Abstract: TH-PO648
Comparison Between Nuclear Medicine Studies, Creatinine Clearance, and Estimated Glomerular Filtration Rate
Session Information
- Transplantation: Basic
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2001 Transplantation: Basic
Authors
- Acosta Peña, Ana Cecilia, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico City, Mexico
- Alamilla Sanchez, Mario, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico City, Mexico
Background
Measurement and estimation of glomerular filtration rate (GFR) are associated with systematic error, leading to differences in measured GFR, estimated GFR, and creatinine clearance. eGFR or CrCl within 30% of a mGFR is appropriate.
Methods
Comparative study between mGFR DTPA by renal scintigraphy, CrCl in 24-hour urine, and eGFR CKD-EPI/MDRD. Means were compared, with a 95% CI calculation. Bias and precision are assessed, providing a standard margin of ±30% relative to mGFR DTPA.
Results
40 donors were studied, 50% women, aged 42 years [20 – 67 years], weight 72.9 ± 13.2 kg, serum creatinine 0.74 ± 0.15 mg/dL. The mGFR DTPA measurement was on average 128.4 ± 23 ml/min; higher in men [136.1 vs. 120.7 mL/min; p = 0.03]. The eGFR were: CKD-EPI 107.6 ± 17.2 mL/min, MDRD 105.3 ± 20 mL/min; no differences between men and women [p= 0.84]; CrCl was 113.1 ± 32.6 mL/min; significantly higher in men [p= 0.006]. Differences were found between mGFR DTPA vs CrCl [128 vs 113 mL/min; p=0.01] vs. CKD-EPI [128 vs. 107 mL/min; p < 0.001] vs. MDRD [128 vs. 105 mL/min; p < 0.001]. No differences when comparing CrCl and CKD-EPI [113 vs 108 mL/min, diff. = 4.3ml/min; p = 0.49] or MDRD [113 vs. 107 mL/min; p = 0.39]; neither between CKD-EPI and MDRD [107 vs 105 mL/min; p = 0.13]. When estimating the precision at 30% (p±30) regarding mGFR DTPA between the methods, CrCl had less bias and GFR CKD-EPI better precision.
Conclusion
The use of mGFR DTPA is the best tool to establish GFR, however, among the methods used, CrCl has the least bias and GFR CKD-EPI has the best precision within 30% compared to mGFR DTPA.
Comparison of measurement GFR DTPA vs estimation of GFR CKD-EPI/MDRD vs CrCl
| Method | ml/min | Difference in mL/min vs mGFR DTPA [bias/precision %] | p [IC 95%] |
| mGFR DTPA | 128.4 ± 23 | Ref. | Ref. |
| CrCl | 113.1 ± 32.6 | 15.6 [12 / 80] | 0.01, [3.2 – 28] |
| eGFR CKD-EPI | 107.6 ± 17.2 | 20.8 [16 /85] | < 0.001, [12.9 – 28.6] |
| eGFR MDRD | 105.3 ± 20 | 23 [18 /80] | < 0.001, [14.8 – 31.3] |
Funding
- Government Support – Non-U.S.