Appraisal of GFR-estimating equations following kidney donation.
BACKGROUND
It is not clear which serum creatinine-based glomerular filtration rate (GFR)-estimating model performs best in kidney donors.


METHODS
Study of diagnostic accuracy.


METHODS
From a population of 3,698 kidney donors, 255 donors underwent iohexol GFR measurement (mGFR). INDEX TEST (INTERVENTION): mGFR by means of plasma disappearance of iohexol.


METHODS
GFR was estimated (eGFR) by using the Cockcroft-Gault equation (eGFR(CG)), Mayo Clinic equation (eGFR(MC)), and Modification of Diet in Renal Disease (MDRD) Study equation (eGFR(MDRD)).


RESULTS
Mean mGFR was 71.8 +/- 11.8 mL/min/1.73 m(2), and 85.5% had mGFR greater than 60 mL/min/1.73 m(2). eGFR(CG) underestimated mGFR by 3.96 +/- 13.3 mL/min/1.73 m(2) and was within 30% of mGFR 89.4% of the time. eGFR(MC) overestimated mGFR by 8.44 +/- 11.9 mL/min/1.73 m(2) and was within 30% of mGFR in 83.1% of cases. eGFR(MDRD) underestimated mGFR by only 0.43 +/- 11.7 mL/min/1.73 m(2), and the proportion within 30% of mGFR was greatest in the tested model; 94.1% of the time. However, eGFR(MC) was most accurate in classifying donors according to having eGFR less than 60 mL/min/1.73 m(2).


CONCLUSIONS
Lack of ethnic diversity and response bias.


CONCLUSIONS
The MDRD Study equation is least biased, and because it is routinely reported by most laboratories, it is the best readily available model for estimating GFR in kidney donors.
Sebasky
Meghan
M
Division of Renal Diseases and Hypertension, University of Minnesota, Minneapolis, MN 55414, USA. ibrah007@umn.edu
Kukla
Aleksandra
A
Leister
Erin
E
Guo
Hongfei
H
Akkina
Sanjeev K
SK
El-Shahawy
Yasser
Y
Matas
Arthur J
AJ
Ibrahim
Hassan N
HN
D000328:Adult; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007668:Kidney / Q000502:physiology; D007674:Kidney Diseases / Q000097:blood / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods / Q000502:physiology / Q000639:trends; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods / Q000639:trends