Cantarovich Marcelo, Yoshida Eric M, Peltekian Kevork M, Marotta Paul J, Greig Paul D, Kneteman Norman M, Marleau Denis, Barkun Jeffrey
Royal Victoria Hospital, McGill University Health Centre, Montréal, QC, Canada.
Transplantation. 2006 Aug 15;82(3):433-6. doi: 10.1097/01.tp.0000228888.31242.2b.
The utility of formulas estimating glomerular filtration rate (GFR) in liver transplant patients has not been well described. The purpose is to determine the correlation between the radionuclide GFR (rGFR) with formulas commonly used to estimate GFR. This study represented a secondary outcome measure of a multicenter randomized trial comparing the effectiveness of two immunosuppressive regimens in adult liver transplant patients (n=148). A total of 68 rGFR were measured, 33 at baseline and at 35 at three months after transplantation. GFR was estimated using 1/Scr and Cockcroft-Gault, MDRD, and Nankivell equations. At both time points assessed, all correlations with rGFR were poor: 1/Scr (r: 0.17 and 0.25), Cockcroft-Gault (r: 0.31 and 0.35), MDRD (r: 0.27 and 0.35), and Nankivell (r: 0.11 and 0.20). Accepted formulas to estimate GFR correlate poorly with rGFR during the first three months after liver transplantation. Recalibration of these formulas is required to improve the estimation of GFR in liver transplant patients.
估算肝移植患者肾小球滤过率(GFR)的公式的实用性尚未得到充分描述。目的是确定放射性核素GFR(rGFR)与常用的估算GFR的公式之间的相关性。本研究是一项多中心随机试验的次要结局指标,该试验比较了两种免疫抑制方案对成年肝移植患者(n = 148)的有效性。共测量了68次rGFR,其中33次在基线时测量,35次在移植后三个月时测量。使用1/Scr以及Cockcroft-Gault、MDRD和Nankivell方程估算GFR。在评估的两个时间点,所有与rGFR的相关性均较差:1/Scr(r分别为0.17和0.25)、Cockcroft-Gault(r分别为0.31和0.35)、MDRD(r分别为0.27和0.35)以及Nankivell(r分别为0.11和0.20)。在肝移植后的前三个月,公认的估算GFR的公式与rGFR的相关性较差。需要对这些公式进行重新校准,以改善对肝移植患者GFR的估算。