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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Is DTPA the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy?
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Is DTPA the Gold Standard for Glomerular Filtration Rate Estimation in Voluntary Kidney Donors before and after Donor Nephrectomy?

机译：DTPA是在肾病前后自愿肾脏供体中的肾小球过滤速率估计的金标准吗？

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Precise assessment of renal function of voluntary kidney donors has important implications for both donor and recipient health outcome.The ideal test for assessment of overall renal function is measurement of Glomerular Filtration Rate (GFR).Various centres use various creatinine based formulae to calculate the GFR, however when compared to GFR measurements by 99mTcdiethylenetriaminepentaacetic acid (DTPA) isotope clearance, their performance remain inconclusive.Aim: To assess the efficacy of creatinine-based GFR estimating equations in comparison to DTPA scan in voluntary kidney donors before and after donor nephrectomy.Materials and Methods: This study was conducted on 50 voluntary kidney donors who underwent donor nephrectomy at Army Hospital (R&R), New delhi.This study was conducted from November 2016 to March 2018 as a single centre, prospective, longitudinal cohort study on living related kidney donors with follow up at 1 and 3 months after kidney donation.The predictive capabilities of GFR estimation by Cockroft Gault (CG) equation, CG equation corrected for GFR and 24-hour urine Creatinine Clearance (CrCl) corrected for Body Surface Area (BSA), for both pre- and postdonor nephrectomy at 90 days, were assessed and further compared with DTPA-GFR as reference GFR.Individual quantitative parameters were compared using Student t test.For the normally distributed GFR data, Pearson’s correlation coefficient was also calculated.Statistical Package for the Social Sciences (SPSS), version 24.0, software and MS Excel were used for analysis.Results: Out of 50 subjects studied, 38 (76%) were females and 12 (24%) were males.Majority of donors were spouses.The mean GFR measured by 99mTc-DTPA scan was 99.47±14.4 ml/ min/1.73m2 and 62.1±11.5 ml/min/1.73 m2 pre and postdonation respectively.All the equations being evaluated in this study underestimated the GFR as measured by 99mTc DTPA renal scan prior to kidney donation whereas GFR estimation postdonor nephrectomy by CG CrCl and CG GFR overestimated the GFR values while Urine CrCl underestimated it.Conclusion: All the equations performed unsatisfactorily.Even the best performing equation urine-CrCl was also found to be suboptimal for donor evaluation.More accurate methods of GFR estimation, should, thus be used keeping the potential risks of living kidney donation in perspective.
机译：精确评估自愿肾脏捐赠者的肾功能对供体和受体健康结果的重要意义。评估整体肾功能的理想测试是肾小球过滤速率（GFR）的测量。活动中心使用各种基于肌酐的公式来计算GFR来计算GFR然而，与GFR测量相比，通过99mTC二亚乙基四胺间丙酸（DTPA）同位素清除，它们的性能保持不变：评估基于肌酸酐的GFR估计方程的疗效与供体肾脏捐赠者的志愿肾脏供体中的DTPA扫描相比。方法：这项研究是在50名自愿肾脏捐赠者进行的，在陆军医院（R＆amp; R），新德里举行的捐助肾切除术。本研究于2016年11月至2018年3月作为单一中心，前瞻性，纵向队列的生活研究相关肾脏捐赠者在肾脏捐赠后1和3个月后跟进。预测性斗篷在90天内，评估了在90天时90天内校正了对体表面积（BSA）的GFR和24小时尿肌酐清除（CRCL）的GFR估计的GFR估计的能力，并在90天内进行校正的身体表面积（BSA）。进一步与DTPA-GFR相比，作为参考GFR.使用Student T试验比较了各种定量参数。对于正常分布的GFR数据，Pearson的相关系数也计算了社会科学（SPSS），版本24.0，软件和MS的统计包Excel用于分析。结果：50名学科，38名（76％）是女性，12名（24％）是男性。捐赠者的阵地是配偶。通过99MTC-DTPA扫描测量的平均GFR为99.47±14.4 ml / min / 1.73m2和62.1±11.5 ml / min / 1.73m2预先和折叠。在本研究中评估的等式低估了通过99MTC DTPA肾扫描在肾脏捐赠之前测量的GFR，而CG GFR估计Postdonor Nephrectomy CRCL和CG GFR高估了GFR值，而尿CrCl低估了。结论：所有等式都不令人满意地进行.Eveneven，也发现了最佳性能的等式尿CrCl是捐助者评估的次优。因此，应该是GFR估计的准确方法，因此用来用来保持肾脏捐赠的潜在风险。

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