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Roger,

I couldn't agree more, however an eGFR figure is generated by our labs with each serum creatinine these days regradless of the clinical scenario. If nephrologists follow the trend of changes in serum creatinine in renal transplants patients, I can see no problem with them looking at eGFR figures also, as these are essentially derived from serum creatinine values.

Best wishes

Mohammad

Dr. M A Al-Jubouri
Consultant Chemical Pathologist

----- Original Message ----
From: "Bertholf, Roger" <[log in to unmask]>
To: [log in to unmask]
Sent: Thursday, 3 May, 2007 2:43:58 PM
Subject: Re: R: MDRD-related question

Mohammad:

I think it is also worth considering that the MDRD formula has never, to my knowledge, been validated in this clinical scenario. There are clinical situations, including hospitalized patients, in which the MDRD formula does not correlate very well with the measured GFR. I just heard Greg Miller, who chaired the NKDEP committee that established guidelines for use of the MDRD formula, speak on this topic last week, and he cautioned against use of the calculator for anything except screening outpatients who have risk factors for kidney disease.

Roger

Roger L. Bertholf, Ph.D.

Associate Professor of Pathology

Director of Clinical Chemistry, Toxicology,

and Point of Care Testing

University of Florida Health Science Center/Jacksonville

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Mohammad Al-Jubouri
Sent: Thursday, May 03, 2007 9:09 AM
To: [log in to unmask]
Subject: Re: R: MDRD-related question

It is always good to hear the counter-argument.

So if serum creatinine is 150 umol/L and we use recipient age of 20 years and sex as male, the eGFR will be 55 mL/min/1.73 m2, but if we use donor's age of 60 years and sex as male, then eGFR is 44 mL/min/1.73m2.

I don't think that does matter very much in such scenarios, as we are looking at trend of changes in eGFR, therefore using the recipient age is the only parameter the lab can use and should be good enough for following up trends.

Happy to hear different views.

regards

Mohammad

Dr. M A Al-Jubouri
Consultant Chemical Pathologist

----- Original Message ----
From: Davide Giavarina <[log in to unmask]>
To: [log in to unmask]
Sent: Thursday, 3 May, 2007 12:05:58 PM
Subject: R: MDRD-related question

Why?

This kidney is 60 year old, not 20.

The loss of the nephors during the life remain after the transplantation of a kidney.

If we use the recipient's age, the eGFR will be low.

Da: Clinical biochemistry discussion list [mailto:[log in to unmask]] Per conto di Mohammad Al-Jubouri
Inviato: venerdì 27 aprile 2007 16.22
A: [log in to unmask]
Oggetto: Re: MDRD-related question

What a fantastic question!!

They should use the recipient's age, not the donor's age, as age and sex in MDRD calculation adjust GFR to the muscle mass.

regards

Mohammad

Dr. M A Al-Jubouri
Consultant Chemical Pathologist

----- Original Message ----
From: Dr. Michael Steiner <[log in to unmask]>
To: [log in to unmask]
Sent: Friday, 27 April, 2007 2:49:25 PM
Subject: MDRD-related question

Dear colleagues,

A 20 yr old recipient undergoes a kidney tranplantation and the
transplanted organ comes from a 60 yr old donor. One of our
nephrologists asks which of the two numbers for age should be used in
the MDRD formula.

I promised to collect the wisdom of the listmembers ...

Thank you for your input.

Mike

Dr Michael Steiner
University of Rostock
Institute of Clinical Chemistry & Laboratory Medicine
D-18057 Rostock
GERMANY

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------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/

Yahoo! Answers - Got a question? Someone out there knows the answer. Try it now. ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/

------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/