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

scholarly journals Estimating Glomerular Filtration Rate in Black South Africans by Use of the Modification of Diet in Renal Disease and Cockcroft-Gault Equations

2008 ◽  
Vol 54 (7) ◽  
pp. 1197-1202 ◽  
Author(s):  
Hendrick E van Deventer ◽  
Jaya A George ◽  
Janice E Paiker ◽  
Piet J Becker ◽  
Ivor J Katz
Keyword(s):  
Glomerular Filtration Rate ◽  
African Americans ◽  
Renal Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Gfr ◽  
South Africans ◽  
Mdrd Equation ◽  
Black South Africans ◽  
Measured Gfr

Abstract Background: The 4-variable Modification of Diet in Renal Disease (4-v MDRD) and Cockcroft-Gault (CG) equations are commonly used for estimating glomerular filtration rate (GFR); however, neither of these equations has been validated in an indigenous African population. The aim of this study was to evaluate the performance of the 4-v MDRD and CG equations for estimating GFR in black South Africans against measured GFR and to assess the appropriateness for the local population of the ethnicity factor established for African Americans in the 4-v MDRD equation. Methods: We enrolled 100 patients in the study. The plasma clearance of chromium-51–EDTA (51Cr-EDTA) was used to measure GFR, and serum creatinine was measured using an isotope dilution mass spectrometry (IDMS) traceable assay. We estimated GFR using both the reexpressed 4-v MDRD and CG equations and compared it to measured GFR using 4 modalities: correlation coefficient, weighted Deming regression analysis, percentage bias, and proportion of estimated GFR within 30% of measured GFR (P30). Results: The Spearman correlation coefficient between measured and estimated GFR for both equations was similar (4-v MDRD R2 = 0.80 and CG R2 = 0.79). Using the 4-v MDRD equation with the ethnicity factor of 1.212 as established for African Americans resulted in a median positive bias of 13.1 (95% CI 5.5 to 18.3) mL/min/1.73 m2. Without the ethnicity factor, median bias was 1.9 (95% CI −0.8 to 4.5) mL/min/1.73 m2. Conclusions: The 4-v MDRD equation, without the ethnicity factor of 1.212, can be used for estimating GFR in black South Africans.

Performance of creatinine-based equations for estimating glomerular filtration rate changes over time

2018 ◽  
Vol 35 (5) ◽  
pp. 819-827 ◽  
Author(s):  
Marieke H C van Rijn ◽  
Marie Metzger ◽  
Martin Flamant ◽  
Pascal Houillier ◽  
Jean-Philippe Haymann ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Patient Characteristics ◽  
Estimated Gfr ◽  
Changes Over Time ◽  
Over Time ◽  
Measured Gfr

Abstract Background Glomerular filtration rate (GFR) is commonly used to monitor chronic kidney disease (CKD) progression, but its validity for evaluating kidney function changes over time has not been comprehensively evaluated. We assessed the performance of creatinine-based equations for estimating GFR slope according to patient characteristics and specific CKD diagnosis. Methods In the NephroTest cohort study, we measured GFR 5324 times by chromium 51–labeled ethylenediamine tetraacetic acid renal clearance in 1955 adult patients with CKD Stages 1–4 referred to nephrologists (Stages 1–2, 19%) and simultaneously estimated GFR with both the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations for isotope dilution mass spectrometry traceable creatinine; absolute and relative GFR slopes were calculated using a linear mixed model. Results Over a median follow-up of 3.4 [interquartile range (IQR) 2.0–5.6] years, the decline in mean absolute and relative measured GFR (mGFR) and CKD-EPI and MDRD estimated GFR (eGFR) was 1.6 ± 1.2, 1.5 ± 1.4 and 1.3 ± 1.3 mL/min/1.73 m2/year and 5.9 ± 5.3, 5.3 ± 5.3 and 4.8 ± 5.2%/year, respectively; 52% and 55% of the patients had MDRD and CKD-EPI eGFR slopes within 30% of mGFR slopes. Both equations tended to overestimate the GFR slope in the youngest patients and underestimate it in the oldest, thus producing inverse associations between age and mGFR versus eGFR slope. Other patient characteristics and specific CKD diagnoses had little effect on the performance of the equations in estimating associations. Conclusions This study shows little bias, but poor precision in GFR slope estimation for both MDRD and CKD-EPI equations. Importantly, bias strongly varied with age, possibly due to variations in muscle mass over time, with implications for clinical care and research.

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 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.

Renal function – estimation of glomerular filtration rate

2006 ◽  
Vol 44 (11) ◽  
Author(s):  
Lothar Thomas ◽  
Andreas R. Huber
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Routine Laboratory ◽  
Prediction Equations

AbstractAssessment and follow-up of renal dysfunction is important in the early detection and management of chronic kidney disease. The glomerular filtration rate (GFR) is the most accurate measurement of kidney disease and is reduced before the onset of clinical symptoms. Drawbacks to the measurement of GFR include the high cost and incompatibility with routine laboratory monitoring. Serum creatinine determination is a mainstay in the routine laboratory profile of renal function. The measurement of serum cystatin C has been proposed as a more sensitive marker for GFR. According to National Kidney Foundation-K/DOQ1 clinical guidelines for chronic kidney disease, serum markers should not be used alone to assess GFR. Based on prediction equations, clinical laboratories should report an estimate of GFR, in addition to reporting the serum value. In this article, information is presented on how best to estimate GFR using prediction equations for adults and for children. Using serum creatinine concentration with the Modification of Diet in Renal Disease (MDRD) study equation offers a suitable estimation of GFR in adults. The cystatin C prediction equation with the use of a prepubertal factor seems superior to creatinine-based prediction equations in children of <14years.Clin Chem Lab Med 2006;44:1295–302.

FP250ASSESSING THE VALIDITY OF DIFFERENT PREDICTION EQUATIONS FOR ESTIMATING GLOMERULAR FILTRATION RATE AMONG HEALTHY ADULT BANGLADESHI POPULATION

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii150-iii150
Author(s):  
Palash Mitra ◽  
Wasim Mohammad Mohosinul Haque ◽  
Muhammad Abdur Rahim ◽  
Tasrina Shamnaz Samdani ◽  
Sarwar Iqbal ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Healthy Adult ◽  
Prediction Equations ◽  
Bangladeshi Population

scholarly journals Carboplatin Dosing in Children Using Estimated Glomerular Filtration Rate: Equation Matters

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5963
Author(s):  
Mirjam E. van de Velde ◽  
Emil den Bakker ◽  
Hester N. Blufpand ◽  
Gertjan L. Kaspers ◽  
Floor C. H. Abbink ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Drug Exposure ◽  
Estimated Glomerular Filtration Rate ◽  
Estimated Gfr ◽  
Dependent Change ◽  
Dosing Regimens

Renal function-based carboplatin dosing using measured glomerular filtration rate (GFR) results in more consistent drug exposure than anthropometric dosing. We aimed to validate the Newell dosing equation using estimated GFR (eGFR) and study which equation most accurately predicts carboplatin clearance in children with retinoblastoma. In 13 children with retinoblastoma 38 carboplatin clearance values were obtained from individual fits using MWPharm++. Carboplatin exposure (AUC) was calculated from administered dose and observed carboplatin clearance and compared to predicted AUC calculated with a carboplatin dosing equation (Newell) using different GFR estimates. Different dosing regimens were compared in terms of accuracy, bias and precision. All patients had normal eGFR. Carboplatin exposure using cystatin C-based eGFR equations tended to be more accurate compared to creatinine-based eGFR (30% accuracy 76.3–89.5% versus 76.3–78.9%, respectively), which led to significant overexposure, especially in younger (aged ≤ 2 years) children. Of all equations, the Schwartz cystatin C-based equation had the highest accuracy and lowest bias. Although anthropometric dosing performed comparably to many of the eGFR equations overall, we observed a weight-dependent change in bias leading to underdosing in the smallest patients. Using cystatin C-based eGFR equations for carboplatin dosing in children leads to more accurate carboplatin-exposure in patients with normal renal function compared to anthropometric dosing. In children with impaired kidney function, this trend might be more pronounced. Anthropometric dosing is hampered by a weight-dependent bias.

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