The relationship between estimated GFR based on the CKD-EPI formula and renal inulin clearance in potential kidney donors

Clin Nephrol. 2014 Dec;82(6):353-7. doi: 10.5414/CN108341.

Abstract

It is not yet clear whether or not renal function in the living donor can be sufficiently assessed by estimated glomerular filtration rate (GFR) using creatinine-based equations. The present paper investigates the relationship between GFR values determined using renal inulin clearance (Cin) and those estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. Our study was performed in 287 potential kidney donors with a mean age of 48 ± 10 years. Mean Cin was 1.47 ± 0.28 (1.10 - 2.50) mL/s/1.73 m2. Total bias when using the CKDEPI formula was -0.0183 mL/s/1.73 m2, precision 0.263 mL/s/1.73 m2, and accuracy 90.6% within ± 30% of Cin. The sensitivity of CKD-EPI to estimate a decrease in Cin below 1.33 mL/s/1.73 m2 was 50.5%, with an 85% specificity of detecting a value above the cutoff. Receiver-operating curve analysis for the above produced an area under the curve of 0.766 ± 0.0285 (CI 0.712 - 0.813). For donor screening purposes, CKD-EPI should be interpreted with great caution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Creatinine / blood
  • Creatinine / urine*
  • Female
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Inulin / blood
  • Inulin / urine*
  • Kidney / metabolism
  • Kidney Function Tests / statistics & numerical data
  • Kidney Transplantation*
  • Living Donors*
  • Male
  • Middle Aged
  • ROC Curve
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Inulin
  • Creatinine