Determinants of the intercept and slope of glomerular filtration rate in recipients of a live donor kidney transplant

Hamböck, Martina; Staudenherz, Anton; Kainz, Alexander; Geist, Barbara; Hecking, Manfred; Doberer, Konstantin; Hacker, Marcus; Böhmig, Georg A.

doi:10.1007/s00508-020-01610-3

Cited by 2 publications

(3 citation statements)

References 31 publications

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“…Many factors might prevent recipients from obtaining an ideal eGFR during the perioperative period, including rejection, delayed graft function, and operative complications ( 7 , 46 , 47 ). However, the period of 3 weeks after LDKT is early to optimize immunosuppression, treat comorbidities, and detect and treat surgical complications, including graft vascular stenosis and urinary tract obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…This finding enabled the detection of slightly widening disparities of eGFR after KT between the graft loss and non-graft loss groups, which could not be detected using the actual eGFR after KT. Many factors might prevent recipients from obtaining an ideal eGFR during the perioperative period, including rejection, delayed graft function, and operative complications (7,46,47). However, the period of 3 weeks after LDKT is early to optimize immunosuppression, treat comorbidities, and detect and treat surgical complications, including graft vascular stenosis and urinary tract obstruction.…”

Section: P-valuementioning

confidence: 99%

“…Specifically, donor and recipient characteristics, including donor age, recipient sex, and donor estimated glomerular filtration rate (eGFR), graft pathological features, and anti-human leukocyte antigen (HLA) donor-specific antibodies (DSAs) affect postoperative graft function (1)(2)(3). Postoperative graft function is also affected by operative factors and postoperative complications, including laparoscopic nephrectomy, warm ischemia time, urological and vascular complications, and rejection (4)(5)(6)(7). Calcineurin inhibitors can cause nephrotoxicity and lead to a low eGFR (8,9).…”

Section: Introductionmentioning

confidence: 99%

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Prediction models for the recipients’ ideal perioperative estimated glomerular filtration rates for predicting graft survival after adult living-donor kidney transplantation

Hiramitsu,

Hasegawa,

Futamura

et al. 2023

Front. Med.

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IntroductionThe impact of the perioperative estimated glomerular filtration rate (eGFR) on graft survival in kidney transplant recipients is yet to be evaluated. In this study, we developed prediction models for the ideal perioperative eGFRs in recipients.MethodsWe evaluated the impact of perioperative predicted ideal and actual eGFRs on graft survival by including 1,174 consecutive adult patients who underwent living-donor kidney transplantation (LDKT) between January 2008 and December 2020. Prediction models for the ideal perioperative eGFR were developed for 676 recipients who were randomly assigned to the training and validation sets (ratio: 7:3). The prediction models for the ideal best eGFR within 3 weeks and those at 1, 2, and 3 weeks after LDKT in 474 recipients were developed using 10-fold validation and stepwise multiple regression model analyzes. The developed prediction models were validated in 202 recipients. Finally, the impact of perioperative predicted ideal eGFRs/actual eGFRs on graft survival was investigated using Fine–Gray regression analysis.ResultsThe correlation coefficients of the predicted ideal best eGFR within 3 weeks and the predicted ideal eGFRs at 1, 2, and 3 weeks after LDKT were 0.651, 0.600, 0.598, and 0.617, respectively. Multivariate analyzes for graft loss demonstrated significant differences in the predicted ideal best eGFR/actual best eGFR within 3 weeks and the predicted ideal eGFRs/actual eGFRs at 1, 2, and 3 weeks after LDKT.DiscussionThe predicted ideal best eGFR/actual best eGFR within 3 weeks and the predicted ideal eGFRs/actual eGFRs at 1, 2, and 3 weeks after LDKT were independent prognostic factors for graft loss. Therefore, the perioperative predicted ideal eGFR/actual eGFR may be useful for predicting graft survival after adult LDKT.

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Section: Discussionmentioning

confidence: 99%

Section: P-valuementioning

confidence: 99%