Estimated Glomerular Filtration Rate in Renal Transplantation: The Nephrologist in the Mist.
Transplantation
; 99(12): 2625-33, 2015 Dec.
Article
em En
| MEDLINE
| ID: mdl-26247554
ABSTRACT
BACKGROUND:
Formulas do not estimate renal function with acceptable precision and accuracy.METHODS:
We compared 51 creatinine-based and/or cystatin c-based formulas with a gold standard (iohexol plasma clearance) in 193 renal transplant recipients using concordance correlation coefficient, total deviation index, coverage probability and the error in chronic kidney disease (CKD) stage classification.RESULTS:
No formula showed a concordance correlation coefficient greater than 0.90 (average for creatinine-based formulas â¼0.70 and for cystatin c-based formulas â¼0.85). A wide total deviation index was observed approximately 70% (creatinine-based) and approximately 50% (cystatin c-based), indicating that 90% of the estimations showed bounds of error of ±70% or ±50%, respectively, compared with the gold standard. No formula included 90% of the estimations within a coverage probability of ±10%. Half the CKD stages classified by creatinine-based formulas were incorrect, mainly due to overestimation of renal function. One of 3 CKD stages diagnosed by cystatin c-based formulas was incorrect, with both overestimation and underestimation. Overall, the formulas showed very low precision and accuracy and a high degree of error in reflecting real renal function.CONCLUSIONS:
In conclusion, formulas do not properly reflect renal function in kidney transplantation, which makes their use in clinical practice unreliable. Moreover, their use in clinical trials should be avoided.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transplante de Rim
/
Insuficiência Renal Crônica
/
Transplantados
/
Taxa de Filtração Glomerular
/
Sobrevivência de Enxerto
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Transplantation
Ano de publicação:
2015
Tipo de documento:
Article
País de publicação:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
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UNITED STATES OF AMERICA
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US
/
USA