplantation rate (20%). The 1-year survival of patients and kidneys was the same (97.4% patient survival and 92.1% renal survival). Renal transplant function at 12 months was analyzed in 21 patients without and 19 patients with basiliximab induction with low baseline immunological risk. The patients who received basiliximab inductive immunosuppression had better graft function 12 months compared to patients without basiliximab administration: median serum creatinine level 112 µmol/L vs. 127 µmol/L (P=0.047) and eGFR 0.85 ml/s vs. 0.77 ml/s (P=0.347). Better renal function was also shown in the subgroup of patients older than 65 years. Conclusion At our transplant center, the introduction of basiliximab induction in patients at low immunological risk led to improved graft function in the short term despite the growing subpopulation of geriatric patients.

scholarly journals Comparative Assessment of uNGAL, uNAG and Cystatin C As Early Biomarkers in Renal Post-Transplant Patients

2018 ◽  
Vol 45 (2) ◽  
pp. 12-19
Author(s):  
G. Nikolov ◽  
M. Boncheva ◽  
T. Gruev ◽  
K. T. Trajkovska ◽  
I. Kostovska
Keyword(s):  
Serum Creatinine ◽  
Cystatin C ◽  
Graft Function ◽  
Roc Curves ◽  
Urinary Ngal ◽  
Kidney Transplant Recipients ◽  
Serum Cystatin C ◽  
Post Transplantation ◽  
Post Transplant ◽  
One Year

Abstract Urinary neutrophil gelatinase-associated lipocalin (uNGAL), urinary N-acetyl-bd-glucosaminidase (NAG), urinary α1-microglobulin/creatinine ratio and cystatin C have been suggested as potential early markers of delayed graft function (DGF) following kidney transplantation. We conducted a prospective study in 50 consecutive kidney transplant recipients to evaluate serial changes of these biomarkers within the first week after transplantation and assess their performance in predicting DGF (dialysis requirement during initial post-transplant week) and graft function throughout the first year. Urine samples were collected on post-transplantation days 0, 1, 2, 4, and 7. Statistical analysis: Linear mixed and multivariable regression models, receiver-operating characteristic (ROC), and areas under ROC curves were used. At all-time points, mean urinary NGAL levels were significantly higher in patients developing DGF. Shortly after transplantation (3-6 h), uNGAL and uNAG values were higher in DGF recipients (on average +242 ng/mL; NAG – 6.8 U/mmol creatinine, considering mean dialysis time of 4.1 years) and rose further in the following days, contrasting with prompt function recipients. On Day-1 uNGAL levels accurately predicted DGF (AUC-ROC = 0.93), with a performance higher than serum creatinine (AUC-ROC = 0.76), and similar to cystatin C (AUC-ROC = 0.95). Multivariable analyses revealed that uNGAL levels at days 4 and 7 were strongly associated with one-year serum creatinine level. Urinary NGAL, serum cystatin C is an early marker of graft injury and is independently associated with dialysis requirement within one week after transplantation and one-year graft function.

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