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Estimated glomerular filtration rate for longitudinal follow-up of living kidney donors.

Authors
  • van Londen, Marco1
  • Wijninga, Anthony B1
  • de Vries, Jannieta1
  • Sanders, Jan-Stephan F1
  • de Jong, Margriet F C1
  • Pol, Robert A2
  • Berger, Stefan P1
  • Navis, Gerjan1
  • de Borst, Martin H1
  • 1 Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands. , (Netherlands)
  • 2 Department of Surgery, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands. , (Netherlands)
Type
Published Article
Journal
Nephrology Dialysis Transplantation
Publisher
Oxford University Press
Publication Date
Jun 01, 2018
Volume
33
Issue
6
Pages
1054–1064
Identifiers
DOI: 10.1093/ndt/gfx370
PMID: 29481686
Source
Medline
Language
English
License
Unknown

Abstract

Living kidney donor safety requires reliable long-term follow-up of renal function after donation. The current study aimed to define the precision and accuracy of post-donation estimated glomerular filtration rate (eGFR) slopes compared with measured GFR (mGFR) slopes. In 349 donors (age 51 ± 10, 54% female), we analysed eGFR according to the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault/body surface area (CG/BSA), creatinine clearance (CrCl) and mGFR (125I-iothalamate) changes from 3 months until 5 years post-donation. Donors had a pre-donation mGFR of 116 ± 23 mL/min, at 3 months post-donation mGFR was 73 ± 14 mL/min and at 5 years it was 79 ± 16 mL/min. Between 3 months and 5 years post-donation, 28% of donors had a declining mGFR (-0.82 ± 0.79 mL/min/year), 47% were stable and 25% had an increasing mGFR. Overall, eGFR equations showed good slope estimates (bias eGFRCKD-EPI 0.13 ± 2.16 mL/min/year, eGFRMDRD 0.19 ± 2.10 mL/min/year, eGFRCG/BSA -0.08 ± 2.06 mL/min/year, CrCl -0.12 ± 4.75 mL/min/year), but in donors with a decreasing mGFR the slope was underestimated (bias eGFRCKD-EPI 1.41 ± 2.03 mL/min/year, eGFRMDRD 1.51 ± 1.96 mL/min/year, eGFRCG/BSA 1.20 ± 1.87 mL/min/year). The CrCl had a high imprecision [bias interquartile range -1.51-3.41 mL/min/year]. All eGFR equations underestimated GFR slopes in donors with a declining GFR between 3 months and 5 years post-donation. This study underlines the value of mGFR in the follow-up of donors with risk of progressive GFR loss.

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