Is Dtpa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy?
Introduction: Precise assessment of renal function of voluntary kidney donors has important implications for both donor and recipient health outcome. The ideal test for assessment of overall renal function is measurement of Glomerular Filtration Rate (GFR). Various centres use various creatinin...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2021-06-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://www.jcdr.net/articles/PDF/14969/48903_CE[Ra1]%20F(IK)%20GC(Ank)_PF1(SC_RK)_PFA(SC_KM)_PN(KM).pdf |
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| author | Prashant Bahirani Raghav Talwar Amit Kumar Singh Ajay Shankar Prasad Gagandeep Singh Nimit Solanki Prashant Kumar Dixit |
| author_facet | Prashant Bahirani Raghav Talwar Amit Kumar Singh Ajay Shankar Prasad Gagandeep Singh Nimit Solanki Prashant Kumar Dixit |
| author_sort | Prashant Bahirani |
| collection | DOAJ |
| description | Introduction: Precise assessment of renal function of
voluntary kidney donors has important implications for
both donor and recipient health outcome. The ideal test
for assessment of overall renal function is measurement
of Glomerular Filtration Rate (GFR). Various centres use
various creatinine based formulae to calculate the GFR,
however when compared to GFR measurements by 99mTcdiethylenetriaminepentaacetic acid (DTPA) isotope clearance,
their performance remain inconclusive.
Aim: To assess the efficacy of creatinine-based GFR estimating
equations in comparison to DTPA scan in voluntary kidney
donors before and after donor nephrectomy.
Materials and Methods: This study was conducted on 50
voluntary kidney donors who underwent donor nephrectomy
at Army Hospital (R&R), New delhi. This study was conducted
from November 2016 to March 2018 as a single centre,
prospective, longitudinal cohort study on living related
kidney donors with follow up at 1 and 3 months after kidney
donation. The predictive capabilities of GFR estimation by
Cockroft Gault (CG) equation, CG equation corrected for
GFR and 24-hour urine Creatinine Clearance (CrCl) corrected
for Body Surface Area (BSA), for both pre- and postdonor
nephrectomy at 90 days, were assessed and further
compared with DTPA-GFR as reference GFR. Individual
quantitative parameters were compared using Student t test.
For the normally distributed GFR data, Pearson’s correlation
coefficient was also calculated. Statistical Package for the
Social Sciences (SPSS), version 24.0, software and MS Excel
were used for analysis.
Results: Out of 50 subjects studied, 38 (76%) were females and
12 (24%) were males. Majority of donors were spouses. The
mean GFR measured by 99mTc-DTPA scan was 99.47±14.4 ml/
min/1.73m2
and 62.1±11.5 ml/min/1.73 m2
pre and postdonation
respectively. All the equations being evaluated in this study
underestimated the GFR as measured by 99mTc DTPA renal scan
prior to kidney donation whereas GFR estimation postdonor
nephrectomy by CG CrCl and CG GFR overestimated the GFR
values while Urine CrCl underestimated it.
Conclusion: All the equations performed unsatisfactorily. Even
the best performing equation urine-CrCl was also found to be
suboptimal for donor evaluation. More accurate methods of
GFR estimation, should, thus be used keeping the potential
risks of living kidney donation in perspective. |
| first_indexed | 2024-12-14T18:56:56Z |
| format | Article |
| id | doaj.art-bc2965e26e85476299e07556e42bb886 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-14T18:56:56Z |
| publishDate | 2021-06-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-bc2965e26e85476299e07556e42bb8862022-12-21T22:51:04ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-06-01156PC01PC0710.7860/JCDR/2021/48903.14969Is Dtpa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy?Prashant Bahirani0Raghav Talwar1Amit Kumar Singh2 Ajay Shankar Prasad3Gagandeep Singh4Nimit Solanki5Prashant Kumar Dixit6Assistant Professor, Department of Surgery, Army College of Medical Sciences, New Delhi, India.Professor, Department of Urology, Command Hospital Airforce Bangalore, Karnataka, India.Doctor, Department of Surgery, Armed Forces Medical Services, New Delhi, India.Commanding Officer, Department of Medicine, 11 Airforce Hospital, Ghaziabad, Uttar Pradesh, India.Doctor, Department of Urology, Command Hospital Northern Command, Udhampur, Jammu and Kashmir, India.Doctor, Department of Urology, Base Hospital Delhi Cantt, New Delhi, India.Assistant Professor, Department of Medicine, Command Hospital Airforce Bangalore, Karnataka, India.Introduction: Precise assessment of renal function of voluntary kidney donors has important implications for both donor and recipient health outcome. The ideal test for assessment of overall renal function is measurement of Glomerular Filtration Rate (GFR). Various centres use various creatinine based formulae to calculate the GFR, however when compared to GFR measurements by 99mTcdiethylenetriaminepentaacetic acid (DTPA) isotope clearance, their performance remain inconclusive. Aim: To assess the efficacy of creatinine-based GFR estimating equations in comparison to DTPA scan in voluntary kidney donors before and after donor nephrectomy. Materials and Methods: This study was conducted on 50 voluntary kidney donors who underwent donor nephrectomy at Army Hospital (R&R), New delhi. This study was conducted from November 2016 to March 2018 as a single centre, prospective, longitudinal cohort study on living related kidney donors with follow up at 1 and 3 months after kidney donation. The predictive capabilities of GFR estimation by Cockroft Gault (CG) equation, CG equation corrected for GFR and 24-hour urine Creatinine Clearance (CrCl) corrected for Body Surface Area (BSA), for both pre- and postdonor nephrectomy at 90 days, were assessed and further compared with DTPA-GFR as reference GFR. Individual quantitative parameters were compared using Student t test. For the normally distributed GFR data, Pearson’s correlation coefficient was also calculated. Statistical Package for the Social Sciences (SPSS), version 24.0, software and MS Excel were used for analysis. Results: Out of 50 subjects studied, 38 (76%) were females and 12 (24%) were males. Majority of donors were spouses. The mean GFR measured by 99mTc-DTPA scan was 99.47±14.4 ml/ min/1.73m2 and 62.1±11.5 ml/min/1.73 m2 pre and postdonation respectively. All the equations being evaluated in this study underestimated the GFR as measured by 99mTc DTPA renal scan prior to kidney donation whereas GFR estimation postdonor nephrectomy by CG CrCl and CG GFR overestimated the GFR values while Urine CrCl underestimated it. Conclusion: All the equations performed unsatisfactorily. Even the best performing equation urine-CrCl was also found to be suboptimal for donor evaluation. More accurate methods of GFR estimation, should, thus be used keeping the potential risks of living kidney donation in perspective.https://www.jcdr.net/articles/PDF/14969/48903_CE[Ra1]%20F(IK)%20GC(Ank)_PF1(SC_RK)_PFA(SC_KM)_PN(KM).pdf99mtc-diethylenetriaminepentaacetic acidcockcroft-gault equationcreatinine clearance |
| spellingShingle | Prashant Bahirani Raghav Talwar Amit Kumar Singh Ajay Shankar Prasad Gagandeep Singh Nimit Solanki Prashant Kumar Dixit Is Dtpa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy? Journal of Clinical and Diagnostic Research 99mtc-diethylenetriaminepentaacetic acid cockcroft-gault equation creatinine clearance |
| title | Is Dtpa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy? |
| title_full | Is Dtpa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy? |
| title_fullStr | Is Dtpa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy? |
| title_full_unstemmed | Is Dtpa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy? |
| title_short | Is Dtpa the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy? |
| title_sort | is dtpa the gold standard for glomerular filtration rate estimation in voluntary kidney donors before and after donor nephrectomy |
| topic | 99mtc-diethylenetriaminepentaacetic acid cockcroft-gault equation creatinine clearance |
| url | https://www.jcdr.net/articles/PDF/14969/48903_CE[Ra1]%20F(IK)%20GC(Ank)_PF1(SC_RK)_PFA(SC_KM)_PN(KM).pdf |
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