Formulas Estimating Glomerular Filtration Rate in the Evaluation of Living Kidney Donor Candidates: Comparison of Different Formulas With Scintigraphy-Measured Glomerular Filtration Rate

Transplant Proc. 2021 Apr;53(3):773-778. doi: 10.1016/j.transproceed.2020.10.007. Epub 2020 Nov 26.

Abstract

Introduction: Estimation of kidney function is crucial in the evaluation of living kidney donor candidates. Despite the multitude of glomerular filtration rate (GFR) formulas, no equation is universal, and none were validated in the population of kidney donors. Novel biomarkers, including beta trace protein (BTP) and cystatin C, are studied to help estimate GFR and improve the safe qualification of living kidney donors.

Aim: This study compares the accuracy of different formulas that estimate GFR with reference scintigraphy-measured GFR in the population of living kidney donor candidates.

Material and methods: This study enrolled 30 healthy living kidney donor candidates. GFR was measured using the following 11 different formulas. For reference, GFR was assessed using 99m-Technetium-diethylenetriaminepentaacetic acid.

Results: The accuracy of estimation was generally low in all formulas. The strongest correlation between measured GFR (mGFR) and estimated GFR (eGFR) was achieved by the Nankivell formula (R = 0.47, P = .009); however, in the group of patients with a body mass index of >25 kg/m2, only the equations based on BTP had a statistically significant correlation with mGFR: White (R = 0.59; P = .016) and Poge (R = 0.53; P = .035). Bland-Altman plots revealed wide limits of agreement between eGFRs and mGFR in all groups of patients.

Conclusion: In living kidney donor candidates, GFR estimation formulas should be chosen individually. White formula, which is based on BTP, may be a promising tool in estimating GFR in overweight potential living kidney donor candidates. More than 1 formula and personalized choice of GFR estimation method regarding the given patient should be performed in qualification of kidney donors.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Body Mass Index
  • Creatinine / blood
  • Cystatin C / blood
  • Donor Selection / methods*
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Intramolecular Oxidoreductases / blood
  • Kidney / diagnostic imaging
  • Kidney / physiopathology
  • Kidney Transplantation*
  • Lipocalins / blood
  • Living Donors / statistics & numerical data*
  • Male
  • Middle Aged
  • Radionuclide Imaging / statistics & numerical data*
  • Statistics as Topic*
  • Technetium Tc 99m Pentetate

Substances

  • Biomarkers
  • CST3 protein, human
  • Cystatin C
  • Lipocalins
  • Creatinine
  • Intramolecular Oxidoreductases
  • prostaglandin R2 D-isomerase
  • Technetium Tc 99m Pentetate