METHODS: In total, 32 patients undergoing LTx met the study criteria. At pre-LTx and 1-, 3-, and 12-weeks post-LTx, GFR was determined by 51Cr-EDTA and by equations for estimating GFR based on plasma (P)-Creatinine, P-Cystatin C, or a combination of both.
RESULTS: Measured GFR declined from 98.0 mL/min/1.73 m2 at pre-LTx to 54.1 mL/min/1.73 m2 at 12-weeks post-LTx. Equations based on P-Creatinine underestimated GFR decline after LTx, whereas equations based on P-Cystatin C overestimated this decline. Overall, the 2021 CKD-EPI combination equation had the lowest bias and highest precision at both pre-LTx and post-LTx.
CONCLUSIONS: Caution must be applied when interpreting renal function based on equations for estimating GFR in the acute postoperative period following LTx. Simplified methods for measuring GFR may allow for more widespread use of measured GFR in this vulnerable patient population.
方法:总共,32例接受LTx的患者符合研究标准。在pre-LTx和1-,3-,LTx后12周,通过51Cr-EDTA和基于血浆(P)-肌酸酐的估算GFR的方程式测定GFR,P-胱抑素C,或两者的组合。
结果:测得的GFR从LTx前的98.0mL/min/1.73m2下降到LTx后12周的54.1mL/min/1.73m2。基于P-肌酸酐的方程低估了LTx后GFR的下降,而基于P-胱抑素C的方程高估了这种下降。总的来说,2021年CKD-EPI组合方程在LTx前和LTx后的偏差最低,精度最高.
结论:在基于估算LTx术后急性期GFR的方程解释肾功能时,必须谨慎。用于测量GFR的简化方法可以允许在该脆弱患者群体中更广泛地使用测量的GFR。