Estimating Glomerular Filtration Rate in Kidney Transplant Recipients: Comparing a Novel Equation With Commonly Used Equations in this Population.Salvador CL, Hartmann A, et al.
Transplantation Direct 2017; 3(12): e332.
To develop a new equation for estimating glomerular filtration rate (GFR) in adult kidney recipients and to evaluate its performance compared to other published estimated GFR-equations.
Participants were randomly divided into two groups and used to either generate a new equation (reference group), or to compare the different estimating equations, including evaluation of the new equation (test group).
594 adult kidney transplant recipients.
Measured outcomes included bias (difference in GFR between the test method and reference method), precision (interquartile range of the differences) and accuracy (percentage of test method estimated GFR results within 15% and 30% of the reference measured GFR).
8 weeks and 1 year
Existing formulae for estimating glomerular filtration rate (GFR) were mainly developed in patients with renal disease and may not be accurate in the estimation of function in transplant recipients. The authors of this study attempt to derive a new equation, based upon creatinine and cystatin C, to improve the accuracy of GFR estimation in a transplant population. A cohort of 594 patients were randomly divided into training and validation sets. A new equation for estimation of GFR was derived and validated, demonstrating improved bias, accuracy and precision compared to existing creatinine and cystatin-based equations. The equation was then externally validated in a more recent set of patients from the same centre, demonstrating good performance. The equation does show promise for GFR estimation in renal transplant recipients, but there are limitations. All patients came from a single centre in Norway with a predominantly white population. All patients were 1 year or less post transplantation. Further external validation will be required to assess accuracy in other populations.
Quality assessment not appropriate