Estimated or Measured GFR in Living Kidney Donors Work‐up?. Issue 10 (15th July 2016)

• Record Type: Journal Article
• Authors: Gaillard, F.; Flamant, M.; Lemoine, S.; Baron, S.; Timsit, M.‐O.; Eladari, D.; Fournier, C.; Prot‐Bertoye, C.; Bertocchio, J.‐P.; Vidal‐Petiot, E.; Lamhaut, L.; Morelon, E.; Péraldi, M.‐N.; Vrtovsnik, F.; Friedlander, G.; Méjean, A.; Houillier, P.; Legendre, C.; Courbebaisse, M.
• Is Part Of: American journal of transplantation. Volume 16:Issue 10(2016:Oct.)
• Page Start: 3024
• Page End: 3032
• Publication Date: 2016-07-15
• Subjects: clinical research/practice -- kidney transplantation/nephrology -- donors and donation: donor evaluation -- donors and donation: living -- glomerular filtration rate (GFR) -- internet; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.13908
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : The value of estimated glomerular filtration rate (eGFR) in living kidney donors screening is unclear. A recently published web‐based application derived from large cohorts, but not living donors, calculates the probability of a measured GFR (mGFR) lower than a determined threshold. Our objectives were to validate the clinical utility of this tool in a cohort of living donors and to test two other strategies based on chronic kidney disease epidemiology collaboration (CKD‐EPI) and on MDRD‐eGFR. GFR was measured using 51 Cr‐ ethylene‐diamine tetraacetic acid urinary clearance in 311 potential living kidney donors (178 women, mean age 50 ± 11.6 years). The web‐based tool was used to predict those with mGFR < 80 mL/min/1.73 m 2 . Inputs to the application were sex, age, ethnicity, and plasma creatinine. In our cohort, a web‐based probability of mGFR <90 mL/min/1.73 m 2 higher than 2% had 100% sensitivity for detection of actual mGFR <80 mL/min/1.73 m 2 . The positive predictive value was 0.19. A CKD‐EPI‐eGFR threshold of 104 mL/min/1.73 m 2 and an MDRD‐eGFR threshold of 100 mL/min/1.73 m 2 had 100% sensitivity to detect donors with actual mGFR <80 mL/min/1.73 m 2 . We obtained similar results in an external cohort of 354 living donors. We confirm the usefulness of the web‐based application to identify potential donors who should benefit from GFR measurement. Abstract : From two independent cohorts of potential living kidney donors, a web‐based application identifies potential donors with a measured glomerular filtration rate higher than 80 mL/min/1.73 m 2 for whom direct GFR measurement can be safely avoided before donation.