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• W2789472085 abstract "INTRODUCTION :Research in renal transplantation has so far considered one-year acute rejection episodes,one-year graft and patient survival as short-term primary outcomes in evaluatingtherapeutic strategies. With recent advances in immunosuppression and care of atransplant recipient, the short-term renal transplant outcomes have been remarkablyexcellent. This makes evaluation of newer therapeutic strategies with such outcomesdifficult. Meanwhile long-term results do not correlate well with these traditional shorttermend-points. Glomerular filtration rate is used as an indicator of renal functionworldwide. Renal function in the short term has well been related to long term outcomesin renal transplantation. This calls for use of Glomerular filtration rate as a significantshort term transplant outcome for further studies evaluating efficacy of newer therapeuticstrategies and to identify prognostic indicators. Renal graft function assessment is now aprimary criterion for evaluation of newer therapeutic interventions in transplantation.Assessment of renal function in a transplant recipient has always been a challenge. Mostof currently existing methods of GFR measurement and estimation are not well validatedin transplant recipients. Inulin Clearance is considered as goal standard in measurementof renal graft function. However, other traditionally accepted reference methods for directmeasurement of GFR include use of exogenous markers like radiolabeled isotopes (51CrEDTA, 99mTc-DTPA or 125I Iothalamate) and non-radioactive contrast agents(Iothalamate or Iohexol). Measurement of GFR in Indian population has been limited tothe reference methods only as Inulin is currently not available in this country. In view ofthe cumbersome nature of these tests, several mathematical formulae based onendogenous markers of GFR such as S. Creatinine and Cystatin C have been developedAIM : To assess the performance characteristics of the various eGFR equations based onserum creatinine and serum Cystatin C in predicting the measured GFR in renal allograftrecipients of Indian Subcontinent.OBJECTIVES :To study the agreement between GFR estimated by various prediction formulae based onSerum Creatinine and Cystatin C with the GFR measured by 99mTc DTPA renalscintigraphy among renal allograft recipients.To determine which estimated GFR prediction formula predicts GFR measured by 99mTcDTPA renal scintigraphy with precision and accuracy in renal allograft recipients.PATIENTS AND METHODS : Renal allograft recipients were studied at 6 months posttransplant. GFR was measured by 99mTcDTPA scintigraphy (mGFR). Serum CystatinC& creatinine were measured. GFR was estimated (eGFR) by various S.Cr based andCysC based equations and compared with mGFR using correlation, bias, precision,accuracy and kappa statistics for agreement.RESULTS : 134 renal allograft recipients (M:F=101:33; age 34.0±11.5years) werestudied. Mean mGFR was 52.1±22.6ml/min/1.73Sq.m. Overall, the S.Cr-eGFRsoverestimated GFR [+15to20±25ml/min/1.73Sq.m.] and had poor correlation (ICC=0.0-0.4), poor accuracy (@30%-35%; @50%-55%) and poor agreement (K= 0.05-0.20; 50-60% misclassified) with mGFR. Among them, CG-LWGFR had marginal correlation(ICC=0.25-0.35), least bias (+4.0±22.4ml/min/1.73Sq.m) and most accuracy (@30%-47.8%; @50%-72.1%). All CysC-eGFRs had better correlation (ICC=0.45-0.50), lowerbias (-10to+1±20ml/min/1.73Sq.m), higher accuracy (@30%-60%; @50%-80%) andbetter agreement (K=0.25-0.45; 35-40% misclassified) with the mGFR. The Larsson,Macissac and MayoClinic CysC GFRs had the best performance characteristics.CONCLUSION : In renal allograft recipients, S.Cr-eGFR estimates poorly correlate,widely differ and rarely agree with the mGFR, compared to CysC-eGFR. The CysCeGFRsby Larsson, Macissac and MayoClinic provide the best GFR estimates. CysC is abetter predictor of GFR than S.Cr at 6 months post transplantation." @default.
• W2789472085 created "2018-03-29" @default.
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• W2789472085 date "2008-01-01" @default.
• W2789472085 modified "2023-09-27" @default.
• W2789472085 title "Cystatin-C and Creatinine Based Formulae for Estimation of Glomerular Filtration Rate in Renal Allograft Recipients." @default.
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