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2016 ; 2
(8
): e96
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Classification of Kidney Transplant Recipients Using a Combination of Estimated
GFR and Albuminuria Reflects Risk
#MMPMID27819037
White CA
; Akbari A
; Talreja H
; Lalani N
; Knoll GA
Transplant Direct
2016[Aug]; 2
(8
): e96
PMID27819037
show ga
BACKGROUND: The 2012 Kidney Dialysis Initiative Global Outcomes chronic kidney
disease (CKD) classification scheme subdivides stage 3 CKD and incorporates the
urinary albumin-to-creatinine ratio (ACR). The aim of this study was to evaluate
whether the novel scheme provides graded risk in kidney transplant recipients
(KTRs). METHODS: Prevalent KTRs with available laboratory data were included. The
primary outcome was a composite of doubling of serum creatinine, graft failure,
or death. Patients were stratified using the CKD-Epidemiolgic Collaboration
equation, and ACR and the event rate per 1000 patient-years in each CKD category
were calculated. RESULTS: There were 269 KTRs with a mean follow-up of 4.5 ± 2.0
years. There was a graded increase in outcomes with increasing ACR and decreasing
estimated glomerular filtration rate (eGFR). For the primary outcome, the event
rate was 15.3 (95% confidence interval, 4.2-39.2) per 1000 patient-years for
those with an eGFR greater than 60 mL/min per 1.73 m(2) and an ACR less than 30
mg/g, whereas it was 375 (95% confidence interval, 193.8-655.1) for those with an
eGFR less than 30 mL/min per 1.73 m(2) and an ACR greater than 300 mg/g.
CONCLUSIONS: The novel Kidney Dialysis Initiative Global Outcomes classification
scheme provides graded risk for important clinical events in KTRs. This
information can be used to identify high-risk patients and to tailor follow-up
and management strategies aimed at improving outcomes.