Assessment of kidney function in lung transplant candidates.
Publication/Presentation Date
6-1-2008
Abstract
BACKGROUND: Glomerular filtration rate (GFR) is the best measure of kidney function; however, 24-hour creatinine clearance (CrCl) is the initial screening test used for lung transplant candidates at most centers. Although creatinine-based formulas that estimate GFR have been derived, none have been validated in patients with severe lung disease.
METHODS: We performed a retrospective cohort study of patients evaluated for lung transplantation at Columbia Presbyterian Medical Center and compared the GFR estimated from the Modification of Diet in Renal Disease (MDRD) and other formulas to the CrCl. We then validated these results in a cohort of patients evaluated at the Hospital of the University of Pennsylvania.
RESULTS: There were strong and statistically significant direct correlations between estimated GFR and CrCl. An estimated GFR of/min by the MDRD was very sensitive at detecting kidney dysfunction by CrCl in the derivation cohort. In the validation cohort, the negative predictive value of this cut-off was 97%.
CONCLUSIONS: Established formulas for estimating GFR are highly discriminating for kidney dysfunction in patients being evaluated for lung transplantation and may actually have greater validity than CrCl in some instances.
Volume
27
Issue
6
First Page
635
Last Page
641
ISSN
1557-3117
Published In/Presented At
Al-Naamani, N., Maarouf, O. H., Ahya, V. N., Lederer, D. J., Mendez, J. D., Wilt, J. S., Doyle, A. M., Rybak, D., D'Ovidio, F., Sonett, J. R., Arcasoy, S. M., Nickolas, T. L., & Kawut, S. M. (2008). Assessment of kidney function in lung transplant candidates. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 27(6), 635–641. https://doi.org/10.1016/j.healun.2008.02.008
Disciplines
Medicine and Health Sciences
PubMedID
18503963
Department(s)
Fellows and Residents
Document Type
Article