title: Validity of estimated glomerular filtration rates for assessment of renal function after renal artery stenting in patients with atherosclerotic renal artery stenosis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the validity of estimates of glomerular filtration rate (eGFR) for assessing serial changes in renal function after renal artery stenting.
  
  
  BACKGROUND
  eGFR are unreliable for assessing serial renal function in patients with atherosclerotic renal artery stenosis (RAS). eGFR have not been validated for assessment of serial renal function after renal artery stenting.
  
  
  METHODS
  Serum creatinine (SCr) and (125)I-iothalamate GFR (iGFR) were measured in RAS patients before and after renal artery stenting. eGFR were calculated from Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft-Gault (CG) formulas. Using iGFR as the reference standard, the sensitivity, specificity, and area under the receiver-operating characteristic curve (AUC) were determined for MDRD, CKD-EPI, and CG for assessing changes in GFR before and after intervention.
  
  
  RESULTS
  Between 1998 and 2007, 84 patients underwent iGFR and eGFR before and after renal artery stenting. All eGFR demonstrated poor sensitivity and reliability for detecting ≥20% changes in iGFR, and poor agreement in the magnitude and direction of change in iGFR, before and after renal stenting.
  
  
  CONCLUSIONS
  In RAS patients, eGFR demonstrate poor sensitivity and reliability for detecting meaningful changes in iGFR after renal artery stenting. eGFR should be abandoned as primary endpoints in major clinical trials assessing the impact of renal revascularization on renal function.
authors.affiliation: Department of Cardiovascular Medicine and Oakland University William Beaumont School of Medicine, Beaumont Health System, Royal Oak, Michigan.
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Crimmins
authors.affiliation: Department of Cardiovascular Medicine and Oakland University William Beaumont School of Medicine, Beaumont Health System, Royal Oak, Michigan.
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Madder
authors.affiliation: Department of Cardiovascular Medicine and Oakland University William Beaumont School of Medicine, Beaumont Health System, Royal Oak, Michigan.
authors.forename: Victor
authors.initials: V
authors.lastname: Marinescu
authors.affiliation: Department of Cardiovascular Medicine and Oakland University William Beaumont School of Medicine, Beaumont Health System, Royal Oak, Michigan. Electronic address: rsafian@beaumont.edu.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Safian
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007483:Iothalamic Acid; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D012078:Renal Artery Obstruction / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015203:Reproducibility of Results; D015607:Stents; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007483:Iothalamic Acid; D003404:Creatinine
keywords: glomerular filtration rate; renal artery stenosis; renal artery stent