Comparison of MDRD equations and the old equations CKD-EPI against new equations CKD-EPI in patients with kidney transplantation when used 51Cr-EDTA to measure glomerular filtration

Utiel, Francisco José Borrego; Navarro, Ana García; Rosa, Rafael José Esteban de la; Soto, Juan Antonio Bravo

doi:10.1016/j.nefroe.2020.02.001

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…31 Chronic diseases, muscle mass alterations, and advanced age affect serum creatinine. 32 BMI also affects creatinine excretion and interpretation UACR. This implies that both GF measurement and estimation, based on creatinine, would lead to a significant underestimation bias.…”

Section: Discussionmentioning

confidence: 99%

Chronic kidney disease prevalence in asymptomatic patients with risk factors—usefulness of serum cystatin C: a cross-sectional study

Avila,

Luciardi,

Oldano

et al. 2023

Porto Biomedical Journal

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Background: Chronic kidney disease is recognized as a worldwide public health problem, particularly within an increasing prevalence of obesity, diabetes mellitus, and hypertension. This disease affects more than 13% of the world's population and is increasing. Further biochemical assessment with new biomarkers, such as serum cystatin C (CysC), would improve patient care and disease control. The aim of this study was to detect chronic kidney disease (CKD) in asymptomatic subjects with risk factors and evaluate CysC as early biomarker of renal damage and accurate test to estimation glomerular filtration (GF). Methods: This observational analytic and cross-sectional design included 195 patients of both sexes. A full clinical evaluation included height, weight, waist circumference, body mass index (BMI), blood pressure (BP), and family history of disease. Renal function was evaluated through serum creatinine (SCrea), serum CysC, urinary albumin, and urinary creatinine. GF was calculated using CKD-EPI creatinine (CKD-EPI Crea) and CKD-EPI creatinine-cystatin C equations (CKD-EPI Crea-CysC). Results: Renal injury showed 24% of patients with albuminuria; 18% of them were categorized as A2 and 6% as A3. Therefore, 73% had no progression risk (baseline risk), 20% moderate risk, and 7% high risk. Among analyzed groups, significant differences were found in BMI, BP, Screa, CysC, CKD-EPI Crea, and CKD-EPI Crea-CysC. Overweight population was analyzed by assessing CysC and calculating CKD-EPI Crea-CysC, showing an important change with respect to the general population. Conclusion: Combined CysC and Crea measurement provides incremental improvement in predicting measured GF.

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Section: Discussionmentioning

confidence: 99%

Chronic kidney disease prevalence in asymptomatic patients with risk factors—usefulness of serum cystatin C: a cross-sectional study

Avila,

Luciardi,

Oldano

et al. 2023

Porto Biomedical Journal

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“…Patient’s demographics and clinical data including sex, age, systolic blood pressure (SBP), diastolic blood pressure, serum hemoglobin, platelet, erythrocyte sedimentation rate, prothrombin time, activated partial thromboplastin time, fibrinogen (FIB), D-dimer, serum albumin, serum globulin, serum creatinine, eGFR, serum uric acid, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, serum IgG, serum IgA, serum IgE, Complement 3, Complement 4, C-reactive protein, and proteinuria and hematuria levels were collected at the time of renal biopsy. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation [10]. For the evaluation of pathologic injuries in IgAN, the Oxford classification was utilized (MEST-C: M, mesangial hypercellularity; E, endocapillary hypercellularity; S, segmental glomerulosclerosis; T, tubular atrophy/interstitial fibrosis; and C, crescent) [11].…”

Section: Methodsmentioning

confidence: 99%

Prognosis of IgA Nephropathy with Stages 3b-5 CKD

Wu,

Li,

Liu

et al. 2024

Kidney Blood Press Res

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Introduction: There are conflicting opinions regarding the use of immunosuppressant treatment in IgA nephropathy (IgAN) patients with an estimated glomerular filtration rate (eGFR) of less than 45 mL/min/1.73 m2 and persistent proteinuria with a daily excretion of ≥1.0 g. Methods: This retrospective study involved 110 IgAN patients for whom clinical data were available; of these, 90 had complete follow-up data. Patients were grouped based on whether they received immunotherapy during follow-up, their renal function, proteinuria levels, and the percentage of crescentic glomeruli observed at the time of renal biopsy. Results: The mean eGFR for the participants was 32.0 ± 10.2 mL/min/1.73 m2. The average follow-up duration was 46.1 ± 37.9 months. The mean rate of decline in eGFR was 3.6 mL/min/1.73 m2 per year. There were 43 (47.8%) composite kidney endpoints occurred in these patients. In the group that received immunotherapy, the incidence of kidney endpoint events was lower than in the untreated group (45.1% vs. 57.9%), but the difference was not statistically significant (p = 0.320). Among patients with stage CKD 3b, the incidence of endpoint events was lower than in those with stages CKD 4 and 5 (36.8% vs. 66.7%, p = 0.006). Conversely, the high proteinuria group saw a higher incidence of endpoint events compared to the low proteinuria group (51.9% vs. 23.1%), although this difference was not statistically significant (p = 0.054). Meanwhile, there was no significant difference in the incidence of endpoint events between the two crescent glomerular ratio groups (48.7% vs. 41.7%, p = 0.649). Kaplan-Meier survival analysis indicated that renal function level (p < 0.001) and proteinuria (p = 0.023) were associated with renal survival in IgAN patients. In contrast, the administration of immunosuppressive therapy (p = 0.288) and the prevalence of C lesions (p = 0.982) did not show a significant association with renal survival. Further, Cox regression analysis identified systolic blood pressure, fibrinogen, and CKD stage as risk factors for eGFR decline in IgAN patients (all p < 0.05). Conclusion: IgAN patients with stages 3b-5 CKD exhibited a poor prognosis. It appears that in this specific cohort of IgAN patients, immunosuppressive therapy may not provide significant advantages over supportive care therapeutic regimens in terms of disease management.

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“…Therefore, the Modification of Diet in Renal Disease (MDRD) equation was used to calculate the eGFR as 19 it provides at least a better accuracy of eGFR in adults to adults kidney transplant recipients than the Chronic Kidney Disease Epidemiology Collaboration equation. 20 , 21 Proteinuria was evaluated by measuring the protein/creatinine-ratio (normal range < 11 mg/mmol) at 6 months after transplantation and annually thereafter. Blood pressure was measured at every visit and was recorded at specified time points.…”

Section: Methodsmentioning

confidence: 99%

Excellent Clinical Long-Term Outcomes of Kidney Transplantation From Small Pediatric Donors (Age ≤ 5 Years) Despite Early Hyperfiltration Injury

Burkhalter

Holzmann

Georgalis

et al. 2023

Can J Kidney Health Dis

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Background: The use of small pediatric donors (age ≤ 5 years and body weight < 20kg) for adult transplant recipients is still regarded controversially in terms of early complications, long-term outcomes, and development of hyperfiltration injury due to body size mismatch. Objective: To investigate long-term outcomes of adult renal allograft recipients receiving a kidney from small pediatric donor (SPD) in terms of kidney function and early features of hyperfiltration injury such as histological changes and proteinuria. Design: Retrospective, single center study. Settings: Transplant center of the University Hospital of Basel, Switzerland. Patients: Adult renal allograft recipients receiving a kidney from a small pediatric donor at our center between 2005 and 2017. Methods: The outcome of 47 transplants from SPD were compared with 153 kidney transplants from deceased-standard criteria donors (SCD) occurring during the same time period. Incidence of clinical signs of hyperfiltration injury (eg, proteinuria) was investigated. According to our policy, surveillance biopsies were taken at 3 and 6 months post-transplant and were evaluated in terms of signs of hyperfiltration injury. Results: At a median follow-up of 2.3 years post-transplant, death-censored graft survival of SPD was comparable to transplants from SCD (94% vs 93%; P = .54). Furthermore, allograft function at last follow-up (estimated glomerular filtration rate–Modification of Diet in Renal Disease) was significantly higher in pediatric transplant (80 vs 55 ml/min/1.73 m2, P = .002). We found histological signs of early hyperfiltration injury in 55% of SPD. There was an equally low proteinuria in both groups during follow-up. Limitations: It is a single center and retrospective observational study with small sample size. The outcomes were investigated in a well-selected population of recipients with low body mass index, low immunological risk, and well-controlled hypertension and was not compared with equal selected group of recipients. Conclusions: Early histological and clinical signs of hyperfiltration injury in SPD is frequent. Despite the hyperfiltration injury, there is an equal allograft survival and even superior allograft function in SPD compared with SCD during follow-up. This observation supports the concept of high adaptive capacity of pediatric donor kidneys.

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Comparison of MDRD equations and the old equations CKD-EPI against new equations CKD-EPI in patients with kidney transplantation when used 51Cr-EDTA to measure glomerular filtration

Cited by 7 publications

References 26 publications

Chronic kidney disease prevalence in asymptomatic patients with risk factors—usefulness of serum cystatin C: a cross-sectional study

Chronic kidney disease prevalence in asymptomatic patients with risk factors—usefulness of serum cystatin C: a cross-sectional study

Prognosis of IgA Nephropathy with Stages 3b-5 CKD

Excellent Clinical Long-Term Outcomes of Kidney Transplantation From Small Pediatric Donors (Age ≤ 5 Years) Despite Early Hyperfiltration Injury

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