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2015 ; 4
(3
): 345-53
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Estimating glomerular filtration rate in kidney transplantation: Still searching
for the best marker
#MMPMID26167457
Santos J
; Martins LS
World J Nephrol
2015[Jul]; 4
(3
): 345-53
PMID26167457
show ga
Kidney transplantation is the treatment of choice for end-stage renal disease.
The evaluation of graft function is mandatory in the management of renal
transplant recipients. Glomerular filtration rate (GFR), is generally considered
the best index of graft function and also a predictor of graft and patient
survival. However GFR measurement using inulin clearance, the gold standard for
its measurement and exogenous markers such as radiolabeled isotopes ((51)Cr EDTA,
(99m)Tc DTPA or (125)I Iothalamate) and non-radioactive contrast agents
(Iothalamate or Iohexol), is laborious as well as expensive, being rarely used in
clinical practice. Therefore, endogenous markers, such as serum creatinine or
cystatin C, are used to estimate kidney function, and equations using these
markers adjusted to other variables, mainly demographic, are an attempt to
improve accuracy in estimation of GFR (eGFR). Nevertheless, there is some concern
about the inability of the available eGFR equations to accurately identify
changes in GFR, in kidney transplant recipients. This article will review and
discuss the performance and limitations of these endogenous markers and their
equations as estimators of GFR in the kidney transplant recipients, and their
ability in predicting significant clinical outcomes.