In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 7 ( 2022-7-7), p. e0270827-
Abstract:
Most transplant centers in the Netherlands use estimated glomerular filtration rate (eGFR) for evaluation of potential living kidney donors. Whereas eGFR often underestimates GFR, especially in healthy donors, measured GFR (mGFR) allows more precise kidney function assessment, and therefore holds potential to increase the living donor pool. We hypothesized that mGFR-based donor screening leads to acceptance of donors with lower pre-donation eGFR than eGFR-based screening. Methods In this longitudinal cohort study, we compared eGFR (CKD-EPI) before donation in one center using mGFR-based screening (mGFR-cohort, n = 250) with two centers using eGFR-based screening (eGFR-cohort1, n = 466 and eGFR-cohort2, n = 160). We also compared differences in eGFR at five years after donation. Results Donor age was similar among the cohorts (mean±standard deviation (SD) mGFR-cohort 53±10 years, eGFR-cohort1 52±13 years, P = 0.16 vs. mGFR-cohort, and eGFR-cohort2 53±9 years, P = 0.61 vs. mGFR-cohort). Estimated GFR underestimated mGFR by 10±12 mL/min/1.73m 2 (mean±SD), with more underestimation in younger donors. In the overall cohorts, mean±SD pre-donation eGFR was lower in the mGFR-cohort (91±13 mL/min/1.73m 2 ) than in eGFR-cohort1 (93±15 mL/min/1.73m 2 , P 〈 0.05) and eGFR-cohort2 (94±12 mL/min/1.73m 2 , P 〈 0.05). However, these differences disappeared when focusing on more recent years, which can be explained by acceptance of more older donors with lower pre-donation eGFR over time in both eGFR-cohorts. Five years post-donation, mean±SD eGFR was similar among the centers (mGFR-cohort 62±12 mL/min/1.73m 2 , eGFR-cohort1 61±14 mL/min/1.73m 2 , eGFR-cohort2 62±11 mL/min/1.73m 2 , P = 0.76 and 0.95 vs. mGFR-cohort respectively). In the mGFR-cohort, 38 (22%) donors were excluded from donation due to insufficient mGFR with mean±SD mGFR of 71±9 mL/min/1.73m 2 . Conclusions Despite the known underestimation of mGFR by eGFR, we did not show that the routine use of mGFR in donor screening leads to inclusion of donors with a lower pre-donation eGFR. Therefore eGFR-based screening will be sufficient for the majority of the donors. Future studies should investigate whether there is a group (e.g. young donors with insufficient eGFR) that might benefit from confirmatory mGFR testing.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0270827
DOI:
10.1371/journal.pone.0270827.g001
DOI:
10.1371/journal.pone.0270827.g002
DOI:
10.1371/journal.pone.0270827.g003
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10.1371/journal.pone.0270827.g004
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10.1371/journal.pone.0270827.t001
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10.1371/journal.pone.0270827.t002
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10.1371/journal.pone.0270827.t003
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10.1371/journal.pone.0270827.t004
DOI:
10.1371/journal.pone.0270827.t005
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10.1371/journal.pone.0270827.s001
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10.1371/journal.pone.0270827.s002
DOI:
10.1371/journal.pone.0270827.s003
DOI:
10.1371/journal.pone.0270827.s004
DOI:
10.1371/journal.pone.0270827.s005
DOI:
10.1371/journal.pone.0270827.s006
DOI:
10.1371/journal.pone.0270827.s007
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10.1371/journal.pone.0270827.s008
DOI:
10.1371/journal.pone.0270827.s009
DOI:
10.1371/journal.pone.0270827.s010
DOI:
10.1371/journal.pone.0270827.s011
DOI:
10.1371/journal.pone.0270827.s012
DOI:
10.1371/journal.pone.0270827.s013
DOI:
10.1371/journal.pone.0270827.r001
DOI:
10.1371/journal.pone.0270827.r002
DOI:
10.1371/journal.pone.0270827.r003
DOI:
10.1371/journal.pone.0270827.r004
DOI:
10.1371/journal.pone.0270827.r005
DOI:
10.1371/journal.pone.0270827.r006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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