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Kidney Week

Abstract: PO2426

Transition of Renal Transplant Care from Pediatrics to Adolescence and Young Adulthood: Retrospective Study Comparing Serum Creatinine-Based GFR Estimating Equations

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Dandamudi, Raja, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, United States
  • Hmiel, Stanley P., Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, United States
  • Dharnidharka, Vikas R., Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, United States
Background

The evaluation of graft function is vital in the management of pediatric kidney transplant (pKTx) recipients. Measured GFR (mGFR) using exogenous markers,is very accurate,but not suitable for daily use. Estimated glomerular filtration rate (eGFR) using Serum creatinine (Scr) is the easiest way and equations are categorized as either pediatric or adult specific.None of the equations were formally compared in adolescents and young adults with renal transplants.
The aim of study was to assess the performance of creatinine-based formulas in a cohort of pKTx in pediatric, adolescents and young adult age groups.

Methods


This retrospective study was conducted at our hospital from January 2000 to March 2019 from 125 pKTx recipients. We compared 415 mGFR values to 5 different Scr-based eGFR formulae (original Schwartz(OS), BS, Pottel, Modification of Diet in Renal Disease (MDRD) ,CKD-EPI, and average of BS and CKD EPI.
Basing on the age at which the GFR was measured we divided the cohort in to 3 categories (children <12 ys, Adolescents (12.1-17.9 ys and young adults >18-21 ys. We used Bland-Altman analysis to evaluate the bias,precision and accuracy between eGFR and mGFR .

Results


Pottel and BS performed well across pediatric and adolescent age groups with high 30% accuracy(figure). MDRD and CKD EPI performance improved in young adults >18 years . Average of BS and CKD EPI outperformed all other equations with minimal bias (0.006 ml/min/1.732 m2) and 90% accuracy in young adults.

Conclusion

Height independent Pottel and height dependent BS formulae had low bias and high accuracy in children and adolescents. Average of BS and CKD EPI outperformed other equations in young adults and provides an overall unbiased estimate of GFR.