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Kidney Week

Abstract: SA-PO153

The Association Between Kinetic Estimated Glomerular Filtration Rate and Clinical Outcomes: A Systematic Review

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Frank, Cairina E., McGill University, Montrel, Quebec, Canada
  • Mavrakanas, Thomas, Geneva University Hospital, Geneva, Switzerland
  • Alam, Ahsan, McGill University Health Centre, Montreal, Quebec, Canada
Background

Accurate assessment of kidney function is an essential aspect of clinical care. In acute kidney injury or renal function recovery, serum creatinine lags behind true kidney function, and GFR estimation using conventional formulae is problematic when serum creatinine is not at steady state. The kinetic estimated glomerular filtration rate (KeGFR) was proposed an alternative as it takes into account changing creatinine over a period of time. The objective of this systematic review was to examine the association between KeGFR and clinical outcomes.

Methods

We conducted a systematic review of studies examining the association between KeGFR and clinical outcomes. The databases searched were PubMed, EMBASE, CINAHL, Scopus and Web of Science, searching for articles in French and English and published from 2013 until 2019. Quality of each study was assessed using the Newcastle-Ottawa scale.

Results

Of 488 articles identified, there were 19 that met inclusion criteria (12 full articles, 7 supplements/abstracts). Ten articles examined the association between KeGFR and acute kidney injury (AKI). KeGFR was not only associated with AKI, but all but one study found that that it better discriminated risk or injury in certain populations. KeGFR could also detect AKI earlier than other commonly used formulae. Four of the five studies that examined mortality found that KeGFR was associated with an increased risk of death and performed better than other biomarkers. KeGFR was also found to accurately predict delayed graft function (n=3) and discontinuation of renal replacement therapy (n=4). Two studies examining the use of KeGFR in therapeutic drug monitoring found it to be a poor predictor.

Conclusion

KeGFR has been shown to be an accurate method of predicting adverse outcomes including acute kidney injury, mortality and renal recovery, however, it appears to not be as effective when used for therapeutic drug monitoring. Prospective studies to validate its use in clinical practice are warranted.