Suitability of the IDMS-traceable MDRD equation method to estimate GFR in early postoperative renal transplant recipients.
OBJECTIVE
Accurate measurement of glomerular filtration rate (GFR) is critical for the management of kidney transplant recipients. Comparison of creatinine and cystatin C in renal transplant recipients gave conflicting results. We aimed to compare the performance of creatinine- and cystatin C-based equations and creatinine clearance in 102 early postoperative Korean renal transplant patients.


METHODS
We measured (51)Cr-EDTA clearance using a 2-compartment model and considered this the reference GFR. Then, we estimated GFR using 13 creatinine- and 7 cystatin C-based equations. Serum creatinine value was calibrated to isotope-dilution mass spectrometry (IDMS).


RESULTS
The mean reference GFR was 76.77 +/- 17.01 ml/min/1.73 m(2). The IDMS-traceable MDRD (IDMS-MDRD) equation had the highest accuracy (94.12 within 30% of the reference; 99.02 within 50% of the reference) with a bias of 0.33 ml/min/1.73 m(2) and a precision of 12.57 ml/min/1.73 m(2). The Mayo Clinic equation also performed well (92.16% within 30% of the reference; 99.02% within 50% of the reference; bias: -0.19 ml/min/1.73 m(2)). As for cystatin C-based equations, the Filler equation had the least bias (0.03 ml/min/1.73 m(2)) but low accuracy (78.43% within 30% of the reference).


CONCLUSIONS
We conclude that the IDMS-MDRD equation provided the best estimate of GFR in our early postoperative Korean renal transplant patients.
Yeo
Youngsun
Y
Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Han
Duck-Jong
DJ
Moon
Dae Hyuk
DH
Park
Jung Sik
JS
Yang
Won Seok
WS
Chang
Jai Won
JW
Byun
Seung Woon
SW
Park
Su-Kil
SK
D000293:Adolescent; D000328:Adult; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D007723:Korea / Q000453:epidemiology; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D011182:Postoperative Care / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D051437:Renal Insufficiency / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult