Performance of different prediction equations for estimating renal function in kidney transplantation

Flavio Gaspari, Silvia Ferrari, Nadia Stucchi, Emmanuel Centemeri, Fabiola Carrara, Marisa Pellegrino, Giulia Gherardi, Eliana Gotti, Giuseppe Segoloni, Maurizio Salvadori, Paolo Rigotti, Umberto Valente, Donato Donati, Silvio Sandrini, Vito Sparacino, Giuseppe Remuzzi, Norberto Perico

Research output: Contribution to journalArticlepeer-review

Abstract

Numerous formulas have been developed to estimate renal function from biochemical, demographic and anthropometric data. Here we compared renal function derived from 12 published prediction equations with glomerular filtration rate (GFR) measurement by plasma iohexol clearance as reference method in a group of 81 renal transplant recipients enrolled in the Mycophenolate Mofetil Steroid Sparing (MY.S.S.) trial. Iohexol clearances and prediction equations were carried out in all patients at months 6, 9 and 21 after surgery. All equations showed a tendency toward GFR over-estimation: Walser and MDRD equations gave the best performance, however not more than 45% of estimated values were within ±10% error. These formulas showed also the lowest bias and the highest precision: 0.5 and 9.2 mL/min/1.73 m2 (Walser), 2.7 and 10.4 mL/min/1.73 m2 (MDRD) in predicting GFR. A significantly higher rate of GFR decline ranging from -5.0 mL/min/1.73 m 2/year (Walser) to -7.4 mL/min/1.73 m2/year (Davis-Chandler) was estimated by all the equations as compared with iohexol clearance (-3.0 mL/min/1.73 m2/year). The 12 prediction tion equations do not allow a rigorous assessment of renal function in kidney transplant recipients. In clinical trials of kidney transplantation, graft function should be preferably monitored using a reference method of GFR measurement, such as iohexol plasma clearance.

Original languageEnglish
Pages (from-to)1826-1835
Number of pages10
JournalAmerican Journal of Transplantation
Volume4
Issue number11
DOIs
Publication statusPublished - Nov 2004

Keywords

  • GFR calculations
  • Iohexol clearance
  • Serum creatinine

ASJC Scopus subject areas

  • Immunology

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