The Impact of Age and Body Composition on the Agreement between Estimated and Measured GFR in Heart Transplant Recipients.

IF 2.3 4区医学 Q2 UROLOGY & NEPHROLOGY Nephron Pub Date : 2024-09-14 DOI:10.1159/000540530

Mads Hornum, Morten Buus Jørgensen, Lærke Marie Sidenius Nelson, Bo Feldt-Rasmussen, Kasper Rossing, Esteban Porrini, Peter Oturai, Finn Gustafsson

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Abstract

Background: Estimated GFR (eGFR) has shown poor agreement with measured GFR (mGFR) in several populations. We investigated the impact of age and body composition on the accuracy and precision of eGFR in heart transplant (HTx) recipients.

Methods: In a longitudinal, observational, retrospective study design, patients receiving first-time HTx with at least one registered mGFR value within 15 months after HTx and a corresponding plasma creatinine were included. GFR was measured by 51Cr-EDTA and eGFR calculated by creatinine-based CKD-EPI formula.

Results: A total of 150 patients with a total of 723 mGFR measurements were included. During the first year after HTx, mean weight increased by 4.2 kg (CI: 3.2 to 5.1) followed by an annual decrease of 0.35 kg/year (Cl: -0.05 to 0.74). mGFR increased by 7.5 mL/min (Cl: 3.2 to 11.8) the first year but was stable hereafter (0.0 mL/min/year; CI: -1.0 to 1.0). The initial weigh gain and increase in mGFR were most pronounced in patients <45 years. Neither eGFR adjusted nor unadjusted for BSA detected the initial increase in mGFR. At 1 year after HTx, limits of agreement on the Bland-Altman plot were -37.2 to 33.1 mL/min with a bias of -2.1 mL/min (Cl: -5.0 to 0.9). In patients <45 years, eGFR significantly overestimated mGFR by 7.1 mL/min (Cl: 1.0 to 13.2) and showed a significant lower precision than patients >45 years. There was no effect of BMI class, weight, BSA, or change in BMI class on the difference between eGFR and mGFR.

Conclusion: eGFR is, on average, accurate but imprecise in HTx patients. The agreement is affected by age but not body composition.

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年龄和身体成分对心脏移植受者估计和测量的 GFR 之间一致性的影响。

背景在一些人群中，估算的 GFR（eGFR）与测量的 GFR（mGFR）的一致性较差。我们研究了年龄和身体成分对心脏移植（HTx）受者 eGFR 的准确性和精确性的影响。方法采用纵向、观察性、回顾性研究设计，纳入首次接受心脏移植的患者，这些患者在接受心脏移植后 15 个月内至少有一次登记的 mGFR 值和相应的血浆肌酐。用 51Cr-EDTA 测量 GFR，用基于肌酐的 CKD-EPI 公式计算 eGFR。结果 150 名患者共进行了 723 次 mGFR 测量。HTx 术后第一年，平均体重增加了 4.2 千克（CI:3.2-5.1），随后每年减少 0.35 千克（Cl:-0.05-0.74），mGFR 在第一年增加了 7.5 毫升/分钟（Cl:3.2-11.8），但此后保持稳定（0.0 毫升/分钟/年，CI:-1.0-1.0）。最初体重增加和 mGFR 增加在 45 岁患者中最为明显。调整或未调整 BSA 的 eGFR 均未检测到 mGFR 的初始增长。在 HTx 一年后，Bland-Altman 图的一致性界限为-37.2-33.1 毫升/分钟，偏差为-2.1 毫升/分钟（Cl:-5.0-0.9）。在 45 岁患者中，eGFR 明显高估了 mGFR 7.1 毫升/分钟（Cl:1.0-13.2），精确度明显低于 45 岁患者。BMI 等级、体重、BSA 或 BMI 等级的变化对 eGFR 和 mGFR 之间的差异没有影响。结论在高血压患者中，eGFR 平均准确但不精确。一致性受年龄影响，但不受身体成分影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nephron UROLOGY & NEPHROLOGY-

CiteScore

5.00

自引率

0.00%

发文量

期刊介绍： ''Nephron'' comprises three sections, which are each under the editorship of internationally recognized leaders and served by specialized Associate Editors. Apart from high-quality original research, ''Nephron'' publishes invited reviews/minireviews on up-to-date topics. Papers undergo an innovative and transparent peer review process encompassing a Presentation Report which assesses and summarizes the presentation of the paper in an unbiased and standardized way.