TY - JOUR
T1 - Prediction of measured GFR after living kidney donation from pre-donation parameters
AU - van Londen, Marco
AU - van der Weijden, Jessica
AU - Niznik, Robert S
AU - Mullan, Aidan F
AU - Bakker, Stephan J L
AU - Berger, Stefan P
AU - Nolte, Ilja M
AU - Sanders, Jan-Stephan F
AU - Navis, Gerjan
AU - Rule, Andrew D
AU - de Borst, Martin H
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.
PY - 2022/6/22
Y1 - 2022/6/22
N2 - BACKGROUND: One of the challenges in living kidney donor screening is to estimate remaining kidney function after donation. Here we developed a new model to predict post-donation measured GFR from pre-donation serum creatinine, age and sex.METHODS: In the prospective development cohort (TransplantLines, n = 511) several prediction models were constructed and tested for accuracy, precision, and predictive capacity for short- and long-term post-donation 125I-iothalamate mGFR. The model with optimal performance was further tested in specific high-risk subgroups (pre-donation eGFR < 90 mL/min/1.73m2, a declining 5-year post-donation mGFR slope or age > 65 years), and validated in internal (n = 509) and external (Mayo Clinic, n = 1087) cohorts.RESULTS: In the development cohort, pre-donation eGFR was 86 ± 14 mL/min/1.73m2, and post-donation mGFR 64 ± 11 mL/min/1.73m2. Donors with a pre-donation eGFR ≥ 90 mL/min/1.73m2 (present in 43%) had mean post-donation mGFR of 69 ± 10 mL/min/1.73m2, and 5% of these donors reached an mGFR < 55 mL/min/1.73m2. A model using pre-donation serum creatinine, age and sex performed optimally, predicting mGFR with good accuracy (mean bias 2.56 mL/min/1.73m2, R2 = 0.29, RMSE = 11.61) and precision (bias interquartile range (IQR) 14 mL/min/1.73m2) in the external validation cohort. This model also performed good in donors with pre-donation eGFR < 90 mL/min/1.73m2 (bias 0.35 mL/min/1.73m2 and IQR 10 mL/min/1.73m2), in donors with negative post-donation mGFR slope (bias 4.75 mL/min/1.73m2 and IQR 13 mL/min/1.73m2) and in donors > 65 years (bias 0.003 mL/min/1.73m2 and IQR 9 mL/min/1.73m2).CONCLUSIONS: We developed a novel post-donation mGFR prediction model based on pre-donation serum creatinine, age, and sex.
AB - BACKGROUND: One of the challenges in living kidney donor screening is to estimate remaining kidney function after donation. Here we developed a new model to predict post-donation measured GFR from pre-donation serum creatinine, age and sex.METHODS: In the prospective development cohort (TransplantLines, n = 511) several prediction models were constructed and tested for accuracy, precision, and predictive capacity for short- and long-term post-donation 125I-iothalamate mGFR. The model with optimal performance was further tested in specific high-risk subgroups (pre-donation eGFR < 90 mL/min/1.73m2, a declining 5-year post-donation mGFR slope or age > 65 years), and validated in internal (n = 509) and external (Mayo Clinic, n = 1087) cohorts.RESULTS: In the development cohort, pre-donation eGFR was 86 ± 14 mL/min/1.73m2, and post-donation mGFR 64 ± 11 mL/min/1.73m2. Donors with a pre-donation eGFR ≥ 90 mL/min/1.73m2 (present in 43%) had mean post-donation mGFR of 69 ± 10 mL/min/1.73m2, and 5% of these donors reached an mGFR < 55 mL/min/1.73m2. A model using pre-donation serum creatinine, age and sex performed optimally, predicting mGFR with good accuracy (mean bias 2.56 mL/min/1.73m2, R2 = 0.29, RMSE = 11.61) and precision (bias interquartile range (IQR) 14 mL/min/1.73m2) in the external validation cohort. This model also performed good in donors with pre-donation eGFR < 90 mL/min/1.73m2 (bias 0.35 mL/min/1.73m2 and IQR 10 mL/min/1.73m2), in donors with negative post-donation mGFR slope (bias 4.75 mL/min/1.73m2 and IQR 13 mL/min/1.73m2) and in donors > 65 years (bias 0.003 mL/min/1.73m2 and IQR 9 mL/min/1.73m2).CONCLUSIONS: We developed a novel post-donation mGFR prediction model based on pre-donation serum creatinine, age, and sex.
U2 - 10.1093/ndt/gfac202
DO - 10.1093/ndt/gfac202
M3 - Article
C2 - 35731584
JO - Nephrology, Dialysis, Transplantation
JF - Nephrology, Dialysis, Transplantation
SN - 0931-0509
ER -