Logo-npj
Submitted: 03 Nov 2021
Accepted: 15 Apr 2022
ePublished: 24 Apr 2022
EndNote EndNote

(Enw Format - Win & Mac)

BibTeX BibTeX

(Bib Format - Win & Mac)

Bookends Bookends

(Ris Format - Mac only)

EasyBib EasyBib

(Ris Format - Win & Mac)

Medlars Medlars

(Txt Format - Win & Mac)

Mendeley Web Mendeley Web
Mendeley Mendeley

(Ris Format - Win & Mac)

Papers Papers

(Ris Format - Win & Mac)

ProCite ProCite

(Ris Format - Win & Mac)

Reference Manager Reference Manager

(Ris Format - Win only)

Refworks Refworks

(Refworks Format - Win & Mac)

Zotero Zotero

(Ris Format - Firefox Plugin)

J Nephropharmacol. 2022;11(2): e10443.
doi: 10.34172/npj.2022.10443
  Abstract View: 2528
  PDF Download: 221

Original

Comparison of creatinine-based glomerular filtration rate estimation equations in voluntary Indian kidney donors: A single centre study

Shankar Prasad Nagaraju 1 ORCID logo, Kosuru Srinivas 2 ORCID logo, Mohan V Bhojaraja 1* ORCID logo, Srinivas Vinayak Shenoy 1 ORCID logo, Indu Ramachandra Rao 1 ORCID logo, Ravindra Attur Prabhu 1 ORCID logo, Dharshan Rangaswamy 1 ORCID logo, Vasudev Guddattu 3 ORCID logo, Veena Natti Krishna 4 ORCID logo, Megha Nagaraj Nayak 4 ORCID logo

1 Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy Higher Education, Madhav Nagar, Manipal, Udupi, Karnataka 576104, India
2 Consultant Nephrologist and Transplant Physician, Mahatma Gandhi Hospitals, Narasaraopet, Guntur, Andhra Pradesh 522601, India
3 Department of Statistics, Prasanna School of Public Health, Manipal, Manipal Academy of Higher Education, Madhav Nagar, Manipal, Udupi, Karnataka 576104, India
4 Department of Renal Replacement Therapy and Dialysis Technology (RRT & DT), Manipal, Manipal Academy Higher Education, Madhav Nagar, Manipal, Udupi, Karnataka 576104, India
*Corresponding Author: Corresponding author: Mohan V Bhojaraja, Email: vbmohan86@gmail.com, , Email: mohan.vb@manipal.edu

Abstract

Introduction: In transplantation, accurate estimation of the donor glomerular filtration rate (GFR) is crucial. While various creatinine-based equations are in use, none are validated in Indians.

Objectives: This study was conducted to judge the accuracy of creatinine-based GFR estimation equations and urinary creatinine clearance.

Patients and Methods: A single-centre, observational and retrospective study at a tertiary care hospital. Adult voluntary donors GFR measured (mGFR) by technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA) were included. The primary outcome was the performance of estimated GFR (eGFR) by “Cockcroft-Gault’s formula corrected for body surface area (CG-BSA) formula”, “modification of diet in renal disease (MDRD) 4 and 6 variable equation” and “Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation”; secondary outcome was the performance of “24-hour urinary creatinine clearance (Cr Cl)”.

Results: 102 kidney donors were analysed with mean age of 45.89 ± 9.98 years and 85.3% females. Mean ± SD mGFR by Tc-99m DTPA was 82.11 ± 14.32 mL/min/1.73 m2 . Mean ± SD eGFR by “CGBSA” was 99.68 ± 23.71 mL/min/1.73 m2 , by “MDRD-4 variable equation” was 98.25 ± 28.61 mL/ min/1.73 m2 , by “MDRD-6 variable equation” was 93.66 ± 19.44 ml/min/1.73 m2 and by “CKD-EPI” was 111.14 ± 31.61 mL/min/1.73 m2 . The lowest bias (2.3), highest precision (16.23), and accuracy (97.1%) were with “MDRD-6 variable equation”; “24-hour urinary Cr Cl” highly overestimated GFR (158.27 mL/min/1.73 m2 ) with the highest bias, lowest precision, and accuracy.

Conclusion: The “MDRD-6 variable equation” was the most precise and accurate of the equations, whereas “24-hour urinary Cr Cl” was the least dependable. This study highlights the need for a correction factor or a new GFR estimation equation and not to consider urinary Cr Cl to assess donor GFR.


Implication for health policy/practice/research/medical education:

There are very few studies on Indian kidney donors and in this study among the existing estimated glomerular filtration rate (eGFR) equations, the modification of diet in renal disease (MDRD)-6 variable equation showed the highest precision and accuracy in correlation to measured (mGFR) by technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA) in our population. As per the authors’ knowledge, this is the first study wherein we are comparing the measured GFR by technetium99m diethylenetriaminepentaacetic acid (Tc-99m DTPA) against all the creatinine-based GFR estimation equations and 24- hour urinary creatinine clearance. This study highlights the fact that for donor evaluation in the Indian population none of the existing GFR estimation equations is accurate and there is a need for a correction factor to existing equations or a newer equation for our population. 24-hour urinary creatinine clearance should not be considered as a donor GFR estimation measure due to its variability and poor reliability.

Please cite this paper as: Nagaraju SP, Srinivas K, Bhojaraja MV, Shenoy SV, Rao IR, Prabhu RA, Rangaswamy D, Guddattu V, Krishna VN, Nayak MN. Comparison of creatinine-based glomerular filtration rate estimation equations in voluntary Indian kidney donors: A single centre study. J Nephropharmacol. 2022;11(2):e10443. DOI: 10.34172/npj.2021.10443.

First Name
 
Last Name
 
Email Address
 
Comments
 
Security code


Abstract View: 2529

Your browser does not support the canvas element.


PDF Download: 221

Your browser does not support the canvas element.