{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T13:23:15Z","timestamp":1767964995767,"version":"3.49.0"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Most transplant centers in the Netherlands use estimated glomerular filtration rate (eGFR) for evaluation of potential living kidney donors. Whereas eGFR often underestimates GFR, especially in healthy donors, measured GFR (mGFR) allows more precise kidney function assessment, and therefore holds potential to increase the living donor pool. We hypothesized that mGFR-based donor screening leads to acceptance of donors with lower pre-donation eGFR than eGFR-based screening.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this longitudinal cohort study, we compared eGFR (CKD-EPI) before donation in one center using mGFR-based screening (mGFR-cohort, n = 250) with two centers using eGFR-based screening (eGFR-cohort1, n = 466 and eGFR-cohort2, n = 160). We also compared differences in eGFR at five years after donation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Donor age was similar among the cohorts (mean\u00b1standard deviation (SD) mGFR-cohort 53\u00b110 years, eGFR-cohort1 52\u00b113 years, P = 0.16 vs. mGFR-cohort, and eGFR-cohort2 53\u00b19 years, P = 0.61 vs. mGFR-cohort). Estimated GFR underestimated mGFR by 10\u00b112 mL\/min\/1.73m<jats:sup>2<\/jats:sup> (mean\u00b1SD), with more underestimation in younger donors. In the overall cohorts, mean\u00b1SD pre-donation eGFR was lower in the mGFR-cohort (91\u00b113 mL\/min\/1.73m<jats:sup>2<\/jats:sup>) than in eGFR-cohort1 (93\u00b115 mL\/min\/1.73m<jats:sup>2<\/jats:sup>, P&lt;0.05) and eGFR-cohort2 (94\u00b112 mL\/min\/1.73m<jats:sup>2<\/jats:sup>, P&lt;0.05). However, these differences disappeared when focusing on more recent years, which can be explained by acceptance of more older donors with lower pre-donation eGFR over time in both eGFR-cohorts. Five years post-donation, mean\u00b1SD eGFR was similar among the centers (mGFR-cohort 62\u00b112 mL\/min\/1.73m<jats:sup>2<\/jats:sup>, eGFR-cohort1 61\u00b114 mL\/min\/1.73m<jats:sup>2<\/jats:sup>, eGFR-cohort2 62\u00b111 mL\/min\/1.73m<jats:sup>2<\/jats:sup>, P = 0.76 and 0.95 vs. mGFR-cohort respectively). In the mGFR-cohort, 38 (22%) donors were excluded from donation due to insufficient mGFR with mean\u00b1SD mGFR of 71\u00b19 mL\/min\/1.73m<jats:sup>2<\/jats:sup>.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Despite the known underestimation of mGFR by eGFR, we did not show that the routine use of mGFR in donor screening leads to inclusion of donors with a lower pre-donation eGFR. Therefore eGFR-based screening will be sufficient for the majority of the donors. Future studies should investigate whether there is a group (e.g. young donors with insufficient eGFR) that might benefit from confirmatory mGFR testing.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0270827","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T17:36:13Z","timestamp":1657215373000},"page":"e0270827","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of measured versus estimated glomerular filtration rate-based screening on living kidney donor characteristics: A study of multiple cohorts"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0247-7526","authenticated-orcid":true,"given":"Jessica","family":"van der Weijden","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"van Londen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joke I.","family":"Roodnat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia L.","family":"Kho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"van de Wetering","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinrich","family":"Kloke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ine M. M.","family":"Dooper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan J. L.","family":"Bakker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerjan","family":"Navis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilja M.","family":"Nolte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-8733","authenticated-orcid":true,"given":"Martin H.","family":"De Borst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan P.","family":"Berger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,7,7]]},"reference":[{"key":"pone.0270827.ref001","unstructured":"(NTS) NTS. 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