Tailored Predictive Formulas for Glomerular Filtration Rate for Early Detection of Deteriorating Renal Function After Pediatric Living-Donor Liver Transplant

Exp Clin Transplant. 2018 Dec;16(6):708-713. doi: 10.6002/ect.2017.0159. Epub 2018 Mar 9.

Abstract

Objectives: In pediatric patients, renal dysfunction after living-donor liver transplant is a major issue that is difficult to evaluate. Recently, predictive equations for Japanese children have been introduced.

Materials and methods: We conducted a retrospective study by prospectively collecting data on 26 patients under 16 years old who underwent living-donor liver transplant between June 2004 and March 2015. Serum creatinine and cystatin C levels were measured. Paired t tests and Bland-Altman plots were used to compare the following formulas for estimated glomerular filtration rate: the Schwartz formula and 3 formulas that were matched with Japanese children (polynomial, simple, and cystatin C formulas).

Results: Average estimated glomerular filtrations rates (in mL/min/1.73 m2) were 143.46, 122.90, 121.58, and 123.31 using the Schwartz, polynomial, simple, and cystatin C formulas, respectively. The estimated glomerular filtrations rate for biliary atresia was 141.53 ± 31.37 versus 109.95 ± 19.52 for other diseases, with significant differences only noted with the cystatin C formula. The formulas tailored for Japanese children showed significantly lower estimated glomerular filtrations rates than those obtained using the Schwartz formula (P < .01).

Conclusions: The use of formulas for measuring estimated glomerular filtrations rates that are based on race may allow early detection of deteriorating renal function.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adolescent
  • Age Factors
  • Asian People
  • Biomarkers / blood
  • Child
  • Child, Preschool
  • Creatinine / blood
  • Cystatin C / blood
  • Early Diagnosis
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Infant
  • Japan
  • Kidney / physiopathology*
  • Kidney Diseases / blood
  • Kidney Diseases / diagnosis*
  • Kidney Diseases / ethnology
  • Kidney Diseases / physiopathology
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Living Donors*
  • Male
  • Models, Biological*
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • CST3 protein, human
  • Cystatin C
  • Creatinine