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Estimation of glomerular filtration rates after orthotopic liver transplantation: Evaluation of cystatin C-based equations.
Liver Transpl. 2006 Nov; 12(11):1667-72.LT

Abstract

Early detection of renal dysfunction in patients after orthotopic liver transplantation is important. Creatinine-based equations to estimate glomerular filtration rate (GFR) were found to be less accurate in liver transplant recipients than in their original populations. Since cystatin C (CysC) is independent from muscle mass and hepatic biosynthesis, we evaluated the diagnostic accuracy of 3 CysC-based equations (Larson, Hoek, and Filler formulae) that are based on the same CysC method as that of our center in comparison to the abbreviated creatinine-based modification of diet in renal disease (MDRD) formula in 59 liver transplant recipients. "True GFR" was measured by 99mTc-diethylene triamine pentaacetic acid ((99m)Tc-DTPA) clearance. Neither correlation with the GFR (correlation coefficients: 0.594-0.640) nor precision (root mean square error: 15.7-18.17 mL/min/1.73 m(2)) differed significantly between the tested formulae. The biases of the Hoek and Larsson formulae were significantly smaller than those of the MDRD and Filler equations (-0.1 and -2.3 vs. 10.1 and 7.9 mL/min/1.73 m(2), respectively; P </= 0.0023). Mean estimates of MDRD (61.9 +/- 21.4 mL/min/1.73 m(2)) and Filler (61.2 +/- 22.1 mL/min/1.73 m(2)) differed significantly from the measured GFR (52.3 +/- 17.5 mL/min/1.73 m(2); P < 0.005), whereas Larsson and Hoek did not (49.5 +/- 20.2 and 51.4 +/- 17.9 mL/min/1.73 m(2), respectively). Accuracy within 30% and 50% of the true GFR was best for the Hoek (76.3% and 93.2%) formula, albeit not significantly different from MDRD (64.4% and 83.1%). Taken together, these data show the best overall performance for GFR estimates derived from the Hoek equation with respect to bias, precision, and accuracy.

Authors+Show Affiliations

Department of Internal Medicine I, University of Bonn, Bonn, Germany. thomas.gerhardt@ukb.uni-bonn.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

17031831

Citation

Gerhardt, Thomas, et al. "Estimation of Glomerular Filtration Rates After Orthotopic Liver Transplantation: Evaluation of Cystatin C-based Equations." Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, vol. 12, no. 11, 2006, pp. 1667-72.
Gerhardt T, Pöge U, Stoffel-Wagner B, et al. Estimation of glomerular filtration rates after orthotopic liver transplantation: Evaluation of cystatin C-based equations. Liver Transpl. 2006;12(11):1667-72.
Gerhardt, T., Pöge, U., Stoffel-Wagner, B., Ahrendt, M., Wolff, M., Spengler, U., Palmedo, H., Sauerbruch, T., & Woitas, R. P. (2006). Estimation of glomerular filtration rates after orthotopic liver transplantation: Evaluation of cystatin C-based equations. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 12(11), 1667-72.
Gerhardt T, et al. Estimation of Glomerular Filtration Rates After Orthotopic Liver Transplantation: Evaluation of Cystatin C-based Equations. Liver Transpl. 2006;12(11):1667-72. PubMed PMID: 17031831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Estimation of glomerular filtration rates after orthotopic liver transplantation: Evaluation of cystatin C-based equations. AU - Gerhardt,Thomas, AU - Pöge,Uwe, AU - Stoffel-Wagner,Birgit, AU - Ahrendt,Manuela, AU - Wolff,Martin, AU - Spengler,Ulrich, AU - Palmedo,Holger, AU - Sauerbruch,Tilman, AU - Woitas,Rainer P, PY - 2006/10/13/pubmed PY - 2007/1/31/medline PY - 2006/10/13/entrez SP - 1667 EP - 72 JF - Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society JO - Liver Transpl VL - 12 IS - 11 N2 - Early detection of renal dysfunction in patients after orthotopic liver transplantation is important. Creatinine-based equations to estimate glomerular filtration rate (GFR) were found to be less accurate in liver transplant recipients than in their original populations. Since cystatin C (CysC) is independent from muscle mass and hepatic biosynthesis, we evaluated the diagnostic accuracy of 3 CysC-based equations (Larson, Hoek, and Filler formulae) that are based on the same CysC method as that of our center in comparison to the abbreviated creatinine-based modification of diet in renal disease (MDRD) formula in 59 liver transplant recipients. "True GFR" was measured by 99mTc-diethylene triamine pentaacetic acid ((99m)Tc-DTPA) clearance. Neither correlation with the GFR (correlation coefficients: 0.594-0.640) nor precision (root mean square error: 15.7-18.17 mL/min/1.73 m(2)) differed significantly between the tested formulae. The biases of the Hoek and Larsson formulae were significantly smaller than those of the MDRD and Filler equations (-0.1 and -2.3 vs. 10.1 and 7.9 mL/min/1.73 m(2), respectively; P </= 0.0023). Mean estimates of MDRD (61.9 +/- 21.4 mL/min/1.73 m(2)) and Filler (61.2 +/- 22.1 mL/min/1.73 m(2)) differed significantly from the measured GFR (52.3 +/- 17.5 mL/min/1.73 m(2); P < 0.005), whereas Larsson and Hoek did not (49.5 +/- 20.2 and 51.4 +/- 17.9 mL/min/1.73 m(2), respectively). Accuracy within 30% and 50% of the true GFR was best for the Hoek (76.3% and 93.2%) formula, albeit not significantly different from MDRD (64.4% and 83.1%). Taken together, these data show the best overall performance for GFR estimates derived from the Hoek equation with respect to bias, precision, and accuracy. SN - 1527-6465 UR - https://www.unboundmedicine.com/medline/citation/17031831/Estimation_of_glomerular_filtration_rates_after_orthotopic_liver_transplantation:_Evaluation_of_cystatin_C_based_equations_ L2 - https://doi.org/10.1002/lt.20881 DB - PRIME DP - Unbound Medicine ER -