PLoS ONE (Jan 2020)

Comparison of creatinine-based equations for estimating glomerular filtration rate in deceased donor renal transplant recipients.

  • Luciano da Silva Selistre,
  • Sandrine Lemoine,
  • Allyriane Dantec,
  • Fanny Buron,
  • Vandréa Carla de Souza,
  • Mariana Bertoldo,
  • Carlos Eduardo Poli-de-Figueiredo,
  • Thomas Rimmelé,
  • Olivier Thaunat,
  • Lionel Badet,
  • Emmanuel Morelon,
  • Antoine Sicard,
  • Laurence Dubourg

DOI
https://doi.org/10.1371/journal.pone.0231873
Journal volume & issue
Vol. 15, no. 4
p. e0231873

Abstract

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BACKGROUND:Estimating glomerular filtration rate (GFR) is important for clinical management in kidney transplantation recipients (KTR). However, very few studies have evaluated the performance of the new GFR estimating equations (Lund-Malmö Revised-LMR, and Full Age Spectrum-FAS) in KTR. METHODS:GFR was estimated (eGFR) using CKD-EPI, MDRD, LMR, and FAS equations and compared to GFR measurement (mGFR) by reference methods (inuline urinary and iohexol plasma clearance) in 395 deceased-donor KTR without corticosteroids. The equations performance was assessed using bias (mean difference of eGFR and mGFR), precision (standard deviation of the difference), accuracy (concordance correlation coefficient-CCC), and agreements (total deviation index-TDI). The area under receiver operating characteristic curves (ROC) and the likelihood ratio for a positive result were calculated. RESULTS:In the total population, the performance of the CKD-EPI, MDRD and FAS equations was significantly lower than the LMR equation regarding the mean [95%CI] difference in bias (-2.0 [-4.0; -1.5] versus 9.0 [7.5; 10.0], 5.0 [3.5; 6.0] and 10.0 [8.5; 11.0] mL/min/1.73m2, P0.900), and LMR equation had the best ability to correctly predict KTR with mGFR<45 mL/min/1.73 m2 (positive likelihood ratio: 8.87 [5.79; 13.52]). CONCLUSION:Among a referral group of subjects KTR, LMR equation had the best mean bias and TDI, but with no significant superiority in other agreement tools. Caveat is required in the use and interpretation of PCr-based equations in this specific population.