A comparison of prediction equations for estimating glomerular filtration rate in Chinese potential living kidney donors.

BACKGROUND: Accurate measurement of donor renal function has important long-term implications for both donors and recipients. In clinical practice, renal function may be estimated by using 24-h urinary creatinine clearance (urine-CrCl) and various specifically derived prediction equations. We assessed the suitability of urine-CrCl and prediction equations for evaluating Chinese kidney donors.

METHODS: A total of 224 donors who had undergone (99m)Tc-diethylenetriaminepentaacetic acid glomerular filtration rate (GFR) estimation were enrolled. We evaluated the performance of the Cockcroft-Gault equation (CG-CrCl), the CG-CrCl equation corrected for GFR (CG-GFR), the isotope dilution mass spectrometry traceable modification of diet in renal disease (IDMS-MDRD) study equation, the new MDRD study equation for Chinese (C-MDRD 1), the modified MDRD study equation with a Chinese coefficient (C-MDRD 2), the modified IDMS-MDRD study equation with a Japanese coefficient (J-MDRD), and urine-CrCl in predicting GFR before donation.

RESULTS: Of 224 donors selected, 68 were male and 156 were female. Of all the prediction equations, C-MDRD 1 was the least scattered and most precise. However, predictive performance was poor for all the equations.

CONCLUSION: The performance of urine-CrCl and all the equations was disappointing, and even the best performing equation C-MDRD 1 was unacceptable. Considering the potential risk of living kidney donation, other more accurate methods of GFR measurement should be used in clinical practice.