Glomerular filtration rate: Utility for assessing long-term renal allograft outcomes in kidney allograft recipients

Glomerular filtration rate (GFR) is the parameter currently used in renal transplantation to monitor renal function and to predict long-term survival of the graft. Due to practical difficulties in measuring GFR through inulin or creatinine clearance, formulas have been designed to estimate GFR from serum creatinine and indirect indices of creatinine production from muscles, i.e., gender, age and body weight. These formulas have been used to monitor renal graft function and to predict graft outcome. Present evidence indicates that estimated GFR (eGFR) can be a relatively imprecise instrument to measure renal function, but remains useful for monitoring graft function and predicting graft outcome. Despite certain limitations, eGFR has provided invaluable information on the determinants of renal graft outcome, especially on the effects of different immunosuppressive regimens. A number of trials examining new immunosuppressive regimens (including calcineurin inhibitor minimization and novel therapeutics) have employed eGFR as an endpoint for assessing clinical benefit. In this capacity, eGFR assessment has provided important data for comparing regimens. This paper reviews the usefulness of eGFR for predicting renal transplant outcomes.