Title: Estimated Glomerular Filtration Rate (eGFR) in Healthy Kidney Donors
Authors: Sheetal LG, Lakshminarayana GR, Anil M, Rajesh R, George K, Unni VN
DOI: http://dx.doi.org/10.18535/jmscr/v4i1.39
Introduction:This study was done to determine the range of Glomerular filtration rate (GFR) in healthy kidney donors, from Kerala. Materials and Methods: This retrospective study was done by including all consecutive voluntary kidney donors, who underwent donor nephrectomy at Amrita Institute of Medical Sciences, Kochi, Kerala from 2001 to 2011. The GFR was assessed by 99mTc-diethylenetriamine pentaacetic acid (DTPA) renogram (GC Gates method) as part of protocol during preoperative evaluation. The GFR by DTPA method was compared to values obtained by four variable MDRD formula and Cockcroft-Gault formula (CGF). Results: The mean age of the study population was 45.32 years (Range - 18 to 64 years) with 71.7 % being females. The majority of the donors were parents (54.78%) followed by siblings (33.04%) and spouses (12.17%). The eGFR in a healthy kidney donor ranged was 56 to 117 ml/min by 99mTc DTPA; GC Gates method. The mean eGFR were 82.89 (SD:22.46), 85.25 (SD:16.90), and 84.56 (SD:11.60) ml/min by CGF, MDRD and DTPA respectively. There was positive correlation in eGFR between methods used in the study. In donors with DTPA GFR ranging from 80-100 ml/min; there was no significant difference in mean eGFR between methods. Conclusions: The mean eGFR of a kidney donor from India, was 84.56 (±11.60) ml/min, which is lower than the normal value of western population. In donors with DTPA GFR < 80 ml/min; MDRD and CGF methods overestimated GFR. In donors with DTPA GFR >100 ml/min; the CGF, MDRD methods underestimated the GFR. 1. Chitra K, Sebastain A, Manjula VD, Sumadevi VS, Annamma K. Age Related Changes of GFR in a Population of Kerala”. Journal of Evidence based Medicine and Healthcare 2015; 34 (2): 5226-5231, DOI: 10.18410/jebmh/ 2015/727. 2. Sahay M, Narayen G, Anuradha. Risk of live kidney donation--Indian perspective.J Assoc Physicians India. 2007; 55 :267-270. 3. Barai S, Gambhir S, Prasad N, Sharma RK, Ora M, Kumar A, Gupta A, Parasar DS, Suneetha B. Levels of GFR and protein-induced hyperfiltration in kidney donors: a single-center experience in India.Am J Kidney Dis. 2008; 51(3): 407-414. DOI: 10.1053/j.ajkd.2007.11.008. 4. Barai S, Bandopadhayaya GP, Patel CD, Rathi M, Kumar R, Bhowmik D, Gambhir S, Singh NG, Malhotra A, Gupta KD. Do healthy potential kidney donors in india have an average glomerular filtration rate of 81.4 ml/min?Nephron Physiol. 2005;101(1): 21-26. 5. Mahajan S, Mukhiya GK, Singh R, Tiwari SC, Kalra V, Bhowmik DM, et al. Assessing glomerular filtration rate in healthy Indian adults: a comparison of various prediction equations.J Nephrol. 2005; 18(3):257-261. 6. Senthamizhselvan K, Karthikeyan S, Sundaramurthy G. A study of glomerular filtration rate estimation by Cockcroft-Gault, MDRD and CKD-EPI. formula in comparison with DTPA renal scan – a comparative study among live related kidney donors in south India.Int J Biol Med Res. 2013; 4(2): 3073- 3077. 7. Julie Hephzibah, NyllaShanthly, RegiOommen. Comparison of glomerular filtration rate measured by plasma sample technique, Cockroft Gault method and Gates’ method in voluntary kidney donors and renal transplant recipients. Indian Journal of Nuclear Medicine 2013; 28 (3): 144-151. DOI: 10.4103/0972-3919.119544 8. Narayan P, Barai S, Sharma RK, Gambhir S, Gupta A, Alok K. Levels of GFR and renal reserve capacity in living kidney donors in India. Indian Journal of Nephrology 2007; 17 (3): 99. 9. Kumar R, Chauhan MS, Sharma A, Jain A. Glomerular Filtration Rate Estimation with the Diethylene Triamine Penta-Acetic Acid (DTPA) Camera Method in Indian Healthy Donors and Comparison with Modified Diet in Renal Disease Formula (four variable)-Our Experience, IRPMS, 2015; 1(2): 33-39. 10. Srinivas S, Annigeri RA, Mani MK, Rao BS, Kowdle PC and Seshadri R. Estimation of glomerular filtration rate in South Asian healthy adult kidney donors. Nephrology 2008; 13 (5): 440–446. DOI: 10.1111/j.1440-1797.2008. 00967.x 11. Grewal GS, Blake GM. Reference data for 51Cr-EDTA measurements of the glomerular filtration rate derived from live kidney donors.Nucl Med Commun. 2005; 26(1):61-65. 12. Pierre D, Elke S, Natalie E, Etienne C, Christophe M, Jean-Marie K, Olivier M.Normal reference values for glomerular filtration rate:what do we really know? Nephrol Dial Transplant 2012; 27: 2664–2672. DOI: 10.1093/ndt/gfs265. 13. Byung HC, Jee HY, Hyuk JC, Ji-Il K, In SM, Cheol WP, Chul, WY, et al. Comparison of Estimating Equations for the Prediction of Glomerular Filtration Rate in Kidney Donors before and after Kidney Donation. PLoS ONE. 2013; 8(4): e60720. DOI: 10.1371/journal.pone.0060720 14. Yasar C and Alaattin Y. Evaluation of the Medically Complex Living Kidney Donor. Journal of Transplantation 2012,1-6. DOI:10.1155/2012/450471 15. Gopalakrishnan G, Gourabathini SP. Marginal kidney donor. Indian Journal of Urology 2007; 23: 286-293.Abstract
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