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Limitations of glomerular filtration rate equations in the renal transplant patient
: This study aims to compare the performance of endogenous creatinine clearance (CLcr) and a number of published mathematical equations to calculate glomerular filtration rate (GFR) in renal transplant patients considering 99mTc DTPA isotope scan as the reference method. A total of 152 GFR were per...
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| Published in: | Clinical transplantation 2005-04, Vol.19 (2), p.259-268 |
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| container_end_page | 268 |
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| container_title | Clinical transplantation |
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| creator | Raju, Dharmapaul L Grover, Vaneeta K Shoker, Ahmed |
| description | : This study aims to compare the performance of endogenous creatinine clearance (CLcr) and a number of published mathematical equations to calculate glomerular filtration rate (GFR) in renal transplant patients considering 99mTc DTPA isotope scan as the reference method. A total of 152 GFR were performed on 81 renal transplant patients. Accuracy of each method was measured at different percentiles. The bias and precision of all the methods were then compared. A paired t‐test was used to compare the performance of each calculation to the respective GFR measured by isotope study performed on the same day. In the total population, all calculated methods correlated significantly with the isotope results. Accuracies within specific ranges of the isotope GFR were limited in all equations (agreement with isotope result ≤72% at 30% accuracy range in the total group). Within the limited accuracy, Edwards’ equation (K.D. Edwards and H.M. Whyte, Australas Ann Med 1959; vol. 8: p. 218) had the least bias in the total population. Bjornsson (T.D. Bjornsson, Clin Pharmacokinet 1979; vol. 4: p. 200) had the least bias in patients with GFR ≥ 50 mL/min and Gates in patients with GFR |
| doi_str_mv | 10.1111/j.1399-0012.2005.00335.x |
| format | article |
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A total of 152 GFR were performed on 81 renal transplant patients. Accuracy of each method was measured at different percentiles. The bias and precision of all the methods were then compared. A paired t‐test was used to compare the performance of each calculation to the respective GFR measured by isotope study performed on the same day. In the total population, all calculated methods correlated significantly with the isotope results. Accuracies within specific ranges of the isotope GFR were limited in all equations (agreement with isotope result ≤72% at 30% accuracy range in the total group). Within the limited accuracy, Edwards’ equation (K.D. Edwards and H.M. Whyte, Australas Ann Med 1959; vol. 8: p. 218) had the least bias in the total population. Bjornsson (T.D. Bjornsson, Clin Pharmacokinet 1979; vol. 4: p. 200) had the least bias in patients with GFR ≥ 50 mL/min and Gates in patients with GFR < 50 mL/min. Salazar (D.E. Salazar and G.B. Corcoran, Am J Med 1988; vol. 84: p. 1053) had the least bias in patients with BMI above 30 kg/m2 and the Davis equation (G.A. Davis and M.H. Chandler, Am J Health Syst Pharm 1996; vol. 53: p. 1028) in patients with BMI <25 kg/m2. In all analyses, Nankivell (B.J. Nankivell, S.M. Gruenwald, R.D.M. Allen and J.R. Chapman, Transplantation 1995; vol. 59: p. 1683) overestimated GFR by more than 80% and MDRD 1 and 2 in <10% of the time. The results demonstrate the inherited limitation in the currently available equations to calculate GFR in renal transplant patients.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/j.1399-0012.2005.00335.x</identifier><identifier>PMID: 15740565</identifier><language>eng</language><publisher>Oxford, UK: Munksgaard International Publishers</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Bias ; Biological and medical sciences ; Body Mass Index ; Cardiology. Vascular system ; Creatinine - blood ; Creatinine - urine ; creatinine clearance equations ; Female ; Forecasting ; glomerular filtration rate ; Glomerular Filtration Rate - physiology ; Humans ; Kidney - diagnostic imaging ; Kidney - metabolism ; Kidney Transplantation - physiology ; Male ; Mathematics ; Medical sciences ; Middle Aged ; Models, Biological ; Nephrology. Urinary tract diseases ; Radionuclide Imaging ; Radiopharmaceuticals ; renal transplant ; Retrospective Studies ; Technetium Tc 99m Pentetate</subject><ispartof>Clinical transplantation, 2005-04, Vol.19 (2), p.259-268</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4345-ac8874a57171749c3f977019ba32317553caeba1be77791a9ab9bd402c536edc3</citedby><cites>FETCH-LOGICAL-c4345-ac8874a57171749c3f977019ba32317553caeba1be77791a9ab9bd402c536edc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16582079$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15740565$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Raju, Dharmapaul L</creatorcontrib><creatorcontrib>Grover, Vaneeta K</creatorcontrib><creatorcontrib>Shoker, Ahmed</creatorcontrib><title>Limitations of glomerular filtration rate equations in the renal transplant patient</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>: This study aims to compare the performance of endogenous creatinine clearance (CLcr) and a number of published mathematical equations to calculate glomerular filtration rate (GFR) in renal transplant patients considering 99mTc DTPA isotope scan as the reference method. A total of 152 GFR were performed on 81 renal transplant patients. Accuracy of each method was measured at different percentiles. The bias and precision of all the methods were then compared. A paired t‐test was used to compare the performance of each calculation to the respective GFR measured by isotope study performed on the same day. In the total population, all calculated methods correlated significantly with the isotope results. Accuracies within specific ranges of the isotope GFR were limited in all equations (agreement with isotope result ≤72% at 30% accuracy range in the total group). Within the limited accuracy, Edwards’ equation (K.D. Edwards and H.M. Whyte, Australas Ann Med 1959; vol. 8: p. 218) had the least bias in the total population. Bjornsson (T.D. Bjornsson, Clin Pharmacokinet 1979; vol. 4: p. 200) had the least bias in patients with GFR ≥ 50 mL/min and Gates in patients with GFR < 50 mL/min. Salazar (D.E. Salazar and G.B. Corcoran, Am J Med 1988; vol. 84: p. 1053) had the least bias in patients with BMI above 30 kg/m2 and the Davis equation (G.A. Davis and M.H. Chandler, Am J Health Syst Pharm 1996; vol. 53: p. 1028) in patients with BMI <25 kg/m2. In all analyses, Nankivell (B.J. Nankivell, S.M. Gruenwald, R.D.M. Allen and J.R. Chapman, Transplantation 1995; vol. 59: p. 1683) overestimated GFR by more than 80% and MDRD 1 and 2 in <10% of the time. The results demonstrate the inherited limitation in the currently available equations to calculate GFR in renal transplant patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bias</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>Cardiology. Vascular system</subject><subject>Creatinine - blood</subject><subject>Creatinine - urine</subject><subject>creatinine clearance equations</subject><subject>Female</subject><subject>Forecasting</subject><subject>glomerular filtration rate</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Humans</subject><subject>Kidney - diagnostic imaging</subject><subject>Kidney - metabolism</subject><subject>Kidney Transplantation - physiology</subject><subject>Male</subject><subject>Mathematics</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Biological</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Radionuclide Imaging</subject><subject>Radiopharmaceuticals</subject><subject>renal transplant</subject><subject>Retrospective Studies</subject><subject>Technetium Tc 99m Pentetate</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNqNkEFv1DAQha0K1C6lf6Hypb0l2HEcxxKXdgULYgUIijhajncCXpxkaydi---Z7UbtFfswI7_v2eNHCOUs57jebHMutM4Y40VeMCZzxoSQ-f6ELJ6EF2TBNCuwr8QZeZXSFk8rXslTcsalKpms5IJ8X_vOj3b0Q5_o0NJfYeggTsFG2vowxkeFYgEK99PM-Z6Ov4FG6G2gyPRpF2w_0h3q0I-vycvWhgQXcz0nP96_u1t-yNZfVh-XN-vMlaKUmXV1rUorFcddaidarRTjurGiEFxJKZyFxvIGlFKaW20b3WxKVjgpKtg4cU6uj_fu4nA_QRpN55ODgLPAMCVTqRJ9tUCwPoIuDilFaM0u-s7GB8OZOQRqtuaQmznkZg6BmsdAzR6tl_MbU9PB5tk4J4jA1QzY5GxoMQ3n0zNXybpgSiP39sj99QEe_nsAs7z7hg3as6PdpxH2T3Yb_-A3hZLm5-eVWYnydr2Un8xX8Q9XtaBl</recordid><startdate>200504</startdate><enddate>200504</enddate><creator>Raju, Dharmapaul L</creator><creator>Grover, Vaneeta K</creator><creator>Shoker, Ahmed</creator><general>Munksgaard International Publishers</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200504</creationdate><title>Limitations of glomerular filtration rate equations in the renal transplant patient</title><author>Raju, Dharmapaul L ; Grover, Vaneeta K ; Shoker, Ahmed</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4345-ac8874a57171749c3f977019ba32317553caeba1be77791a9ab9bd402c536edc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bias</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>Cardiology. Vascular system</topic><topic>Creatinine - blood</topic><topic>Creatinine - urine</topic><topic>creatinine clearance equations</topic><topic>Female</topic><topic>Forecasting</topic><topic>glomerular filtration rate</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Humans</topic><topic>Kidney - diagnostic imaging</topic><topic>Kidney - metabolism</topic><topic>Kidney Transplantation - physiology</topic><topic>Male</topic><topic>Mathematics</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Models, Biological</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Radionuclide Imaging</topic><topic>Radiopharmaceuticals</topic><topic>renal transplant</topic><topic>Retrospective Studies</topic><topic>Technetium Tc 99m Pentetate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Raju, Dharmapaul L</creatorcontrib><creatorcontrib>Grover, Vaneeta K</creatorcontrib><creatorcontrib>Shoker, Ahmed</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Raju, Dharmapaul L</au><au>Grover, Vaneeta K</au><au>Shoker, Ahmed</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limitations of glomerular filtration rate equations in the renal transplant patient</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2005-04</date><risdate>2005</risdate><volume>19</volume><issue>2</issue><spage>259</spage><epage>268</epage><pages>259-268</pages><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>: This study aims to compare the performance of endogenous creatinine clearance (CLcr) and a number of published mathematical equations to calculate glomerular filtration rate (GFR) in renal transplant patients considering 99mTc DTPA isotope scan as the reference method. A total of 152 GFR were performed on 81 renal transplant patients. Accuracy of each method was measured at different percentiles. The bias and precision of all the methods were then compared. A paired t‐test was used to compare the performance of each calculation to the respective GFR measured by isotope study performed on the same day. In the total population, all calculated methods correlated significantly with the isotope results. Accuracies within specific ranges of the isotope GFR were limited in all equations (agreement with isotope result ≤72% at 30% accuracy range in the total group). Within the limited accuracy, Edwards’ equation (K.D. Edwards and H.M. Whyte, Australas Ann Med 1959; vol. 8: p. 218) had the least bias in the total population. Bjornsson (T.D. Bjornsson, Clin Pharmacokinet 1979; vol. 4: p. 200) had the least bias in patients with GFR ≥ 50 mL/min and Gates in patients with GFR < 50 mL/min. Salazar (D.E. Salazar and G.B. Corcoran, Am J Med 1988; vol. 84: p. 1053) had the least bias in patients with BMI above 30 kg/m2 and the Davis equation (G.A. Davis and M.H. Chandler, Am J Health Syst Pharm 1996; vol. 53: p. 1028) in patients with BMI <25 kg/m2. In all analyses, Nankivell (B.J. Nankivell, S.M. Gruenwald, R.D.M. Allen and J.R. Chapman, Transplantation 1995; vol. 59: p. 1683) overestimated GFR by more than 80% and MDRD 1 and 2 in <10% of the time. The results demonstrate the inherited limitation in the currently available equations to calculate GFR in renal transplant patients.</abstract><cop>Oxford, UK</cop><pub>Munksgaard International Publishers</pub><pmid>15740565</pmid><doi>10.1111/j.1399-0012.2005.00335.x</doi><tpages>10</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Bias Biological and medical sciences Body Mass Index Cardiology. Vascular system Creatinine - blood Creatinine - urine creatinine clearance equations Female Forecasting glomerular filtration rate Glomerular Filtration Rate - physiology Humans Kidney - diagnostic imaging Kidney - metabolism Kidney Transplantation - physiology Male Mathematics Medical sciences Middle Aged Models, Biological Nephrology. Urinary tract diseases Radionuclide Imaging Radiopharmaceuticals renal transplant Retrospective Studies Technetium Tc 99m Pentetate |
| title | Limitations of glomerular filtration rate equations in the renal transplant patient |
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