Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot, Lyon, France.
Universidade de Caxias do Sul, Caxias do Sul, Brazil.
Transpl Int. 2019 Jan;32(1):75-83. doi: 10.1111/tri.13333. Epub 2018 Sep 19.
Estimating glomerular filtration rate (GFR) is important for clinical management and research studies in simultaneous pancreas-kidney transplantation (SPK) recipients. No study has specifically investigated the reliability of recent creatinine-based GFR estimating equations in this singular population. We assessed the performances of CKD-EPI, MDRD, Schwartz-2009, Schwartz-Lyon, Lund-Malmo and Full Age Spectrum equations for estimating GFR after SPK. 126 patients were included. GFR was measured by a reference method (mGFR) one year after SPK and estimated with the different equations from a standardized measure of serum creatinine. Relative bias, precisions, 10% and 30% accuracies (P30) were used to determine equations reliability. Ages ranged from 29 to 58. Mean mGFR was 56.3 ± 13.3 [23.6-92.5] ml/min/1.73 m . In the whole population, P30 of the CKD-EPI and MDRD equations were 42% (38.0; 46.0) and 65% (61.5; 69) respectively. As compared to the other equations, the Schwartz-Lyon equation was significantly more accurate (P30 = 86.0% [83.5-88.0], P < 0.01) and less biased (1.13 [1.06-1.19], P < 0.01). Conclusions were similar whatever the age class (<40 or ≥40) and mGFR level (<60 or ≥60 ml/min/1.73 m ). This study suggests that the CKD-EPI and MDRD equations have poor performances in SPK recipients and that the Schwartz-Lyon equation is a reliable alternative.
估算肾小球滤过率（GFR）对于同时进行胰腺和肾脏移植（SPK）受者的临床管理和研究非常重要。尚无研究专门针对这一特殊人群中最近基于肌酐的 GFR 估算方程的可靠性进行研究。我们评估了 CKD-EPI、MDRD、Schwartz-2009、Schwartz-Lyon、Lund-Malmo 和 Full Age Spectrum 方程在 SPK 后估算 GFR 的性能。共纳入 126 例患者。SPK 后 1 年通过参考方法（mGFR）测量 GFR，并通过标准化血清肌酐测量值估算不同方程的 GFR。相对偏差、精度、10%和 30%准确性（P30）用于确定方程的可靠性。年龄范围为 29 至 58 岁。平均 mGFR 为 56.3±13.3[23.6-92.5]ml/min/1.73m 。在整个人群中，CKD-EPI 和 MDRD 方程的 P30 分别为 42%（38.0；46.0）和 65%（61.5；69）。与其他方程相比，Schwartz-Lyon 方程明显更准确（P30=86.0%[83.5-88.0]，P<0.01），偏差更小（1.13[1.06-1.19]，P<0.01）。无论年龄组（<40 或≥40）和 mGFR 水平（<60 或≥60 ml/min/1.73m ），结论均相似。本研究表明，CKD-EPI 和 MDRD 方程在 SPK 受者中的表现不佳，而 Schwartz-Lyon 方程是一种可靠的替代方法。
