Timed Creatinine Clearance and Measured Glomerular Filtration Rate in Living Kidney Donors.

Timed Creatinine Clearance and Measured Glomerular Filtration Rate in Living Kidney Donors.
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DOI:
10.1016/j.xkme.2022.100572
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发表时间:
2023-01
期刊:
影响因子:
3.9
通讯作者:
Mohan, Sumit
Mohan, Sumit
中科院分区:
其他
文献类型:
--
作者:
Husain, S. Ali;Stevens, Jacob S.;King, Kristen L.;Robbins-Juarez, Shelief Y.;Cohen, Matthew;Lyashchenko, Alexander K.;Cremers, Serge;Mohan, Sumit

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捐献前肾小球滤过率(GFR)的评估是评估潜在活体肾捐献者的一个关键方面。在美国,供体 GFR 的测量是一项监管要求,最常见的是使用 24 小时定时肌酐清除率 (CrCl 24) 进行评估,尽管由于尿液样本采集和肾小管肌酐分泌时间不正确而可能出现错误。 1, 2 我们的目的是确定 CrCl 24 在活体肾捐献者候选者中的真实表现。我们对在我们中心评估的活体肾捐献者候选者进行了一项回顾性横断面研究。这项研究得到了哥伦比亚大学医学中心机构审查委员会的批准(#AAAI1288)。我们确定了 279 名连续候选人,他们在 2018 年至 2021 年期间接受了冷碘酞酸盐清除测试,以进行 GFR 评估,作为活体肾脏捐赠评估的一部分。在我们的中心,GFR≥ 80 mL/min/1.73 m 2 用于确定大多数候选人是否适合捐献。如果 2009 年慢性肾脏病流行病学合作组织基于肌酐的估计 GFR (eGFR) 或 CrCl 24 < 90 mL/min/1.73 m 2,如果候选者无法进行定时尿液收集,或者如果评估肾病专家要求进行测试,则供体候选者将被转介进行碘酞酸盐清除率测试。在排除数据不完整的捐赠者后(参见第 S1 项中的详细方法),我们分析了 212 名捐赠者候选者的最终队列。
Assessment of predonation glomerular filtration rate (GFR) is a key aspect of the evaluation of potential living kidney donors. In the United States, measurement of donor GFR is a regulatory requirement and most commonly assessed using 24-hour timed creatinine clearance (CrCl 24), despite the potential for error due to incorrectly timed urine sample collection and tubular creatinine secretion. 1, 2 We aimed to determine the real-world performance of CrCl 24 in living donor candidates.We performed a retrospective cross-sectional study of living kidney donor candidates evaluated at our center. This study was approved by the Columbia University Medical Center institutional review board (# AAAI1288). We identified 279 consecutive candidates who underwent cold iothalamate clearance testing from 2018-2021 for GFR assessment as part of living kidney donation evaluation. At our center, a GFR≥ 80 mL/min/1.73 m 2 is used to determine suitability for donation for most candidates. Donor candidates were referred for iothalamate clearance testing if either Chronic Kidney Disease Epidemiology Collaboration 2009 creatinine-based estimated GFR (eGFR) or CrCl 24 was< 90 mL/min/1.73 m 2, if the candidate was unable to perform a timed urinary collection, or if the testing was requested by the evaluating nephrologist. After excluding donors with incomplete data (see detailed methods in Item S1), we analyzed a final cohort of 212 donor candidates.
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发表时间: 2016-09-01
影响因子: 9.8
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