Background: It is very important to determine as accurately as possible the renal function in potential living kidney donors (PLKD). The direct measurement of glomerular filtration rate (mGFR) has been considered the "gold standard" for the kidney failure evaluation. Nonetheless, these are not available in many medical centers due to the complexity of the technique. The estimated GFR with 24-hour urinary creatinine clearance (ClCr) is frequently used because of its availability. In this study we aim to compare the different eGFR using serum-based creatinine formulas (Cockcroft-Gault, MDRD and CKD-EPI) and the eGFR based on 24-hour urinary creatinine clearance to determine the usefulness of eGFR creatinine formulas to evaluate kidney function in PLKD. Methods: We evaluate kidney function in 799 PLKD using 24-hour urinary ClCr method. The GFR obtained was compared with eGFR based on creatinine (Cockcroft-Gault, MDRD and CKD-EPI). We calculated mean bias (difference), precision (SD of this difference), accuracy (proportion of eGFR within ±10% of ClCr GFR) and performed Bland-Altman-plots. Results: Using the Bland Altman graphic, we observed that the most dispersed results are obtained using MDRD. Smallest mean bias and was observed for Cockcroft-Gault (bias of 5.8; SD 25.1) compared to the other equations (CKD-EPI: bias of 9.8; SD 24.8 and MDRD: bias of 13.8; SD 25.3). Smallest bias was found in females for the three equations. Results of mean bias were similar when comparing the three equations in patients with ClCr GFR < 60, however, smaller mean bias were found for the three equations above age 40 years. Regarding the assessment of the 95% limits of agreement (LoA), we found a high dispersion for the three equations being the highest upper limit of agreement 63.5 (MDRD) and the highest lower limit of agreement -43.4 (Cock-roft-Gault). Conclusion: In this PLKD cohort, Cockcroft-Gault equation showed the highest approximation to the reference method. The interval range was too big to assume equivalence between 24-hour urinary ClCr method and eGFR based on creatinine (Cockcroft-Gault, MDRD and CKD-EPI).

Introduction:The number of patients diagnosed with SARS-CoV2 worldwide in 2020 is 83,999,3791. According to the World Health Organization (WHO), 1,937,987 patients diagnosed with SARS-CoV2 died in 2020.2 In 2020, 2.3% of patients diagnosed with SARS-CoV2 died. The COVID 19 pandemic caused by SARS-CoV2 negatively impacts all sectors. One of the affected areas is organ supply and transplantation. The number of patients registered in the Transplant Dialysis Surveillance System (TDIS) waiting for solid organs in Turkey in 2020 is 23,923.3 Of the 1,391 reported brain death cases in 2020, 263 involved families donations. Of these, 1059 organs were used. This is 4.42% of the waiting patients.4 The inadequate supply of organs in our country Our study aimed to investigate the impact of the pandemic COVID -19 on the distribution of brain deaths reported in the regional coordination centers of Bursa, which has the highest number of brain deaths and family donations in Turkey by 2019 2020. Materials and Methods: Using the data from the Transplantation Dialysis Monitoring System of the Ministry of Health -Decision Support Unit (TDIS-KDS), the distribution of brain death, family donation, and organs used data reported between 2019 and 2020 in Turkey was studied. This distribution retrospectively assessed the impact of the COVID -19 pandemic. Results: According to the Transplant Dialysis Monitoring System (TDIS) data, there were 2,309 brain deaths in Turkey in 2019, patients with family donations: 619, and the number of organs used: 2504. The number of brain deaths in 2020: 1,391, the number of patients with family donations: 263, and the number of organs used: 1059.3 The number of brain deaths in 2019 Bursa Regional Coordination Center is 280, the number of patients with family donations: 117, the number of organs used: 222. The number of patients with brain death in 2020 is 208, the number of patients with family donations: 70 and the number of organs used: 104. In Turkey, the brain death rate in 2019 is 12.12%, the rate of patiens family donations: 18.90% and the rate of organs used: 8.86%. In Turkey, the brain death rate in 2020 is 14.95%, the rate of patients family donations: 26.61%, and the rate of organs used: 9.82%. The COVID 19 pandemic has had a negative impact on organ donation rates and organ supply for solid organ transplants. However, with organ donation training in the provinces of the Bursa Regional Coordination Center, an increase in brain death rates, family donations, and organs used was observed in Bursa Regional Coordination Centerin 2020. Conclusion:The COVID19 pandemic has adversely affected patients awaiting solid organ transplants. The demand for cadaveric organ transplants has increased in Turkey. Patients without living donors are losing their lives. Social activities and legal incentives encouraging organ donation are increasing organ donation.

Background: It is very important to determine as accurately as possible the renal function in potential living kidney donors (PLKD). The direct measurement of glomerular filtration rate (mGFR) has been considered the "gold standard" for the kidney failure evaluation. Nonetheless, these are not available in many medical centers due to the complexity of the technique. The estimated GFR with 24-hour urinary creatinine clearance (ClCr) is frequently used because of its availability. In this study we aim to compare the different eGFR using serum-based creatinine formulas (Cockcroft-Gault, MDRD and CKD-EPI) and the eGFR based on 24-hour urinary creatinine clearance to determine the usefulness of eGFR creatinine formulas to evaluate kidney function in PLKD. Methods: We evaluate kidney function in 799 PLKD using 24-hour urinary ClCr method. The GFR obtained was compared with eGFR based on creatinine (Cockcroft-Gault, MDRD and CKD-EPI). We calculated mean bias (difference), precision (SD of this difference), accuracy (proportion of eGFR within ±10% of ClCr GFR) and performed Bland-Altman-plots. Results: Using the Bland Altman graphic, we observed that the most dispersed results are obtained using MDRD. Smallest mean bias and was observed for Cockcroft-Gault (bias of 5.8; SD 25.1) compared to the other equations (CKD-EPI: bias of 9.8; SD 24.8 and MDRD: bias of 13.8; SD 25.3). Smallest bias was found in females for the three equations. Results of mean bias were similar when comparing the three equations in patients with ClCr GFR < 60, however, smaller mean bias were found for the three equations above age 40 years. Regarding the assessment of the 95% limits of agreement (LoA), we found a high dispersion for the three equations being the highest upper limit of agreement 63.5 (MDRD) and the highest lower limit of agreement -43.4 (Cock-roft-Gault). Conclusion: In this PLKD cohort, Cockcroft-Gault equation showed the highest approximation to the reference method. The interval range was too big to assume equivalence between 24-hour urinary ClCr method and eGFR based on creatinine (Cockcroft-Gault, MDRD and CKD-EPI).

Introduction: Kidney transplantation (KT) is the best therapy for chronic kidney disease (CKD). The second most common etiology associated with morbidity and graft loss after KT are major urologic complications (MUCs). The advancement and modifications of surgical techniques have prevented MUCs. The objective of this study is to estimate the incidence, risk factors, and impact on graft survival associated with urological complications in KT patients. Methods: A retrospective cohort was obtained by electronic records of kidney transplant recipients operated in Colombiana de Trasplantes for the period between August 2008 to September 2019. Initiation of follow-up was defined as the date of transplantation up to 3 years post-transplantation. Incidence of ureteral stenosis, ureteral obstruction, and ureteral leak was measured. A logistic regression multivariate model was adjusted to determine the associated factors to MUCs (yes/no). Patient and graft survival time were analyzed using a Kaplan-Meier methods. Results: A total of 1584 KT patients were analyzed during the study period. MUCs were present in 195 (12.6%) of the KT patients. Dialysis duration, cold ischemia time, and operation room time (ORT) were significant in the bivariate analysis. A multivariate analysis indicated that dialysis duration and cold ischemia time remained significant for the incidence of MUCs. Probability of graft and patient survival at 3 years of follow-up was 90.5% and 85.5% respectively. No significant difference was found on graft and patient survival in KT patients with or without MUCs. Conclusion: MUCs are frequent complications for KT and represent an important burden for the patient and the health system. Our study has shown no significant difference in graft or patient survival. The identification of MUCs and risk factors may guide transplant teams for future surgical and clinical decisions.

Background: Living donor kidney transplant (LDKT) is one of the best therapeutic options for end-stage kidney disease (ESKD). The graft and patient survival rates are significantly higher in living-donor kidney transplantation (LDKT) compared to deceased-donor kidney transplantation. However, there is a lack of information in Latin-American populations. Colombiana de Trasplantes has been one of the centers in Colombia that have performed a high proportion of kidney transplantation from living donors. Therefore, we aimed to evaluate main clinical outcomes, graft, and patient survival for LDKT at our center. Methods: We retrospectively evaluated a total of 530 LDKT patients who underwent transplantation form august 2008 to august 2020 at Colombiana de Trasplantes. Graft survival censored for death and patient survival were determined up to 5 years post transplantation by the Kaplan-Meier method. Frequency of thrombosis, hematoma, urinary leak, and reoperation were documented.Results: A total of 530 LDKT patients were analyzed. Most patients were male (56%). The predominant known chronic kidney disease etiology was glomerular (n = 163, 30.8%). There were 123 (23.2%) LDKT patients with a preemptive transplant. Dialysis duration was 22.1 ± 33.5 months. Most kidney recipients had a medical history of hypertension (n = 405, 76.4%). Besides, 43 LDKT patients were obese (8.1%). Most of the live kidney donors (LKD) were female (n = 279, 52.6%), and relatives for the recipient (n = 366, 69.1%). Main clinical outcomes were mortality (n = 22, 4.1%) and graft loss (n = 46, 8.6%). The graft survival death-censored rates were 93.7% and 89% at 1 and 5 years respectively. Patient survival rates were 97.0% and 94.1% at 1 and 5 years respectively. During the follow-up period, a total of 13 patients had vascular complications (2.4%), 18 had peri transplant hematoma (3.4%), 48 had urinary leak (9.1%), and 98 required reoperations (18.5%). Conclusion: This study describes the experience of 5 years performing LKDT. Long-term graft and patient survival rates in our center are comparable to prior reports from other leading centers. Since there have been many updates in the field of transplantation, clinical outcomes from a mediumsized center can be noteworthy, although not entirely new.