TY - JOUR

T1 - Estimating Renal Function Following Lung Transplantation

AU - Hornum, Mads

AU - Houlind, Morten Baltzer

AU - Iversen, Esben

AU - Porrini, Esteban

AU - Luis-Lima, Sergio

AU - Oturai, Peter

AU - Iversen, Martin

AU - Bredahl, Pia

AU - Carlsen, Jørn

AU - Møller, Christian Holdflood

AU - Andersen, Mads Jønsson

AU - Feldt-Rasmussen, Bo

AU - Perch, Michael

N1 - Funding Information: Funding: M.H. was supported by an unrestricted grant from the Helen and Ejnar Bjørnow Foundation and a grant from the Lundbeck Foundation (R187-2015-2148). M.B.H. was supported by a postdoctoral fellowship from The Capital Region’s Research Foundation for Health Research, Denmark (A6882). Funding Information: M.H. was supported by an unrestricted grant from the Helen and Ejnar Bj?rnow Foundation and a grant from the Lundbeck Foundation (R187-2015-2148). M.B.H. was supported by a postdoctoral fellowship from The Capital Region?s Research Foundation for Health Research, Denmark (A6882). Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2022

Y1 - 2022

N2 - Background: Patients undergoing lung transplantation (LTx) experience a rapid decline in glomerular filtration rate (GFR) in the acute postoperative period. However, no prospective longitudinal studies directly comparing the performance of equations for estimating GFR in this patient population currently exist. 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 by51 Cr-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.

AB - Background: Patients undergoing lung transplantation (LTx) experience a rapid decline in glomerular filtration rate (GFR) in the acute postoperative period. However, no prospective longitudinal studies directly comparing the performance of equations for estimating GFR in this patient population currently exist. 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 by51 Cr-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.

KW - Cystatin c

KW - Estimated glomerular filtration rate

KW - Immunosuppression

KW - Lung transplantation

KW - Measured glomerular filtration rate

U2 - 10.3390/jcm11061496

DO - 10.3390/jcm11061496

M3 - Journal article

C2 - 35329822

AN - SCOPUS:85126055667

VL - 11

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

SN - 2077-0383

IS - 6

M1 - 1496

ER -