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12. Performance of estimated glomerular filtration rate equations in Black living kidney donor candidates.

Author

Augustine, Joshua J., Liaqat, Aimen, Arrigain, Susana, Schold, Jesse D., and Poggio, Emilio D.

Subjects
*GLOMERULAR filtration rate, *BLACK political candidates, *CYSTATIN C, *KIDNEYS, *RACE
Abstract

Introduction: New estimated glomerular filtration rate (eGFR) equations using serum creatinine and/or cystatin C have been derived to eliminate adjustment by perceived Black ancestry. We sought to analyze the performance of newer eGFR equations among Black living kidney donor candidates. Methods: Black candidates (n = 64) who had measured iothalamate GFR between January 2015 and October 2021 were included, and eGFR was calculated using race adjusted (eGFRcr2009 and eGFRcr‐cys2012) and race unadjusted (eGFRcys2012, eGFRcr2021, and eGFRcr‐cys2021) CKD‐EPI equations. Bias and accuracy were calculated. Results: The eGFRcr2021 equation had a negative bias of 9 mL/min/1.73 m2, while other equations showed a modest positive bias. Accuracy within 10% and 30% was greatest using the eGFRcr‐cys2021 equation. With the eGFRcr2021 equation, 9.4% of donors with an mGFR > 80 mL/min/1.73 m2 were misclassified as having an eGFR < 80 mL/min/1.73 m2. eGFR was also compared among 18 kidney donors at 6–24 months post‐donation. Post‐donation, the percentage of donors with an eGFR < 60 mL/min/1.73 m2 was 44% using the eGFRcr2021 equation compared to 11% using the eGFRcr‐cys2021 equation. Conclusion: The CKD‐EPICr2021 equation appears to underestimate true GFR in Black living donor candidates. Alternatively, compared to CKD‐EPICr2021, the CKD‐EPICr‐CysC2021 equation appears to perform with less bias and improved accuracy. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Kidney Structural Features from Living Donors Predict Graft Failure in the Recipient

Author

Issa, Naim, primary, Lopez, Camden L., additional, Denic, Aleksandar, additional, Taler, Sandra J., additional, Larson, Joseph J., additional, Kremers, Walter K., additional, Ricaurte, Luisa, additional, Merzkani, Massini A., additional, Alexander, Mariam Priya, additional, Chakkera, Harini A., additional, Stegall, Mark D., additional, Augustine, Joshua J., additional, and Rule, Andrew D., additional

Published
2020
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39. Comparison of high glomerular filtration rate thresholds for identifying hyperfiltration.

Author

Chakkera, Harini A, Denic, Aleksandar, Kremers, Walter K, Stegall, Mark D, Larson, Joseph J, Ravipati, Harish, Taler, Sandra J, Lieske, John C, Lerman, Lilach O, Augustine, Joshua J, and Rule, Andrew D

Subjects
GLOMERULAR filtration rate, BODY surface area, BODY mass index, RENAL biopsy, DEFINITIONS
Abstract

Background High glomerular filtration rate (GFR) is often used as a surrogate for single-nephron hyperfiltration. Our objective was to determine the definition for high GFR that best reflects clinical and structural characteristics of hyperfiltration. Methods We studied living kidney donors at the Mayo Clinic and Cleveland Clinic. Potential donors underwent evaluations that included measured GFR (mGFR) by iothalamate clearance and estimated GFR (eGFR) by the serum creatinine–based Chronic Kidney Disease-Epidemiology collaboration (CKD-EPI) equation. High GFR was defined by the 95th percentile for each method (mGFR or eGFR) using either overall or age-specific thresholds. High mGFR was defined as both corrected and uncorrected for body surface area. The association of high GFR by each definition with clinical characteristics and radiologic findings (kidney volume) was assessed. In the subset that donated, the association of high GFR with kidney biopsy findings (nephron number and glomerular volume) and single-nephron GFR was assessed. Results We studied 3317 potential donors, including 2125 actual donors. The overall 95th percentile for corrected mGFR was 134 mL/min/1.73 m2 and for eGFR was 118 mL/min/1.73 m2. The age-based threshold for uncorrected mGFR was 198 mL/min − 0.943×Age, for corrected mGFR it was 164 mL/min/1.73 m2 − 0.730×Age and for eGFR it was 146 mL/min/1.73 m2 − 0.813×Age. High age-based uncorrected mGFR had the strongest associations with higher single-nephron GFR, larger glomerular volume, larger kidney volume, male gender, higher body mass index and higher 24-h urine albumin, but also had the strongest association with high nephron number. A high age-height-gender–based uncorrected mGFR definition performed almost as well but had a weaker association with nephron number and did not associate with male gender. Conclusions High age-based uncorrected mGFR showed the most consistent associations reflective of hyperfiltration. However, high age-based uncorrected mGFR has limited clinical utility because it does not distinguish between hyperfiltration and high nephron number. [ABSTRACT FROM AUTHOR]

Published
2020
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40. Sodium thiosulfate as first-line treatment for calciphylaxis

Author

Ackermann, Felix, Levy, Annabelle, Daugas, Eric, Schartz, Noel, Riaux, Anne, Derancourt, Christian, Urena, Pablo, Lebbe, Celeste, Robinson, Maria R., Augustine, Joshua J., and Korman, Neil J.

Subjects
Calcification -- Abnormalities, Necrosis -- Care and treatment, Sodium thiosulfate -- Dosage and administration, Parathyroid hormone -- Physiological aspects, Leg -- Ulcers, Leg -- Care and treatment, Health
Published
2007

50. Fever, Infection, and Rejection After Kidney Transplant Failure

Author

Woodside, Kenneth J., primary, Schirm, Zachary W., additional, Noon, Kelly A., additional, Huml, Anne M., additional, Padiyar, Aparna, additional, Sanchez, Edmund Q., additional, Sarabu, Nagaraju, additional, Hricik, Donald E., additional, Schulak, James A., additional, and Augustine, Joshua J., additional

Published
2014
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