ArticleClinical kidney journal2026
Measuring or estimating glomerular filtration rate in potential kidney donors: a comparative study.
Article in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and hypothesis: Accurate assessment of glomerular filtration rate (GFR) is essential during evaluation of prospective kidney donors. While estimated GFR (eGFR) equations are widely used in clinical practice, evidence regarding their performance in individuals with preserved renal function remains limited. We evaluated the agreement of creatinine, cystatin-C, and combined biomarker eGFR equations against measured GFR (mGFR) calculated using iohexol plasma clearance in healthy prospective kidney donors. Methods: We conducted a retrospective observational study of adults undergoing kidney donor assessment at a tertiary UK centre between 2015 and 2018. Serum creatinine and cystatin-C were compared with iohexol plasma clearance. Ten validated eGFR equations were evaluated. Agreement was assessed using Lin's concordance correlation coefficient, bias, P10, P30, and Bland-Altman analyses. Sensitivity and specificity were calculated for each eGFR equation against British Transplant Society age- and sex-specific mGFR donor suitability thresholds. Results: One hundred seven participants were included; 50.5% were females, mean age was 48.5 ± 11.8 years and mean mGFR was 86.5 ± 14.6 ml/min/1.73 m Conclusions: In healthy kidney donors with preserved kidney function, creatinine-based equations, particularly LMR and EKFC, demonstrated improved agreement with iohexol plasma clearance than cystatin-C-based approaches. Despite acceptable population-level performance, low P10 and substantial variability support continued use of mGFR during evaluation of prospective kidney donors.
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