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The combination of area under the curve and percentage change in estimated glomerular filtration rate predicts long‐term outcome of kidney transplants
Author(s) -
Lee Eun Jeong,
Jeon Junseok,
Lee Kyo Won,
Yoo Heejin,
Jang Hye Ryoun,
Park Jae Berm,
Lee Jung Eun,
Kim Kyunga,
Huh Wooseong
Publication year - 2020
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15711
Subject(s) - medicine , renal function , urology , term (time) , outcome (game theory) , mathematics , physics , mathematical economics , quantum mechanics
The development of surrogate markers for long‐term outcomes of kidney transplant (KT) is a focus of attention. We examined the possibility of using a combination of the area under the curve of estimated glomerular filtration rate (eGFR) for 2 years (AUC eGFR2yrs ) and percent change in eGFR between 1 and 2 years after KT (% change eGFR1/2yr ) as a surrogate marker. We compared the predictive power of death‐censored graft failure with various combinations. The combination of >2% vs ≤2% for % change eGFR1/2yr and >1300 vs ≤1300 mL/min/month for AUC eGFR2yr had the highest Harrell C‐index (0.647; 95% confidence interval [95% CI], 0.604‐0.690). The death‐censored graft survival rate of the group with ≤2% change eGFR1/2yr and ≤1300 mL/min/month AUC eGFR2yr was significantly lower than those of other groups. The AUC/% change eGFR had comparable predictive power to the previously identified marker ≥30% decline in eGFR between years 1 and 3 after KT (≤−30% change eGFR1/3yr ) (Harrell's C‐index = 0.645 [95% CI 0.628‐0.662] for ≤−30% change eGFR1/3yr ). The proposed combination might be useful as a surrogate marker in KT trials because it requires a shorter surveillance period than the established marker while having comparable predictive power.