Glomerular filtration rate in prospective living kidney donors

摘要

Purpose: Measurements of glomerular filtration rate (GFR) are frequently interpreted assuming a linear variation with age. Nonlinear relationships may give a better representation of the changes associated with normal ageing. Methods: This was a retrospective study of 904 subjects (468 women, 436 men; age range 18-84 years) undergoing assessment as prospective living kidney donors. GFR was evaluated from 51Cr-EDTA plasma clearance using blood samples taken at 2, 3 and 4 h. The slope-intercept GFR was corrected for body surface area (BSA) using the Haycock formula and for the fast exponential using the Brochner-Mortensen equation. The relationship between age, gender and GFR was examined using best-fit curve analysis. Nonlinear relationships with age were explored using fractional polynomials. Results: There was no gender difference in BSA-corrected GFR over five decades of age (P = 0.40). However, female donors with a body mass index 30 kg/m2 had a statistically significantly lower GFR than nonobese women (P 0.01). The best-fit relationship between age and GFR was nonlinear and described using a fractional polynomial model of degree 1 (GFR = 103.9-0.0061 × Age2 mL/min/1.73 m2) with a root mean standard error of 12.9 mL/min/1.73 m2. The residual variance for this model was significantly smaller than for the best-fit linear model (P = 0.006). Conclusions: GFR measurements in prospective living kidney donors are best corrected for age using a nonlinear relationship.