Race-free eGFR for transplantation offers a more accurate measurement for recipients
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Key takeaways:
- The transplant community had been seeking an eGFR equation specific for evaluating transplant recipients.
- A new equation was needed because previous equations were based only on U.S. data.
A new race-free eGFR equation designed specifically for evaluating organ recipients post-transplant offers a more accurate measurement, a researcher said at the American Transplant Congress.
Marc Raynaud, PhD, MSc, lead scientist at Paris Institute for Transplantation and Organ Regeneration, told attendees that previously created eGFR equation measures used for transplantation have had limited success because they were developed for use on native kidneys, created based on U.S.-only patient data, which may limit their generalizability, and have shown suboptimal performance in measuring GFR in transplanted kidneys.
Creating a new equation specific for transplantation had the support of the Kidney Disease: Improving Global Outcomes consortium, Raynaud said.
The researchers did a literature review and found 33 studies on developing GFR equations, Raynaud said, but only three studies were focused on kidney recipients.
“The goal ... was to develop and validate a kidney transplant-specific GFR equation and compare the performance of this equation to the current GFR equation,” Raynaud and colleagues wrote in correspondence published in The New England Journal of Medicine.
Creating two international studies using 17 cohorts of 3,622 kidney recipients for the development of the equation and 11,867 kidney recipients for the external validation of the study data, Raynaud and colleagues used a linear regression model based on additive and multiplicative models and Lasso regression to develop the equation. Transplant centers in France, U.S., Italy, Croatia, The Netherlands, Austria and Denmark participated in the study. “We gathered data from the donor, the recipient, the transplants and other information about the treatment,” Raynaud said.
Performance of the race-free eGFR equation was then tested according to race, sex, and donor type and in other subpopulations, including recipients of living donor kidneys, deceased donor kidneys, underweight and overweight kidney recipients, and in patients 1 year post-transplant and before 1 year post-transplant. “The equation is race-free and contains the age, sex and race of the recipient,” Raynaud said.
How the new equation will impact the transplant community is unclear, Raynaud said. “We are working with medical agencies so that they engage and support and promote this equation,” Raynaud said. “I do hope it will be applied for use in kidney recipients worldwide.”
References:
Reynaud M, et al. BMJ. 2023;10.1136/bmj-22022-073654.
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Raynaud M, et al. Race-free eGFR equation in kidney recipients: A development and validation study. Presented at: American Transplant Congress; June 3-7, 2023; San Diego (hybrid).
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