Comparison of creatinine based and kidney volume based methods of estimating glomerular filtration rates in potential living kidney donors. 2013

Yen Seow Benjamin Goh, and Mei Wen Fiona Wu, and Bee Choo Tai, and King Chien Joe Lee, and Lata Raman, and Boon Wee Teo, and Anatharaman Vathsala, and Ho Yee Tiong
Department of Urology, National University Health System, Republic of Singapore.

OBJECTIVE Accurate assessment of kidney function is critical to evaluate living kidney donors. Direct glomerular filtration rate measurement using isotopes is currently the gold standard but it is complex and costly. We evaluated the performance of surrogate markers of the glomerular filtration rate in living kidney donors by comparing direct measurement of the rate to the creatinine based equation estimated rate, the kidney volume based estimated rate using a newly developed equation and creatinine clearance. METHODS We first statistically compared direct glomerular filtration rate measurement to the results of the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) creatinine based equations, and to creatinine clearance in 54 potential renal donors from 2006 to 2010. In 32 donors with cross-sectional computerized tomography available we used measured functional renal volume with age, gender, weight and serum creatinine to estimate the rate based on kidney volume according to a previously reported model. Kidney volume based measurement was compared to direct glomerular filtration rate measurement and assessed against the results of the best performing creatinine based equation. RESULTS In the first group of 54 donors the correlation index of the estimated glomerular filtration rate according to MDRD and CKD-EPI creatinine based equations, and to creatinine clearance was low compared to direct measurement. In the subset of 32 potential donors the kidney volume based estimated rate correlated better with direct measurement than MDRD equation results with higher accuracy (estimated 87.5% and 75.0% within 30% and 10% of direct rate measurement, respectively). CONCLUSIONS To estimate the glomerular filtration rate in healthy individuals a volume based model correlated better than the MDRD equation, which is the best performing creatinine based equation used to estimate the rate. By providing a more robust estimation of the glomerular filtration rate in healthy potential kidney donors, the volume based model adds value to routine preoperative computerized tomography above that of anatomical evaluation.

UI MeSH Term Description Entries
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D008297 Male Males
D008433 Mathematics The deductive study of shape, quantity, and dependence. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Mathematic
D008962 Models, Theoretical Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment. Experimental Model,Experimental Models,Mathematical Model,Model, Experimental,Models (Theoretical),Models, Experimental,Models, Theoretic,Theoretical Study,Mathematical Models,Model (Theoretical),Model, Mathematical,Model, Theoretical,Models, Mathematical,Studies, Theoretical,Study, Theoretical,Theoretical Model,Theoretical Models,Theoretical Studies
D009929 Organ Size The measurement of an organ in volume, mass, or heaviness. Organ Volume,Organ Weight,Size, Organ,Weight, Organ
D003404 Creatinine Creatinine Sulfate Salt,Krebiozen,Salt, Creatinine Sulfate,Sulfate Salt, Creatinine
D005260 Female Females
D005919 Glomerular Filtration Rate The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance. Filtration Rate, Glomerular,Filtration Rates, Glomerular,Glomerular Filtration Rates,Rate, Glomerular Filtration,Rates, Glomerular Filtration
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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