Burballa Carla, Crespo Marta, Redondo-Pachón Dolores, Pérez-Sáez María José, Mir Marisa, Arias-Cabrales Carlos, Francés Albert, Fumadó Lluis, Cecchini Lluis, Pascual Julio
Servicio de Nefrología, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, España.
Servicio de Urología, Hospital del Mar, Universitat Autónoma de Barcelona, Barcelona, España.
Nefrologia (Engl Ed). 2018 Mar-Apr;38(2):207-212. doi: 10.1016/j.nefro.2017.02.007. Epub 2017 Apr 12.
The evaluation of the measured Glomerular Filtration Rate (mGFR) or estimated Glomerular Filtration Rate (eGFR) is key in the proper assessment of the renal function of potential kidney donors. We aim to study the correlation between glomerular filtration rate estimation equations and the measured methods for determining renal function.
We analysed the relationship between baseline GFR values measured by Tc-m-DTPA (diethylene-triamine-pentaacetate) and those estimated by the four-variable Modification of Diet in Renal Disease (MDRD4) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in a series of living donors at our institution.
We included 64 donors (70.6% females; mean age 48.3±11 years). Baseline creatinine was 0.8±0.1 mg/dl and it was 1.1±0.2 mg/dl one year after donation. The equations underestimated GFR when measured by Tcm-DTPA (MDRD4-9.4 ± 25ml/min, P<.05, and CKD-EPI-4.4 ± 21ml/min). The correlation between estimation equations and the measured method was superior for CKD-EPI (r=.41; P<.004) than for MDRD4 (r=.27; P<.05). eGFR decreased to 59.6±11 (MDRD4) and 66.2±14ml/min (CKD-EPI) one year after donation. This means a mean eGFR reduction of 28.2±16.7 ml/min (MDRD4) and 27.31±14.4 ml/min (CKD-EPI) at one year.
In our experience, CKD-EPI is the equation that better correlates with mGFR-Tcm-DTPA when assessing renal function for donor screening purposes.
测量的肾小球滤过率(mGFR)或估算的肾小球滤过率(eGFR)的评估是正确评估潜在肾脏供体肾功能的关键。我们旨在研究肾小球滤过率估算方程与测定肾功能的测量方法之间的相关性。
我们分析了在我们机构的一系列活体供体中,通过锝-亚甲基二膦酸盐(Tc-m-DTPA,二乙烯三胺五乙酸)测量的基线GFR值与通过四变量肾病饮食改良(MDRD4)和慢性肾脏病流行病学协作组(CKD-EPI)方程估算的基线GFR值之间的关系。
我们纳入了64名供体(70.6%为女性;平均年龄48.3±11岁)。基线肌酐为0.8±0.1mg/dl,捐献后一年为1.1±0.2mg/dl。当通过Tc-m-DTPA测量时,这些方程低估了GFR(MDRD4为-9.4±25ml/min,P<0.05;CKD-EPI为-4.4±21ml/min)。CKD-EPI估算方程与测量方法之间的相关性(r = 0.41;P<0.004)优于MDRD4(r = 0.27;P<0.05)。捐献后一年,eGFR降至59.6±11(MDRD4)和66.2±14ml/min(CKD-EPI)。这意味着一年时eGFR平均降低28.2±16.7ml/min(MDRD4)和27.31±14.4ml/min(CKD-EPI)。
根据我们的经验,在为供体筛查目的评估肾功能时,CKD-EPI方程与mGFR-Tc-m-DTPA的相关性更好。