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. 2022 Mar 9;11(6):1496.
doi: 10.3390/jcm11061496.

Estimating Renal Function Following Lung Transplantation

Mads Hornum  1   2 , Morten Baltzer Houlind  3   4   5 , Esben Iversen  3 , Esteban Porrini  6   7 , Sergio Luis-Lima  8 , Peter Oturai  9 , Martin Iversen  10 , Pia Bredahl  11 , Jørn Carlsen  12 , Christian Holdflood Møller  13 , Mads Jønsson Andersen  12 , Bo Feldt-Rasmussen  1   2 , Michael Perch  2   10
Affiliations

Estimating Renal Function Following Lung Transplantation

Mads Hornum et al. J Clin Med. .

Abstract

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 by 51Cr-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.

Keywords: cystatin c; estimated glomerular filtration rate; immunosuppression; lung transplantation; measured glomerular filtration rate.

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Conflict of interest statement

The authors declare no conflict of interest regarding this study.

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