Cystatin C-Based Equation Does Not Accurately Estimate the Glomerular Filtration in Japanese Living Kidney Donors
Kazuma Tsujimura, Morihito Ota, Kiyoshi Chinen, Takayuki Adachi, Kiyomitsu Nagayama, Masato Oroku, Morikuni Nishihira, Yoshiki Shiohira, Kunitoshi Iseki, Hideki Ishida, Kazunari Tanabe
Department of Surgery, Tomishiro Central Hospital, Tomigusuku, Okinawa, Japan
Ann Transplant 2017; 22:378-383
Available online: 2017-06-23
Precise evaluation of a living donor’s renal function is necessary to ensure adequate residual kidney function after donor nephrectomy. Our aim was to evaluate the feasibility of estimating glomerular filtration rate (GFR) using serum cystatin-C prior to kidney transplantation.
MATERIAL AND METHODS: Using the equations of the Japanese Society of Nephrology, we calculated the GFR using serum creatinine (eGFRcre) and cystatin C levels (eGFRcys) for 83 living kidney donors evaluated between March 2010 and March 2016. We compared eGFRcys and eGFRcre values against the creatinine clearance rate (CCr).
RESULTS: The study population included 27 males and 56 females. The mean eGFRcys, eGFRcre, and CCr were, 91.4±16.3 mL/min/1.73 m² (range, 59.9–128.9 mL/min/1.73 m²), 81.5±14.2 mL/min/1.73 m² (range, 55.4–117.5 mL/min/1.73 m²) and 108.4±21.6 mL/min/1.73 m² (range, 63.7–168.7 mL/min/1.73 m²), respectively. eGFRcys was significantly lower than CCr (p<0.001). The correlation coefficient between eGFRcys and CCr values was 0.466, and the mean difference between the two values was –17.0 (15.7%), with a root mean square error of 19.2. Thus, eGFRcre was significantly lower than CCr (p<0.001). The correlation coefficient between eGFRcre and CCr values was 0.445, and the mean difference between the two values was –26.9 (24.8%), with a root mean square error of 19.5.
CONCLUSIONS: Although eGFRcys provided a better estimation of GFR than eGFRcre, eGFRcys still did not provide an accurate measure of kidney function in Japanese living kidney donors.
Keywords: Creatinine, cystatin C, Glomerular Filtration Rate, Living Donors