title: A comparison of glomerular filtration rate by creatinine based equations and DTPA-renogram in healthy adult kidney donors.
abstract: BACKGROUND
  Accurate determination of donor kidney function has important long-term implications for both donor health and recipient outcome. Many centers use 24 hour urinary creatinine clearance or creatinine-based GFR estimations to assess kidney function but their performance when compared with GFR measurements by isotope clearance remains inconclusive. We assessed the performance of creatinine based equations against DTPA GFR for evaluating Nepalese kidney donors.
  
  
  METHODS
  All kidney donors who had undergone both DTPA GFR estimation and 24 hour urine CrCl were included. The performance of the urine-CrCl, CG-CrCl, modiﬁed MDRD GFR against DTPA GFR was evaluated by analyzing global bias, precision (R2),Pearson correlation and accuracy percentage within 30% and 15%. The sensitivity and speciﬁcity of each predictive equation in selecting donor with GFR of ≥80 mL/min/1.73 m2 was also calculated.
  
  
  RESULTS
  Of 51 donors analysed, only 18 (35.29%) were male. The mean measured GFR was 102.752±16.71 mL/min/1.73 m2. Of all prediction equations, urine-CrCL has most precision (R2=0.207) with the highest pearson correlation (0.455) and highest accuracy percentage within 30% and 15%. However, predictive performance was poor for all the equations. The urine CrCl had highest sensitivity of 100% for detecting donor with measured GFR>80 mL/min/1.73 m2 with positive predictive value of 92.1%.
  
  
  CONCLUSIONS
  The performance of all equations was disappointing and even the best performing equation urine-CrCl was suboptimal for donor selection. So considering the potential risk of living kidney donation, other more accurate methods of GFR estimation should be used.
authors.affiliation: Department of Nephrology, Bir Hospital.
authors.forename: Ramesh Kumar
authors.initials: RK
authors.lastname: Chaurasia
authors.affiliation: Department of Nephrology, Bir Hospital.
authors.forename: Rajendra Kumar
authors.initials: RK
authors.lastname: Agrawal
authors.affiliation: Department of Nephrology, Bir Hospital.
authors.forename: Rajani
authors.initials: R
authors.lastname: Hada
authors.affiliation: Kanti Children Hospital, Kathmandu, Nepal.
authors.forename: Sweta Kumari
authors.initials: SK
authors.lastname: Chaurasia
authors.affiliation: Department of Nephrology, Bir Hospital.
authors.forename: Santosh
authors.initials: S
authors.lastname: Gurung
authors.affiliation: Department of Nephrology, Bir Hospital.
authors.forename: Shakti
authors.initials: S
authors.lastname: Basnet
mesh_terms: D000328:Adult; D000368:Aged; D003404:Creatinine / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D016284:Technetium Tc 99m Pentetate; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D003404:Creatinine; D016284:Technetium Tc 99m Pentetate