The performance of three serum creatinine-based formulas in estimating GFR in former kidney donors

Studies addressing long-term consequences of living with one kidney have used serum creatinine-based formulas that have not been validated in former kidney donors. Therefore, we evaluated the performance of Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD) and Mayo Clinic formulas in predicting iohexol glomerular filtration rate (iGFR) after donation in 112 randomly selected former kidney donors. Mean time from donation was 12.2 +/- 8.5 years. Serum creatinine was 1.1 +/- 0.2 mg/dL and iohexol GFR was 72 +/- 12 mL/min/1.73 m(2). The majority, 83.9%, of donors had a GFR > 60 mL/min. CG formula overestimated GFR by 3.35 +/- 13.6 mL/min and was within 10% of iohexol GFR in only 43.7% of cases. MDRD formula underestimated iohexol GFR by 6.45 +/- 9.5 mL/min and was within 10% of actual GFR in half of the cases. In contrast, the Mayo Clinic equation was the most biased at 14.71 +/- 12.3 mL/min and was within 10% of measured GFR in only a fifth of the cases. Only MDRD and CG formulas provide estimates of GFR in former kidney donors that are within a clinically acceptable range of actual GFR. In conclusion, the majority of former kidney donors have excellent kidney function and the MDRD formula should be the recommended GFR estimating model in this population.