{"id":24187,"date":"2023-07-23T04:08:00","date_gmt":"2023-07-22T20:08:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24187"},"modified":"2023-07-23T06:11:36","modified_gmt":"2023-07-22T22:11:36","slug":"bmj%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%82%be%e7%a7%bb%e6%a4%8d%e6%82%a3%e8%80%85%e4%b8%8d%e5%8c%85%e6%8b%ac%e7%a7%8d%e6%97%8f%e7%9a%84%e8%82%be%e5%b0%8f%e7%90%83%e6%bb%a4%e8%bf%87","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24187","title":{"rendered":"[BMJ\u53d1\u8868\u8bba\u6587]\uff1a\u80be\u79fb\u690d\u60a3\u8005\u4e0d\u5305\u62ec\u79cd\u65cf\u7684\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\u4f30\u6d4b\u516c\u5f0f"},"content":{"rendered":"\n

Research<\/strong><\/p>\n\n\n\n

Race-free estimated glomerular filtration rate equation in kidney transplant recipients: development and validation study<\/h1>\n\n\n\n

Marc Raynaud, Solaf Al-Awadhi, Ivana Juric,\u00a0et al<\/h3>\n\n\n\n

BMJ<\/em>\u00a02023;\u00a0381\u00a0doi:\u00a0https:\/\/doi.org\/10.1136\/bmj-2022-073654<\/a>\u00a0(Published 31 May 2023)Cite this as:\u00a0BMJ<\/em>\u00a02023;381:e073654<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Objective<\/strong> To compare the performance of a newly developed race-free kidney recipient specific glomerular filtration rate (GFR) equation with the three current main equations for measuring GFR in kidney transplant recipients.<\/p>\n\n\n\n

Design<\/strong> Development and validation study<\/p>\n\n\n\n

Setting<\/strong> 17 cohorts in Europe, the United States, and Australia (14 transplant centres, three clinical trials).<\/p>\n\n\n\n

Participants<\/strong> 15\u2009489 adults (3622 in development cohort (Necker, Saint Louis, and Toulouse hospitals, France), 11\u2009867 in multiple external validation cohorts) who received kidney transplants between 1 January 2000 and 1 January 2021.<\/p>\n\n\n\n

Main outcome measure<\/strong> The main outcome measure was GFR, measured according to local practice. Performance of the GFR equations was assessed using P30<\/sub> (proportion of estimated GFR (eGFR) within 30% of measured GFR (mGFR)) and correct classification (agreement between eGFR and mGFR according to GFR stages). The race-free equation, based on creatinine level, age, and sex, was developed using additive and multiplicative linear regressions, and its performance was compared with the three current main GFR equations: Modification of Diet in Renal Disease (MDRD) equation, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2009 equation, and race-free CKD-EPI 2021 equation.<\/p>\n\n\n\n

Results<\/strong>\u00a0The study included 15\u2009489 participants, with 50\u2009464 mGFR and eGFR values. The mean GFR was 53.18 mL\/min\/1.73m2<\/sup>\u00a0(SD 17.23) in the development cohort and 55.90 mL\/min\/1.73m2<\/sup>\u00a0(19.69) in the external validation cohorts. Among the current GFR equations, the race-free CKD-EPI 2021 equation showed the lowest performance compared with the MDRD and CKD-EPI 2009 equations. When race was included in the kidney recipient specific GFR equation, performance did not increase. The race-free kidney recipient specific GFR equation showed significantly improved performance compared with the race-free CKD-EPI 2021 equation and performed well in the external validation cohorts (P30<\/sub>\u00a0ranging from 73.0% to 91.3%). The race-free kidney recipient specific GFR equation performed well in several subpopulations of kidney transplant recipients stratified by race (P30<\/sub>\u00a073.0-91.3%), sex (72.7-91.4%), age (70.3-92.0%), body mass index (64.5-100%), donor type (58.5-92.9%), donor age (68.3-94.3%), treatment (78.5-85.2%), creatinine level (72.8-91.3%), GFR measurement method (73.0-91.3%), and timing of GFR measurement post-transplant (72.9-95.5%). An online application was developed that estimates GFR based on recipient\u2019s creatinine level, age, and sex (https:\/\/transplant-prediction-system.shinyapps.io\/eGFR_equation_KTX\/<\/a>).<\/p>\n\n\n\n

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Conclusion<\/strong> A new race-free kidney recipient specific GFR equation was developed and validated using multiple, large, international cohorts of kidney transplant recipients. The equation showed high accuracy and outperformed the race-free CKD-EPI 2021 equation that was developed in individuals with native kidneys.<\/p>\n\n\n\n

Trial registration<\/strong> ClinicalTrials.gov NCT05229939<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Research Race-free estimated glomerular filtration rate […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24187"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24187"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24187\/revisions"}],"predecessor-version":[{"id":24188,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24187\/revisions\/24188"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24187"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24187"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24187"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}