Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors
Abstract Background Reliable determination of glomerular filtration rate (GFR) is crucial in the evaluation of living kidney donors. Although some guidelines recommend the use of measured GFR (mGFR), many centres still rely on estimated GFR (eGFR) obtained through equations or 24-h creatinine cleara...
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| Veröffentlicht in: | Clinical kidney journal 2019-10, Vol.12 (5), p.748-755 |
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| creator | González-Rinne, Ana Luis-Lima, Sergio Escamilla, Beatriz Negrín-Mena, Natalia Ramírez, Ana Morales, Adelaida Vega, Nicanor García, Patricia Cabello, Elisa Marrero-Miranda, Domingo Aldea-Perona, Ana Alvarez, Alejandra Abad, María del Carmen Pérez-Tamajón, Lourdes González-Rinne, Federico González-Delgado, Alejandra Díaz Martín, Laura Jiménez-Sosa, Alejandro Torres, Armando Porrini, Esteban |
| description | Abstract
Background
Reliable determination of glomerular filtration rate (GFR) is crucial in the evaluation of living kidney donors. Although some guidelines recommend the use of measured GFR (mGFR), many centres still rely on estimated GFR (eGFR) obtained through equations or 24-h creatinine clearance. However, eGFR is neither accurate nor precise in reflecting real renal function. We analysed the impact of eGFR errors on evaluation and decision making regarding potential donors.
Methods
We evaluated 103 consecutive living donors who underwent mGFR via iohexol plasma clearance and eGFR by 51 creatinine- and/or cystatin C–based equations. The cut-off for living donation in our centre is GFR > 80 mL/min for donors >35 years of age or 90 mL/min for those |
| doi_str_mv | 10.1093/ckj/sfz012 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6768301</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A613867100</galeid><oup_id>10.1093/ckj/sfz012</oup_id><sourcerecordid>A613867100</sourcerecordid><originalsourceid>FETCH-LOGICAL-c475t-eb63932ad2332763a3a20fdbb2ee4d358fbe6b93dfaeaab68b38c222832669b03</originalsourceid><addsrcrecordid>eNp9kV1rFDEUhoMottTe-AMkIIIUts3HTDZzI5TFaqHgjV7HfJxs084k22SmsP56M0xdLIjJRc7Hc15OeBF6S8k5JR2_sPd3F8X_IpS9QMeMNHIlW8pfHmLSHqHTUu5IPbVDmvY1OuK0lU0rumP083rYaTvi5DHknHKZI5tBjyGGCFhHh-2-jHOONxgephqlWHBNx1vABXqwc2We68NjiFt8H1yEPXYpVr036JXXfYHTp_cE_bj6_H3zdXXz7cv15vJmZZt1O67ACN5xph3jnK0F11wz4p0xDKBxvJXegDAdd16D1kZIw6VljEnOhOgM4Sfo06K7m8wAzkIcs-7VLodB571KOqjnnRhu1TY9KrEWkhNaBT4-CeT0MEEZ1RCKhb7XEdJUFKtQU5eTrKLvF3Sre1Ah-lQV7YyrS0G5FGtK5o3O_0HV62AINkXwodafDZwtAzanUjL4w_aUqNlsVc1Wi9kVfvf3fw_oH2sr8GEB0rT7n9Bv6IuzFA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2301433282</pqid></control><display><type>article</type><title>Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford Journals Open Access Collection</source><source>PubMed Central</source><creator>González-Rinne, Ana ; Luis-Lima, Sergio ; Escamilla, Beatriz ; Negrín-Mena, Natalia ; Ramírez, Ana ; Morales, Adelaida ; Vega, Nicanor ; García, Patricia ; Cabello, Elisa ; Marrero-Miranda, Domingo ; Aldea-Perona, Ana ; Alvarez, Alejandra ; Abad, María del Carmen ; Pérez-Tamajón, Lourdes ; González-Rinne, Federico ; González-Delgado, Alejandra ; Díaz Martín, Laura ; Jiménez-Sosa, Alejandro ; Torres, Armando ; Porrini, Esteban</creator><creatorcontrib>González-Rinne, Ana ; Luis-Lima, Sergio ; Escamilla, Beatriz ; Negrín-Mena, Natalia ; Ramírez, Ana ; Morales, Adelaida ; Vega, Nicanor ; García, Patricia ; Cabello, Elisa ; Marrero-Miranda, Domingo ; Aldea-Perona, Ana ; Alvarez, Alejandra ; Abad, María del Carmen ; Pérez-Tamajón, Lourdes ; González-Rinne, Federico ; González-Delgado, Alejandra ; Díaz Martín, Laura ; Jiménez-Sosa, Alejandro ; Torres, Armando ; Porrini, Esteban</creatorcontrib><description>Abstract
Background
Reliable determination of glomerular filtration rate (GFR) is crucial in the evaluation of living kidney donors. Although some guidelines recommend the use of measured GFR (mGFR), many centres still rely on estimated GFR (eGFR) obtained through equations or 24-h creatinine clearance. However, eGFR is neither accurate nor precise in reflecting real renal function. We analysed the impact of eGFR errors on evaluation and decision making regarding potential donors.
Methods
We evaluated 103 consecutive living donors who underwent mGFR via iohexol plasma clearance and eGFR by 51 creatinine- and/or cystatin C–based equations. The cut-off for living donation in our centre is GFR > 80 mL/min for donors >35 years of age or 90 mL/min for those <35 years of age. We analysed the misclassification of donors based on the cut-off for donation-based eGFR.
Results
Ninety-three subjects (90.3%) had mGFR values above (donors) and 10 [9.7% (95% confidence interval 5.4–17)] below (non-donors) the cut-off. In non-donors, most of the equations gave eGFR values above the cut-off, so donation would have been allowed based on eGFR. All non-donors were female with reduced weight, height and body surface. In donors, up to 32 cases showed eGFR below the cut-off, while mGFR was actually higher. Therefore an important number of donors would not have donated based on eGFR alone.
Conclusion
The misclassification of donors around the cut-off for donation is very common with eGFR, making eGFR unreliable for the evaluation of living kidney donors. Whenever possible, mGFR should be implemented in this setting.</description><identifier>ISSN: 2048-8505</identifier><identifier>EISSN: 2048-8513</identifier><identifier>DOI: 10.1093/ckj/sfz012</identifier><identifier>PMID: 31584569</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Contrast media ; Creatinine ; Decision making ; Gifts ; Glomerular filtration rate ; Medical research ; Organ transplantation ; Setting (Literature) ; Tissue donation ; Transplantation ; Type 2 diabetes</subject><ispartof>Clinical kidney journal, 2019-10, Vol.12 (5), p.748-755</ispartof><rights>The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. 2019</rights><rights>The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.</rights><rights>COPYRIGHT 2019 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-eb63932ad2332763a3a20fdbb2ee4d358fbe6b93dfaeaab68b38c222832669b03</citedby><cites>FETCH-LOGICAL-c475t-eb63932ad2332763a3a20fdbb2ee4d358fbe6b93dfaeaab68b38c222832669b03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768301/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768301/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,1599,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31584569$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>González-Rinne, Ana</creatorcontrib><creatorcontrib>Luis-Lima, Sergio</creatorcontrib><creatorcontrib>Escamilla, Beatriz</creatorcontrib><creatorcontrib>Negrín-Mena, Natalia</creatorcontrib><creatorcontrib>Ramírez, Ana</creatorcontrib><creatorcontrib>Morales, Adelaida</creatorcontrib><creatorcontrib>Vega, Nicanor</creatorcontrib><creatorcontrib>García, Patricia</creatorcontrib><creatorcontrib>Cabello, Elisa</creatorcontrib><creatorcontrib>Marrero-Miranda, Domingo</creatorcontrib><creatorcontrib>Aldea-Perona, Ana</creatorcontrib><creatorcontrib>Alvarez, Alejandra</creatorcontrib><creatorcontrib>Abad, María del Carmen</creatorcontrib><creatorcontrib>Pérez-Tamajón, Lourdes</creatorcontrib><creatorcontrib>González-Rinne, Federico</creatorcontrib><creatorcontrib>González-Delgado, Alejandra</creatorcontrib><creatorcontrib>Díaz Martín, Laura</creatorcontrib><creatorcontrib>Jiménez-Sosa, Alejandro</creatorcontrib><creatorcontrib>Torres, Armando</creatorcontrib><creatorcontrib>Porrini, Esteban</creatorcontrib><title>Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors</title><title>Clinical kidney journal</title><addtitle>Clin Kidney J</addtitle><description>Abstract
Background
Reliable determination of glomerular filtration rate (GFR) is crucial in the evaluation of living kidney donors. Although some guidelines recommend the use of measured GFR (mGFR), many centres still rely on estimated GFR (eGFR) obtained through equations or 24-h creatinine clearance. However, eGFR is neither accurate nor precise in reflecting real renal function. We analysed the impact of eGFR errors on evaluation and decision making regarding potential donors.
Methods
We evaluated 103 consecutive living donors who underwent mGFR via iohexol plasma clearance and eGFR by 51 creatinine- and/or cystatin C–based equations. The cut-off for living donation in our centre is GFR > 80 mL/min for donors >35 years of age or 90 mL/min for those <35 years of age. We analysed the misclassification of donors based on the cut-off for donation-based eGFR.
Results
Ninety-three subjects (90.3%) had mGFR values above (donors) and 10 [9.7% (95% confidence interval 5.4–17)] below (non-donors) the cut-off. In non-donors, most of the equations gave eGFR values above the cut-off, so donation would have been allowed based on eGFR. All non-donors were female with reduced weight, height and body surface. In donors, up to 32 cases showed eGFR below the cut-off, while mGFR was actually higher. Therefore an important number of donors would not have donated based on eGFR alone.
Conclusion
The misclassification of donors around the cut-off for donation is very common with eGFR, making eGFR unreliable for the evaluation of living kidney donors. Whenever possible, mGFR should be implemented in this setting.</description><subject>Contrast media</subject><subject>Creatinine</subject><subject>Decision making</subject><subject>Gifts</subject><subject>Glomerular filtration rate</subject><subject>Medical research</subject><subject>Organ transplantation</subject><subject>Setting (Literature)</subject><subject>Tissue donation</subject><subject>Transplantation</subject><subject>Type 2 diabetes</subject><issn>2048-8505</issn><issn>2048-8513</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNp9kV1rFDEUhoMottTe-AMkIIIUts3HTDZzI5TFaqHgjV7HfJxs084k22SmsP56M0xdLIjJRc7Hc15OeBF6S8k5JR2_sPd3F8X_IpS9QMeMNHIlW8pfHmLSHqHTUu5IPbVDmvY1OuK0lU0rumP083rYaTvi5DHknHKZI5tBjyGGCFhHh-2-jHOONxgephqlWHBNx1vABXqwc2We68NjiFt8H1yEPXYpVr036JXXfYHTp_cE_bj6_H3zdXXz7cv15vJmZZt1O67ACN5xph3jnK0F11wz4p0xDKBxvJXegDAdd16D1kZIw6VljEnOhOgM4Sfo06K7m8wAzkIcs-7VLodB571KOqjnnRhu1TY9KrEWkhNaBT4-CeT0MEEZ1RCKhb7XEdJUFKtQU5eTrKLvF3Sre1Ah-lQV7YyrS0G5FGtK5o3O_0HV62AINkXwodafDZwtAzanUjL4w_aUqNlsVc1Wi9kVfvf3fw_oH2sr8GEB0rT7n9Bv6IuzFA</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>González-Rinne, Ana</creator><creator>Luis-Lima, Sergio</creator><creator>Escamilla, Beatriz</creator><creator>Negrín-Mena, Natalia</creator><creator>Ramírez, Ana</creator><creator>Morales, Adelaida</creator><creator>Vega, Nicanor</creator><creator>García, Patricia</creator><creator>Cabello, Elisa</creator><creator>Marrero-Miranda, Domingo</creator><creator>Aldea-Perona, Ana</creator><creator>Alvarez, Alejandra</creator><creator>Abad, María del Carmen</creator><creator>Pérez-Tamajón, Lourdes</creator><creator>González-Rinne, Federico</creator><creator>González-Delgado, Alejandra</creator><creator>Díaz Martín, Laura</creator><creator>Jiménez-Sosa, Alejandro</creator><creator>Torres, Armando</creator><creator>Porrini, Esteban</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20191001</creationdate><title>Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors</title><author>González-Rinne, Ana ; Luis-Lima, Sergio ; Escamilla, Beatriz ; Negrín-Mena, Natalia ; Ramírez, Ana ; Morales, Adelaida ; Vega, Nicanor ; García, Patricia ; Cabello, Elisa ; Marrero-Miranda, Domingo ; Aldea-Perona, Ana ; Alvarez, Alejandra ; Abad, María del Carmen ; Pérez-Tamajón, Lourdes ; González-Rinne, Federico ; González-Delgado, Alejandra ; Díaz Martín, Laura ; Jiménez-Sosa, Alejandro ; Torres, Armando ; Porrini, Esteban</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-eb63932ad2332763a3a20fdbb2ee4d358fbe6b93dfaeaab68b38c222832669b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Contrast media</topic><topic>Creatinine</topic><topic>Decision making</topic><topic>Gifts</topic><topic>Glomerular filtration rate</topic><topic>Medical research</topic><topic>Organ transplantation</topic><topic>Setting (Literature)</topic><topic>Tissue donation</topic><topic>Transplantation</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>González-Rinne, Ana</creatorcontrib><creatorcontrib>Luis-Lima, Sergio</creatorcontrib><creatorcontrib>Escamilla, Beatriz</creatorcontrib><creatorcontrib>Negrín-Mena, Natalia</creatorcontrib><creatorcontrib>Ramírez, Ana</creatorcontrib><creatorcontrib>Morales, Adelaida</creatorcontrib><creatorcontrib>Vega, Nicanor</creatorcontrib><creatorcontrib>García, Patricia</creatorcontrib><creatorcontrib>Cabello, Elisa</creatorcontrib><creatorcontrib>Marrero-Miranda, Domingo</creatorcontrib><creatorcontrib>Aldea-Perona, Ana</creatorcontrib><creatorcontrib>Alvarez, Alejandra</creatorcontrib><creatorcontrib>Abad, María del Carmen</creatorcontrib><creatorcontrib>Pérez-Tamajón, Lourdes</creatorcontrib><creatorcontrib>González-Rinne, Federico</creatorcontrib><creatorcontrib>González-Delgado, Alejandra</creatorcontrib><creatorcontrib>Díaz Martín, Laura</creatorcontrib><creatorcontrib>Jiménez-Sosa, Alejandro</creatorcontrib><creatorcontrib>Torres, Armando</creatorcontrib><creatorcontrib>Porrini, Esteban</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical kidney journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>González-Rinne, Ana</au><au>Luis-Lima, Sergio</au><au>Escamilla, Beatriz</au><au>Negrín-Mena, Natalia</au><au>Ramírez, Ana</au><au>Morales, Adelaida</au><au>Vega, Nicanor</au><au>García, Patricia</au><au>Cabello, Elisa</au><au>Marrero-Miranda, Domingo</au><au>Aldea-Perona, Ana</au><au>Alvarez, Alejandra</au><au>Abad, María del Carmen</au><au>Pérez-Tamajón, Lourdes</au><au>González-Rinne, Federico</au><au>González-Delgado, Alejandra</au><au>Díaz Martín, Laura</au><au>Jiménez-Sosa, Alejandro</au><au>Torres, Armando</au><au>Porrini, Esteban</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors</atitle><jtitle>Clinical kidney journal</jtitle><addtitle>Clin Kidney J</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>12</volume><issue>5</issue><spage>748</spage><epage>755</epage><pages>748-755</pages><issn>2048-8505</issn><eissn>2048-8513</eissn><abstract>Abstract
Background
Reliable determination of glomerular filtration rate (GFR) is crucial in the evaluation of living kidney donors. Although some guidelines recommend the use of measured GFR (mGFR), many centres still rely on estimated GFR (eGFR) obtained through equations or 24-h creatinine clearance. However, eGFR is neither accurate nor precise in reflecting real renal function. We analysed the impact of eGFR errors on evaluation and decision making regarding potential donors.
Methods
We evaluated 103 consecutive living donors who underwent mGFR via iohexol plasma clearance and eGFR by 51 creatinine- and/or cystatin C–based equations. The cut-off for living donation in our centre is GFR > 80 mL/min for donors >35 years of age or 90 mL/min for those <35 years of age. We analysed the misclassification of donors based on the cut-off for donation-based eGFR.
Results
Ninety-three subjects (90.3%) had mGFR values above (donors) and 10 [9.7% (95% confidence interval 5.4–17)] below (non-donors) the cut-off. In non-donors, most of the equations gave eGFR values above the cut-off, so donation would have been allowed based on eGFR. All non-donors were female with reduced weight, height and body surface. In donors, up to 32 cases showed eGFR below the cut-off, while mGFR was actually higher. Therefore an important number of donors would not have donated based on eGFR alone.
Conclusion
The misclassification of donors around the cut-off for donation is very common with eGFR, making eGFR unreliable for the evaluation of living kidney donors. Whenever possible, mGFR should be implemented in this setting.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31584569</pmid><doi>10.1093/ckj/sfz012</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical kidney journal, 2019-10, Vol.12 (5), p.748-755 |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford Journals Open Access Collection; PubMed Central |
| subjects | Contrast media Creatinine Decision making Gifts Glomerular filtration rate Medical research Organ transplantation Setting (Literature) Tissue donation Transplantation Type 2 diabetes |
| title | Impact of errors of creatinine and cystatin C equations in the selection of living kidney donors |
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