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dc.creatorLezaić, V.
dc.creatorMirković, Duško
dc.creatorRistić, S.
dc.creatorRadivojević, Dragana
dc.creatorDajak, Marijana
dc.creatorNaumović, Radomir
dc.creatorMarinković, Jelena
dc.creatorĐukanović, Ljubica
dc.date.accessioned2019-09-02T11:35:28Z
dc.date.available2019-09-02T11:35:28Z
dc.date.issued2013
dc.identifier.issn0041-1345
dc.identifier.urihttps://farfar.pharmacy.bg.ac.rs/handle/123456789/1963
dc.description.abstractPurpose. Because no consensus exists regarding the most accurate calculation to estimate glomerular filtration rate (GFR) based on serum creatinine concentrations (sCr) after kidney transplantation, this study sought to assess the potential role of tubular dysfunction on GFR estimates using various equations as well as the effect of pharmacologic blockades on tubular secretion of creatinine on creatinine clearance (ClCr). Methods. Iohexol GFR (mGFR) was performed in 17 stable kidney transplant recipients(R) at >24 months post-transplantation. Their mean age was 48.3 +/- 11.3 years. All R were treated with a calcineurin inhibitor (CNI). At the time of study we measured sCr, 24 hour-ClCr, cystatin C, 24-hour proteinuria, microalbuminuria, FE Na, alfa1-microglobulinuria (alfa1-MG), and CNI concentrations. To block tubular secretion of Cr, recipients were prescribed cimetidine (2400 mg) 2 days before the sCr measurement. Additionally, to exclude dietary influences on sCr, R did not eat meat for 2 days before testing. GFR was estimated using the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Cockroft-Gault (C&G), and Cystatin C (Cyst C) GFR equations. Mean kidney graft function over the previous 6 months was used as the contra. Pearson correlation was determined between the differences between mGFR and estimatedGFR: Iohexol minus MDRD, EPI, Cyst C or C&G GFR for paired estimates. The diagnostic accuracy of the eGFRs to detect an mGFR of 60 mL/min/1.73 m(2) was examined by receiver operating characteristic curves. Results. Mean mGFR was 75.2 +/- 35.8 mL/min/1.73 m2. The sCr increased but the 24-hour ClCr, MDRD, EPI, and C&G decreased after vs before cimetidine. The difference was significant for sCr (F = 12.933; P = .002) and MDRD GFR (F = 15.750; P = .001). mGFR was not significantly higher than all pair values of eGFRs, and not significantly lower than 24-hour ClCr before and after cimetidine. However, in comparison to all eGFRs, ClCr after cimetidine most approached mGFR. A significant positive correlation was observed between alfa1-MG and the difference between mGFR and MDRD (before, r = .543 [P = .045]; after cimeticline, 0.568 [P = .034]), EPI (before, r = 0.516 [P = .050]; after cimetidine, r = 0.562 [P = .0361), and ClCr (r = 0.633; P = .016), C&G (P = .581; P = .029) before cimetidine. Accuracy of eGFRs to detect mGFR of 60 mL/min/1.73 m(2) showed EPI GFR before cimetidine to show diagnostic accuracy for patients with GFR >60 mL/min/1.73 m(2) with a sensitivity of 81.8% and a specificity of 71.4%.en
dc.publisherElsevier Science Inc, New York
dc.rightsrestrictedAccess
dc.sourceTurkish Journal of Medical Sciences
dc.titlePotential Influence of Tubular Dysfunction on the Difference Between Estimated and Measured Glomerular Filtration Rate After Kidney Transplantationen
dc.typearticle
dc.rights.licenseARR
dcterms.abstractМирковић, Душко; Лезаић, В.; Ристић, С.; Радивојевић, Драгана; Дајак, Маријана; Наумовић, Радомир; Маринковић, Јелена; Ђукановић, Љубица;
dc.citation.volume45
dc.citation.issue4
dc.citation.spage1651
dc.citation.epage1654
dc.citation.other45(4): 1651-1654
dc.citation.rankM23
dc.identifier.wos000320627500089
dc.identifier.doi10.1016/j.transproceed.2013.02.105
dc.identifier.pmid23726641
dc.identifier.scopus2-s2.0-84878574446
dc.type.versionpublishedVersion


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