Malik Suhail Iqbal, Abideen Zain Ul, Alam Muhammad Fiyaz, Khan Raheel, Habib Rashid, Shah Syed Umair
Department of Nephro Urology Dialysis & Renal Transplantation, Bahawal Victoria Hospital, Quaid-e-Azam Medical College, Bahawalpur, PAK.
Department of Nephro Urology Dialysis & Renal Transplantation, Bahawal Victoria Hospital, Quaid e Azam Medical College, Bahawalpur, PAK.
Cureus. 2021 Nov 15;13(11):e19588. doi: 10.7759/cureus.19588. eCollection 2021 Nov.
Background Accurate estimation of the donor's glomerular filtration rate (GFR) is crucial for not only ensuring the medical appropriateness of the donor but also for the prediction of future allograft performance. The aim of this study was to compare the GFR estimation formulas and 24-hour urine creatinine clearance with diethylene triamine pentaacetic acid (DTPA) renal scan GFR. Methods This cross-sectional study was done at the Department of Nephro Urology Dialysis & Renal Transplantation, Bahawal Victoria Hospital, Quaid e Azam Medical College, Bahawalpur, Pakistan from September 2018 to September 2021. A total of 92 potential healthy live-related kidney donors of both genders, aged 18 to 60 years having body mass index below 35 kg/m were included. GFR was calculated with modification of diet in renal disease (MDRD), Cockcroft-Gault (CG), chronic kidney disease epidemiology (CKD-EPI) equations as well as by 24-hour urine creatinine clearance. DTPA renal scan was done to record GFR findings. GFR was compared using analysis of variance (ANOVA) among different methods. Results Out of a total of 92 individuals, 49 (53.3%) were male and 43 (46.7%) female. Mean age and BMI were noted to be 34.62±10.57 years and 24.40±2.71 kg/m, respectively. Statistically significant differences existed between various methods of GFR estimation (p<0.001). Mean GFR as per DTPA renal scan findings was noted to be 97.32±9.39 ml/min/1.73 m. Difference of 31.48±20.81, 27.37±21.1, 23.38±6.38, 15.52±37.52 was noted in estimated GFR (ml/min/1.73 m) with CG formula, MDRD formula, EPI-CKD formula and 24-hour urine creatinine clearance respectively when compared with DTPA renal scan findings. The highest proportion of patients was seen with normal GFR with DTPA renal scan findings as 83 (90.2%) individuals while 24-hour urine creatinine clearance observed these to be 59 (64.1%), CG EPI-CKD formula 44 (47.8%), MDRD formula 39 (42.4%) and 40 (43.5%) with CG formula. Conclusion None of the GFR estimation methods resulted in similar findings. With reference to the DTPA renal scan, 24-hour urine creatinine clearance was the closest GFR estimation followed by CKD-EPI and MDRD equations.
准确估算供体的肾小球滤过率（GFR）不仅对于确保供体的医学适宜性至关重要，而且对于预测未来同种异体移植物的性能也很关键。本研究的目的是比较GFR估算公式以及24小时尿肌酐清除率与二乙三胺五乙酸（DTPA）肾扫描GFR。
这项横断面研究于2018年9月至2021年9月在巴基斯坦巴哈瓦尔布尔的巴哈瓦尔维多利亚医院、真纳医学院的肾泌尿透析与肾移植科进行。纳入了92名年龄在18至60岁、体重指数低于35kg/m²的潜在健康的亲属活体肾供体，男女不限。采用肾病饮食改良（MDRD）公式、Cockcroft-Gault（CG）公式、慢性肾脏病流行病学（CKD-EPI）公式以及24小时尿肌酐清除率来计算GFR。进行DTPA肾扫描以记录GFR结果。使用方差分析（ANOVA）比较不同方法之间的GFR。
在总共92名个体中，49名（53.3%）为男性，43名（46.7%）为女性。平均年龄和BMI分别为34.62±10.57岁和24.40±2.71kg/m²。GFR估算的各种方法之间存在统计学显著差异（p<0.001）。根据DTPA肾扫描结果，平均GFR为97.32±9.39ml/min/1.73m²。与DTPA肾扫描结果相比，CG公式、MDRD公式、EPI-CKD公式和24小时尿肌酐清除率估算的GFR（ml/min/1.73m²）差异分别为31.48±20.81、27.37±21.1、23.38±6.38、15.52±37.52。DTPA肾扫描结果显示GFR正常的患者比例最高，为83名（90.2%）个体，而24小时尿肌酐清除率观察到这一比例为59名（64.1%），CG公式、EPI-CKD公式为44名（47.8%），MDRD公式为39名（42.4%），CG公式为40名（43.5%）。
没有一种GFR估算方法得出相似的结果。参照DTPA肾扫描，24小时尿肌酐清除率是最接近GFR估算值的，其次是CKD-EPI和MDRD公式。
