RESUMO
OBJECTIVES: There are conflicting reports on the reliability of the various glomerular filtration rate formula in renal allografts, to assess the performance of various glomerular filtration rate formula in estimating renal function of renal allografts. MATERIALS AND METHODS: Glomerular filtration rate was measured using an isotope Tc99m DTPA in 97 renal transplant patients and estimated using modification of diet in renal disease, Cockroft-Gault formula, Nankivell, and a cystatin C-based formula. The overall performance of these formula was evaluated by calculating bias, accuracy and precision. RESULTS: Mean age was 39.8 years (-/+ 12.7), body mass index was 26.9 (-/+ 6.3) and serum creatinine was 114.5 micromol/L (-/+ 39.3). The mean measured glomerular filtration rate was 58.1 mL/min (-/+ 25.6). The bias with modification of diet in renal disease was 7.7 (P = .03), with Cockroft-Gault formula it was 3.2 (P = .3), with Nankivell it was 10.3 (P = .0002), and with cystatin C it was 0.31 (P = .9) The precisions (r) for modification of diet in renal disease, Cockroft-Gault formula, Nankivell, and cystatin C were 0.26 (P = .01), 0.26 (P = .01), 0.42 (P = .0001), and 0.60 (P < .0001), respectively. We also investigated the impact of sex, age, body mass index, and glomerular filtration rate on the performance of these 4 formula. CONCLUSION: The best correlation, highest precision, accuracy, and least bias were seen when using cystatin C. The largest bias was seen when using Nankivell and modification of diet in renal disease formula.
Assuntos
Cistatina C/sangue , Taxa de Filtração Glomerular , Indicadores Básicos de Saúde , Nefropatias/diagnóstico , Transplante de Rim , Modelos Biológicos , Adulto , Viés , Biomarcadores/sangue , Creatinina/sangue , Feminino , Humanos , Nefropatias/diagnóstico por imagem , Nefropatias/etiologia , Nefropatias/fisiopatologia , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Cintilografia , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Pentetato de Tecnécio Tc 99m , Transplante Homólogo , Resultado do TratamentoRESUMO
The importance of religion In Islamic countries is undoubted. Fatwas (opinion from religious scholars) have been passed in most Islamic countries approving the concepts of brain death and organ transplantation. There are some specific points that have be considered while talking of organ transplantation in Islamic countries. They include public attitude, taking organ(s) from donors who have committed suicide, the influence of local Imams as well as feeding breast milk, concept of spousal donation, timing of death as well as soul departure and extended families that exist in these countries. Sound knowledge of these factors is mandatory to any transplant coordinator and lack of sensitivity to these issues could be disastrous.
