title: Assessment of kidney function in lung transplant candidates.
abstract: BACKGROUND
  Glomerular filtration rate (GFR) is the best measure of kidney function; however, 24-hour creatinine clearance (CrCl) is the initial screening test used for lung transplant candidates at most centers. Although creatinine-based formulas that estimate GFR have been derived, none have been validated in patients with severe lung disease.
  
  
  METHODS
  We performed a retrospective cohort study of patients evaluated for lung transplantation at Columbia Presbyterian Medical Center and compared the GFR estimated from the Modification of Diet in Renal Disease (MDRD) and other formulas to the CrCl. We then validated these results in a cohort of patients evaluated at the Hospital of the University of Pennsylvania.
  
  
  RESULTS
  There were strong and statistically significant direct correlations between estimated GFR and CrCl. An estimated GFR of <95 ml/min by the MDRD was very sensitive at detecting kidney dysfunction by CrCl in the derivation cohort. In the validation cohort, the negative predictive value of this cut-off was 97%.
  
  
  CONCLUSIONS
  Established formulas for estimating GFR are highly discriminating for kidney dysfunction in patients being evaluated for lung transplantation and may actually have greater validity than CrCl in some instances.
authors.affiliation: Lung Transplant Program, Columbia University, New York, New York 10032, USA.
authors.forename: Nadine
authors.initials: N
authors.lastname: Al-Naamani
authors.forename: Omar H
authors.initials: OH
authors.lastname: Maarouf
authors.forename: Vivek N
authors.initials: VN
authors.lastname: Ahya
authors.forename: David J
authors.initials: DJ
authors.lastname: Lederer
authors.forename: James D
authors.initials: JD
authors.lastname: Mendez
authors.forename: Jessie S
authors.initials: JS
authors.lastname: Wilt
authors.forename: Alden M
authors.initials: AM
authors.lastname: Doyle
authors.forename: Debbie
authors.initials: D
authors.lastname: Rybak
authors.forename: Frank
authors.initials: F
authors.lastname: D'Ovidio
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Sonett
authors.forename: Selim M
authors.initials: SM
authors.lastname: Arcasoy
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Nickolas
authors.forename: Steven M
authors.initials: SM
authors.lastname: Kawut
mesh_terms: D000328:Adult; D003404:Creatinine / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000503:physiopathology*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003404:Creatinine