scholarly journals A Comparison of Glomerular Filtration Rate by Creatinine Based Equations and DTPA-Renogram in Healthy Adult Kidney Donors

2013 ◽  
Vol 52 (190) ◽  
Author(s):  
Ramesh Kumar Chaurasia ◽  
Rajendra Kumar Agrawal ◽  
Rajani Hada ◽  
Sweta Kumari Chaurasia ◽  
Santosh Gurung ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Pearson Correlation ◽  
Accurate Determination ◽  
Kidney Donors ◽  
Gfr Estimation ◽  
Measured Gfr

Introduction: Accurate determination of donor kidney function has important long-term implications for both donor health and recipient outcome. Many centers use 24 hour urinary creatinine clearance or creatinine-based GFR estimations to assess kidney function but their performance when compared with GFR measurements by isotope clearance remains inconclusive. We assessed the performance of creatinine based equations against DTPA GFR for evaluating Nepalese kidney donors.Methods: All kidney donors who had undergone both DTPA GFR estimation and 24 hour urine CrCl were included. The performance of the urine-CrCl, CG-CrCl, modified MDRD GFR against DTPA GFR was evaluated by analyzing global bias, precision (R2),Pearson correlation and accuracy percentage within 30% and 15%. The sensitivity and specificity of each predictive equation in selecting donor with GFR of ≥80 mL/min/1.73 m2 was also calculated.Results: Of 51 donors analysed, only 18 (35.29%) were male. The mean measured GFR was 102.752±16.71 mL/min/1.73 m2. Of all prediction equations, urine-CrCL has most precision (R2=0.207) with the highest pearson correlation (0.455) and highest accuracy percentage within 30% and 15%. However, predictive performance was poor for all the equations. The urine CrCl had highest sensitivity of 100% for detecting donor with measured GFR>80 mL/min/1.73 m2 with positive predictive value of 92.1%.Conclusions: The performance of all equations was disappointing and even the best performing equation urine-CrCl was suboptimal for donor selection. So considering the potential risk of living kidney donation, other more accurate methods of GFR estimation should be used._________________________________________________________Keywords: Cockcroft-Gault equation; creatinine clearance; glomerular filtration rate; modification of diet in enal disease formula; 99mTc-Diethylene-Triamine Pentaacetic Acid.

scholarly journals Assessing glomerular filtration rate in healthy adult potential kidney donors in Bangladesh: A comparison of various prediction equations with measured glomerular filtration rate by diethylentriamine pentaacetic acid renogram

2014 ◽  
Vol 39 (2) ◽  
pp. 74-79
Author(s):  
F Jahan ◽  
MNU Chowdhury ◽  
T Mahbub ◽  
SM Arafat ◽  
S Jahan ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Healthy Adult ◽  
Healthy Population ◽  
Prediction Equations ◽  
Estimated Gfr ◽  
Kidney Donors ◽  
Measured Gfr

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

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 Is DtPa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy?

2021 ◽  
Author(s):  
Prashant Bahirani ◽  
Raghav Talwar ◽  
Amit Kumar Singh ◽  
Ajay Shankar Prasad ◽  
Gagandeep Singh ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Donor Nephrectomy ◽  
Kidney Donation ◽  
Kidney Donors ◽  
Before And After ◽  
Gfr Estimation ◽  
Prospective Longitudinal

Introduction: Precise assessment of renal function of voluntary kidney donors has important implications for both donor and recipient health outcome. The ideal test for assessment of overall renal function is measurement of Glomerular Filtration Rate (GFR). Various centres use various creatinine based formulae to calculate the GFR, however when compared to GFR measurements by 99mTc-diethylenetriaminepentaacetic acid (DTPA) isotope clearance, their performance remain inconclusive. Aim: To assess the efficacy of creatinine-based GFR estimating equations in comparison to DTPA scan in voluntary kidney donors before and after donor nephrectomy. Materials and Methods: This study was conducted on 50 voluntary kidney donors who underwent donor nephrectomy at Army Hospital (R&R), New delhi. This study was conducted from November 2016 to March 2018 as a single centre, prospective, longitudinal cohort study on living related kidney donors with follow up at 1 and 3 months after kidney donation. The predictive capabilities of GFR estimation by Cockroft Gault (CG) equation, CG equation corrected for GFR and 24-hour urine Creatinine Clearance (CrCl) corrected for Body Surface Area (BSA), for both pre- and postdonor nephrectomy at 90 days, were assessed and further compared with DTPA-GFR as reference GFR. Individual quantitative parameters were compared using Student t test. For the normally distributed GFR data, Pearson’s correlation coefficient was also calculated. Statistical Package for the Social Sciences (SPSS), version 24.0, software and MS Excel were used for analysis. Results: Out of 50 subjects studied, 38 (76%) were females and 12 (24%) were males. Majority of donors were spouses. The mean GFR measured by 99mTc-DTPA scan was 99.47±14.4 ml/min/1.73m2 and 62.1±11.5 ml/min/1.73 m2 pre and postdonation respectively. All the equations being evaluated in this study underestimated the GFR as measured by 99mTc DTPA renal scan prior to kidney donation whereas GFR estimation postdonor nephrectomy by CG CrCl and CG GFR overestimated the GFR values while Urine CrCl underestimated it. Conclusion: All the equations performed unsatisfactorily. Even the best performing equation urine-CrCl was also found to be suboptimal for donor evaluation. More accurate methods of GFR estimation, should, thus be used keeping the potential risks of living kidney donation in perspective.

scholarly journals Comparative Assessment of Glomerular Filtration Rate (GFR) Google APPs and CKD Prepare GFR India Google App

2021 ◽  
pp. 63-69
Author(s):  
P. B. Shah ◽  
L. Jeyaseelan ◽  
P. Soundararajan ◽  
B. W. C. Sathiyasekaran
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Mobile Applications ◽  
Filtration Rate ◽  
Comparative Assessment ◽  
Single View ◽  
Single User Interface ◽  
Gfr Estimation ◽  
Google Apps

Aim: Glomerular filtration rate (GFR) estimation is an important parameter for assessment of kidney function and management of the patient with suspected kidney function. These mobile applications hence change the way better patient care is managed. In the research project, there is an attempt to perform comparative assessment of GFR Google APPs and CKD PREPARE GFR India Google APP.  Methods: Google app store was searched to identify all the applications which may help in estimation of GFR. All the application were compared except general medical calculators and non-English applications. All important parameters were identified with the guidance of delphi group and comparison chart was made. Results: The search of Google play store led to 35 mobile applications related to GFR estimation. The majority of the applications were by IT company developers and  few were by associations or individuals. There are few companies who have developed multiple mobile applications with different formulas. Many of these aspects of the mobile applications which are considered had important parameters. Few of the applications have multiple page interfaces which may lead to multiple clicks before reaching to GFR estimation which may be at times may be difficult in case of large amounts of use.  Conclusion: All the GFR estimation applications are comparable. Single user interface applications have advantages over others where all the data can be entered and results are available in a single view. The disclaimer of using calculators under medical guidance of a qualified physicians is always required.

Net urate reabsorption in the Dalmatian coach hound with a note on automated measurement of urate in species with low plasma urate

1982 ◽  
Vol 60 (12) ◽  
pp. 1499-1504 ◽  
Author(s):  
B. Moulin ◽  
P. Vinay ◽  
N. Duong ◽  
A. Gougoux ◽  
G. Lemieux
Keyword(s):  
Glomerular Filtration Rate ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Progressive Reduction ◽  
Clearance Ratio ◽  
Plasma Urate ◽  
Urate Reabsorption ◽  
Dalmatian Dog ◽  
Pyrazinoic Acid

A progressive reduction of renal blood flow and glomerular filtration rate induced by the stepwise clamping of a Goldblatt clamp increases the urate over creatinine clearance ratio from 1.2 to 1.9 in normal urate-secreting Dalmatian dogs. These clearance data support the existence of a predominant postreabsorptive secretory flux of urate in the normal Dalmatian dog. In contrast, in Dalmatians loaded with pyrazinoic acid which suppresses urate secretion, net reabsorption of urate is unmasked and the urate over creatinine clearance ratio decreases with the progressive reduction in glomerular filtration rate (down to 0.44). It is concluded that the net reabsorption of urate measured by conventional clearance techniques after pharmacologic depression of the urate secretory flux probably reflects true urate reabsorption in the nephron of this species.

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