Measurement of renal function in a kidney donor: a comparison of creatinine-based and volume-based GFRs

• Published in: European radiology Vol. 25; no. 11; pp. 3143 - 3150
• Main Authors: Choi, Don Kyoung, Choi, See Min, Park, Bong Hee, Jeong, Byong Chang, Seo, Seong Il, Jeon, Seong Soo, Lee, Hyun Moo, Choi, Han-Yong, Jeon, Hwang Gyun
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2015; Springer Nature B.V
• Subjects: Adult; Age; Age Factors; Algorithms; Angiography - methods; Body Height; Body Weight; Clinical medicine; Collaboration; Computed Tomography; Contrast Media; Creatinine; Creatinine - blood; Diagnostic Radiology; Epidemiology; Estimates; Female; Females; Glomerular Filtration Rate - physiology; Humans; Image Processing, Computer-Assisted - methods; Imaging; Imaging, Three-Dimensional - methods; Internal Medicine; Interventional Radiology; Kidney - anatomy & histology; Kidney - diagnostic imaging; Kidney diseases; Kidney Transplantation; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Multidetector Computed Tomography - methods; Neuroradiology; Organ Size; Performance evaluation; Radiology; Retrospective Studies; Sex Factors; Tissue Donors; Tomography; Ultrasound; Urology; Technetium Tc 99 m Pentetate; Kidney function test; Living donor; Glomerular filtration rate; Multidetector computed tomography
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-015-3741-0

Objective We aimed to evaluate the performance of various GFR estimates compared with direct measurement of GFR (dGFR). We also sought to create a new formula for volume-based GFR (new-vGFR) using kidney volume determined by CT. Materials and methods GFR was measured using creatinine-based methods (MDRD, the Cockcroft-Gault equation, CKD-EPI formula, and the Mayo clinic formula) and the Herts method, which is volume-based (vGFR). We compared performance between GFR estimates and created a new vGFR model by multiple linear regression analysis. Results Among the creatinine-based GFR estimates, the MDRD and C-G equations were similarly associated with dGFR (correlation and concordance coefficients of 0.359 and 0.369 and 0.354 and 0.318, respectively). We developed the following new kidney volume-based GFR formula: 217.48-0.39XA + 0.25XW-0.46XH-54.01XsCr + 0.02XV-19.89 (if female) (A = age, W = weight, H = height, sCr = serum creatinine level, V = total kidney volume). The MDRD and CKD-EPI had relatively better accuracy than the other creatinine-based methods (30.7 % vs. 32.3 % within 10 % and 78.0 % vs. 73.0 % within 30 %, respectively). However, the new-vGFR formula had the most accurate results among all of the analyzed methods (37.4 % within 10 % and 84.6 % within 30 %). Conclusions The new-vGFR can replace dGFR or creatinine-based GFR for assessing kidney function in donors and healthy individuals. Key Points • Accurate prediction of GFR is crucial in kidney donors . • DTPA is accurate but costly , invasive , and clinically difficult to apply . • Volume - based GFR estimation performs as well as the Cr - based method . • New volume - based GFR estimation performs better among GFR estimation formulas .