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Glomerular filtration rate: new age- and gender- specific reference ranges and thresholds for living kidney donation

Lookup NU author(s): Dr Emma Montgomery, Professor Neil Sheerin

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

Background There is a need for a large, contemporary, multi-centre series of 32 measured glomerular filtration rates (mGFR) from healthy individuals to determine 33 age- and gender-specific reference ranges for GFR. We aimed to address this and to 34 use the ranges to provide age- and gender-specific advisory GFR thresholds 35 considered acceptable for living kidney donation. 36 Methods Individual-level data including pre-donation mGFR from 2974 prospective 37 living kidney donors from 18 UK renal centres performed between 2003 and 2015 38 were amalgamated. Age- and gender-specific GFR reference ranges were 39 determined by segmented multiple linear regression and presented as means ± two 40 standard deviations. 41 Results Males had a higher GFR than females (92.0 vs 88.1 mL/min/1.73m2, 42 P<0.0001). Mean mGFR was 100 mL/min/1.73m2 until 35 years of age, following 43 which there was a linear decline that was faster in females compared to males (7.7 44 vs 6.6 mL/min/1.73m2/decade, P=0.013); 10.5% of individuals aged >60 years had a 45 GFR <60 mL/min/1.73m2. The GFR ranges were used along with other published 46 evidence to provide advisory age- and gender-specific GFR thresholds for living 47 kidney donation. 48 Conclusions These data suggest that GFR declines after 35 years of age, and the 49 decline is faster in females. A significant proportion of the healthy population over 60 50 years of age have a GFR <60 mL/min/1.73m2 which may have implications for the 51 definition of chronic kidney disease. Age and gender differences in normal GFR can 52 be used to determine advisory GFR thresholds for living kidney donation.


Publication metadata

Author(s): Fenton A, Montgomery E, Nightingale P, Peters AM, Sheerin N, Wroe AC, Lipkin GW

Publication type: Article

Publication status: Published

Journal: BMC Nephrology

Year: 2018

Volume: 19

Online publication date: 22/11/2018

Acceptance date: 31/10/2018

ISSN (electronic): 1471-2369

Publisher: BioMed Central Ltd.

URL: https://doi.org/10.1186/s12882-018-1126-8

DOI: 10.1186/s12882-018-1126-8


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