MDRD Equations for Estimation of GFR in Renal Transplant Recipients

Pöge, Uwe; Gerhardt, Thomas; Palmedo, Holger; Klehr, H. U.; Sauerbruch, Tilman; Woitas, Rainer P.

doi:10.1111/j.1600-6143.2005.00861.x

Cited by 172 publications

(113 citation statements)

References 24 publications

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“…eGFR was calculated by the abbreviated formula provided by the Modification of Diet in Renal Disease study. 34 The immunosuppressive regimen consisted of induction therapy (68% rabbit ATG or IL-2r), intravenous methylprednisolone, and a calcineurin inhibitor with mycophenolate with or without maintenance prednisone. The presence of DGF was defined as the need for at least one dialysis treatment within the first 7 d after transplantation.…”

Section: Patientsmentioning

confidence: 99%

Tubular Expression of KIM-1 Does not Predict Delayed Function After Transplantation

Schröppel

Krüger

Walsh³

et al. 2010

Journal of the American Society of Nephrology

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Injured epithelial cells of the proximal tubule upregulate the glycoprotein kidney injury molecule 1 (KIM-1), suggesting its potential as a biomarker of incipient kidney allograft injury. It is unknown whether KIM-1 expression changes in kidney allografts with delayed graft function (DGF), which often follows ischemia-reperfusion injury. Here, we prospectively measured KIM-1 RNA and protein expression in preperfusion biopsies of 30 living-and 85 deceased-donor kidneys and correlated the results with histologic and clinical outcomes after transplantation. We detected KIM-1 expression in 62% of deceased-donor kidneys and only 13% of living-donor kidneys (P Ͻ 0.0001). The level of KIM-1 expression before reperfusion correlated inversely with renal function at the time of procurement and correlated directly with the degree of interstitial fibrosis. Surprising, however, we did not detect a significant correlation between KIM-1 staining intensity and the occurrence of DGF. Our findings are consistent with a role for KIM-1 as an early indicator of tubular injury but do not support tissue KIM-1 measurement before transplantation to identify kidneys at risk for DGF.

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Section: Patientsmentioning

confidence: 99%

Tubular Expression of KIM-1 Does not Predict Delayed Function After Transplantation

Schröppel

Krüger

Walsh³

et al. 2010

Journal of the American Society of Nephrology

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“…Patient factors that were tested were race; age; gender; weight; albumin level; alanine transferase; bilirubin; alkaline phosphatase; hemoglobin; red blood cell count; DGF; diabetes; cyclosporine dose; cyclosporine predose concentration; MMF dose; corticosteroid dose; the use of antiviral agents, proton pump inhibitors, antacids, H 2 -antagonists, and sirolimus; and renal function. With regard to renal function, two estimates were tested: Estimation of creatinine clearance according to the Cockcroft and Gault formula (C&G) (34) and estimation of the GFR with the abbreviated Modification of Diet in Renal Disease (aMDRD) method (35). First, all different variables were tested in the model developed during the first step, in a univariate way.…”

Section: Pharmacokinetic Analysismentioning

confidence: 99%

Explaining Variability in Mycophenolic Acid Exposure to Optimize Mycophenolate Mofetil Dosing

Hest¹,

Mathôt²,

Pescovitz

et al. 2006

Journal of the American Society of Nephrology

175

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Large between-and within-patient variability has been observed in the pharmacokinetics of mycophenolic acid (MPA). However, conflicting results exist about the influence of patient characteristics that explain the variability in MPA exposure. This population pharmacokinetic meta-analysis of MPA in renal transplant recipients was performed to explore whether race, renal function, albumin level, delayed graft function, diabetes, and co-medication are determinants of total MPA exposure. A total of 13,346 MPA concentration-time data points from 468 renal transplant patients who participated in six clinical studies were combined and analyzed retrospectively. Sampling occasions ranged from day 1 after transplantation to 10 yr after transplantation. Concentration-time data were analyzed with nonlinear mixed-effect modeling. Exposure to total MPA, as determined by MPA clearance, significantly increased with increasing renal function, albumin level, and hemoglobin as well as decreasing cyclosporine predose level (P < 0.001). These variables could explain 18% of the between-patient and 38% of the within-patient variability in MPA exposure. Differences in MPA exposure between patients with or without delayed graft function or between patients of different races are likely to be caused by the effect of renal function on MPA exposure. Diabetes did not have an effect on MPA exposure. The clinical implication is that a change in renal function or albumin level provides an indication for therapeutic drug monitoring as MPA exposure may be altered. Patients in whom cyclosporine and mycophenolate mofetil are combined may need higher mycophenolate mofetil doses, especially during the early phase after transplantation than currently recommended for optimal MPA exposure.

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“…However, in kidney transplants, the Modification of Diet in Renal Disease equation has been validated as an accurate indicator of estimated kidney function and is better than other formulas. 22 In addition, the older living donors were 45 to 66 years, and we do not know whether this result is consistent for older donors than donors in this cohort and in the donation after cardiac death cohort.…”

Section: Discussionmentioning

confidence: 96%

Untitled

Suri²,

Huang³

et al. 2014

Exp Clin Transplant

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Objectives: The purpose of this study was to evaluate the effect of donor-recipient body surface area ratio on donor age and donor glomerular filtration rate in living-donor kidney transplant. Materials and Methods: This retrospective study included 254 rejection-free patients who underwent their first living-donor kidney transplant at our center between April 2007 and April 2011. We performed multivariate linear regression and receiver operating characteristic curve analyses to determine independent associations and the cumulative effects on posttransplant graft function and outcomes in persons in China who had a livingdonor kidney transplant. Results: In multivariate linear regression, donor age, donor estimated glomerular filtration rate, and donor-recipient body surface area ratio were independent predictors of 1-year graft function. Linear regression showed that correcting donor age by donor-recipient body surface area ratio increased the strength of the correlation between donor age and 1-year graft function. In the older group (donor age ≥ 45 y), the effect of donor-recipient body surface area ratio on graft function was stronger. By considering the 1-year donor estimated glomerular filtration rate in 2 groups (< 60 or ≥ 60 mL/min/1.73 m 2 ), the cutoff values for corrected donor age was 55 years and donor estimated glomerular filtration rate before surgery was 113 mL/min/1.73 m 2 . Conclusions: By correcting for donor-recipient body surface area ratio, donor age accurately predicted and correlated better with 1 year graft function. During preoperative evaluation donor and recipient body surface area matching may be useful.

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MDRD Equations for Estimation of GFR in Renal Transplant Recipients

Cited by 172 publications

References 24 publications

Tubular Expression of KIM-1 Does not Predict Delayed Function After Transplantation

Tubular Expression of KIM-1 Does not Predict Delayed Function After Transplantation

Explaining Variability in Mycophenolic Acid Exposure to Optimize Mycophenolate Mofetil Dosing

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