Prognostic value for long-term graft survival of estimated glomerular filtration rate and proteinuria quantified at 3 months after kidney transplantation
Abstract
Background. The estimated glomerular filtration rate (eGFR) measured at 1 year is the usual benchmark applied in kidneytransplantation (KT). However, acting on earlier eGFR values could help in managing KT during the first post-operative year.We aimed to assess the prognostic value for long-termgraft survival of the early (3 months) quantification of eGFR andproteinuria following KT.Methods. The 3-, 6- and 12-month eGFR using the Modified Diet in Renal Disease equation (eGFRMDRD) was determined andproteinuria was measured in 754 patients who underwent their first KT between 2000 and 2010 (with a mean follow-up of8.3 years) in our centre. Adjusted associations with graft survival were estimated using a multivariable Cox model. Thepredictive accuracy was estimated using the C-index and net reclassification index. These same analyses were measured ina multicentre validation cohort of 1936 patients.Results. Both 3-month eGFRMDRD and proteinuria were independent predictors of return to dialysis (all P<0.05) and therewas a strong correlation between eGFR at 3 and 12 months (Spearman’s q¼0.76). The predictive accuracy of the 3-month
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