Accuracy of Estimated Glomerular Filtration Rate Equations in Potential Vietnamese Living Kidney Donors
1
Faculty of Medicine, Van Lang University, 69/68 Dang Thuy Tram Street, Ward 13, Binh Thanh District, Ho Chi Minh City 700000, Vietnam
2
Department of Physiology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, 179 Nguyen Van Cu Street, An Khanh Ward, Ninh Kieu District, Can Tho City 900000, Vietnam
3
Department of Urology, Cho Ray Hospital, 201B Nguyen Chi Thanh Street, District 5, Ho Chi Minh City 700000, Vietnam
*
Author to whom correspondence should be addressed.
Transplantology 2024, 5(4), 312-320; https://doi.org/10.3390/transplantology5040031
Submission received: 4 November 2024
/
Revised: 1 December 2024
/
Accepted: 18 December 2024
/
Published: 21 December 2024
(This article belongs to the Section Solid Organ Transplantation)
Abstract
:Background: The accurate assessment of the glomerular filtration rate (GFR) in potential living kidney donors (PLKDs) is essential for successful transplantation and safeguarding kidney donation practice. Scintigraphy-measured GFR (mGFR) is widely regarded as the clinical reference standard. Various estimated GFR (eGFR) equations, such as the Modification of Diet in Renal Disease (MDRD), Cockcroft–Gault (CG), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, have been developed; however, none have been specifically validated for Vietnamese PLKDs. This study aimed to evaluate the accuracy of eGFR formulas compared to mGFR in PLKDs. Methods: This convenience retrospective study analyzed 189 PLKDs at Cho Ray Hospital in Vietnam from January 2014 to December 2020. The eGFR was calculated using various formulas and compared to the mGFR assessed using 99mTechnetium-diethylenetriaminepentaacetic acid. Bias, accuracy, and Bland–Altman plots were used to assess the significance of the eGFR values. Results: The median mGFR was 94.20 mL/min/1.73 m2 (interquartile range [IQR]: 88.40–100.50). The eGFR values were as follows: 77.52 mL/min/1.73 m2 (IQR: 70.50–86.33) for CG; 76.14 mL/min/1.73 m2 (IQR: 68.05–83.37) for MDRD; 106.80 ± 15.24 mL/min/1.73 m2 for CKD-EPI cystatin C 2012; 96.44 ± 13.40 mL/min/1.73 m2 for CKD-EPI creatinine cystatin C 2012; 88.74 ± 13.27 mL/min/1.73 m2 for CKD-EPI creatinine 2021; and 101.32 ± 12.82 mL/min/1.73 m2 for CKD-EPI creatinine cystatin C 2021. Among these formulas, the CKD-EPI creatinine cystatin C 2012 (P30 = 98.96%) and 2021 (P30 = 97.92%) showed the best consistency with the mGFR, owing to their high accuracy, low bias, and narrow limits of agreement in the Bland–Altman plots. Conclusions: The CKD-EPI equations based on creatinine and cystatin C are reliable tools for donor screening.
1. Introduction
Kidney transplantation is recognized as the optimal therapy for end-stage kidney disease, with living donors as a donor source [1]. Living kidney donors are typically healthy individuals who willingly accept the risk of donating a kidney to help patients or family members, without expecting any personal benefit. Research has shown that kidney donation is generally safe, with minimal short-term risks for healthy donors and a low risk of perioperative mortality (0.03%) [2]. For most healthy donors, removing one kidney does not significantly impair the function of the remaining kidney [3]. However, the long-term risks for kidney donors are not yet fully understood [4,5,6,7]. The accurate assessment of kidney function in potential living kidney donors is crucial for ensuring successful transplantation and maintaining the safety of kidney donation practices [8]. The glomerular filtration rate (GFR) has been considered as a predictive factor for kidney function [9]. The measured glomerular filtration rate (mGFR), using an exogenous substance such as inulin, is regarded as the gold standard, though it is time-consuming and expensive. The renal dynamic imaging method, using radioisotopes (99mTechnetium-diethylenetriaminepentaacetic acid—[99mTc-DTPA], chromium-51 ethylenediamine tetraacetic acid, and iothalamate radioiodine 131J or 125J), has been widely used as a clinical reference standard for GFR assessment [9,10].
In clinical practice, the most common method employed to assess the GFR is calculating the estimated glomerular filtration rate (eGFR) using mathematical equations based on serum creatinine or cystatin C, making GFR assessment faster and more cost-effective. The most widely used eGFR equations include the Modification of Diet in Renal Disease (MDRD), Cockcroft–Gault (CG), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas, which are valuable tools for estimating the GFR and classifying kidney function [11,12,13,14]. Although there are many formulas for calculating the eGFR, none have been validated as reliable screening alternatives to mGFR in a population of potential Vietnamese kidney donors. Therefore, we conducted a study to evaluate the accuracy of values derived from GFR-estimating formulas (MDRD, Cockcroft–Gault, CKD-EPI) compared to the mGFR derived from 99mTc-DTPA renography in potential Vietnamese kidney donors.
2. Materials and Methods
This retrospective study was conducted in the kidney transplantation examination room at the Cho Ray Hospital, Ho Chi Minh City, Vietnam, from January 2014 to December 2020. Potential kidney donors over 18 years of age were included. Serum creatinine, serum Cystatin C, and 99mTc-DTPA GFR were measured for all participants. Medical history and physical examinations were performed by the medical team. The exclusion criteria included a history of primary renal or systemic diseases affecting kidney function, the use of nephrotoxic drugs (e.g., aminoglycosides, NSAIDs, cimetidine) that impair kidney function and alter GFR measurement, and pregnancy, due to its physiological effects on renal function and GFR assessment.
The eGFR was calculated using the following formulas: MDRD [14], Cockcroft–Gault [15], CKD-EPI cystatin C 2012 [12], CKD-EPI creatinine cystatin C 2012 [12], CKD-EPI creatinine 2021 [16], and CKD-EPI creatinine cystatin C 2021 [16]. These estimates were compared to the mGFR assessed using 99mTc-DTPA. mGFR measurement with 99mTc-DTPA is simple, highly precise, and capable of evaluating split renal function. Moreover, it has been proposed as an alternative to inulin clearance as the reference standard for determining GFR [9,10].
2.1. Ethical Considerations
This study was approved by the Ethics Committee on Biological Research at Can Tho University of Medicine and Pharmacy in Vietnam (No. 536/PCT-HĐĐĐ; 5 November 2021). All participants were fully informed of the study objectives and procedures and enrolled after providing consent to participate in the study. All participants had the option to decline involvement or to withdraw at any point, and the privacy rights of the participants were observed.
2.2. Statistical Analysis
All statistical analyses were conducted using SPSS Statistics version 22. Continuous variables with a normal distribution were expressed as mean ± standard deviation (SD); while those with a skewed distribution were presented as median and interquartile range (IQR). Categorical variables were summarized as frequency and percentage (%). Regarding their bias and accuracy, we evaluated the performance of various prediction equations. Bias was defined as the median difference between mGFR and eGFR, and the 95% confidence limits were used to express the absolute values of the differences. Accuracy was defined as the proportion of eGFR values within ±10% (P10), ±20% (P20), and ±30% (P30) of the mGFR. The P30 value serves as an indicator of the clinical accuracy to support effective medical decision-making based on the eGFR [17]. Bland–Altman consistency analysis was used to evaluate the agreement between eGFR and mGFR.
We estimated that with 80% power, we would be able to detect the expected mean differences between eGFR and mGFR using a two-sided 5% significance level. Based on a mean difference of 0.01, a standard deviation of 0.55, and a maximum difference of 1.31 and 96.2% [18], the total minimum number of participants required was 179. Subgroup analyses were performed for sex, age, and BMI.
3. Results
We studied 189 potential kidney donors, of which 83 (43.92%) were male and 106 (56.08%) were female. The median age was 51 years (IQR: 42–56), with 84.13% of the participants over the age of 40. The estimated GFR values calculated using various formulas were as follows: 77.52 mL/min/1.73 m2 (IQR: 70.50–86.33) (Cockcroft–Gault); 76.14 mL/min/1.73 m2 (IQR: 68.05–83.37) (MDRD); 106.80 ± 15.24 mL/min/1.73 m2 (CKD-EPI cystatin C 2012); 96.44 ± 13.40 mL/min/1.73 m2 (CKD-EPI creatinine cystatin C 2012); 88.74 ± 13.27 mL/min/1.73 m2 (CKD-EPI creatinine 2021); and 101.32 ± 12.82 mL/min/1.73 m2 (CKD-EPI creatinine cystatin C 2021). The measured GFR assessed using 99mTc-DTPA was 94.20 mL/min/1.73 m2 (IQR: 88.40–100.50). The demographic and descriptive characteristics of the study participants are described in Table 1.
The accuracy of the values derived from various GFR equations within the range of ±10%, ±20%, and ±30% of the mGFR is detailed in Table 2. The accuracy of estimation within ±10% was low (18.75–67.19%), while the accuracy within ±20% ranged from 50% to 92.71%. The accuracy of all the equations within ±30% was higher than 75%, with the CKD-EPI creatinine cystatin C 2012 and the CKD-EPI creatinine 2021 equations achieving the highest accuracy, at 98.96%. The bias indices of these equations in relation to the mGFR are depicted in Table 3 (CG = −16.14, MDRD = −18.60, CKD-EPI cystatin C 2012 = 10.92, CKD-EPI creatinine cystatin C 2012 = 0.56, CKD-EPI creatinine 2021 = −7.14, and CKD-EPI creatinine cystatin C 2021 = 5.44). The Bland–Altman plots of the mGFR and eGFR values with bias and 95% limits of agreement for each equation showed that the CKD-EPI creatinine cystatin C 2012 equation had the smallest mean bias (0.56) (Figure 1). When analyzing the subgroups by gender, BMI, and age groups, the CKD-EPI equations based on creatinine and cystatin C showed better accuracy in females, individuals with a BMI under 25, and those aged 40 and older. In comparison, for males, individuals with a BMI over 25, and those under 40 years of age, the CKD-EPI creatinine 2021 demonstrated better performance.
4. Discussion
In the present study, the participants were healthy adults donating kidneys to relatives with end-stage renal disease. The CKD-EPI creatinine cystatin C 2012, CKD-EPI creatinine 2021, and CKD-EPI creatinine cystatin C 2021 formulas demonstrated the highest accuracy among the estimated formulas (P30 > 90%).
The CKD-EPI equation consistently met the clinically significant threshold of P30 ≥ 75%, as suggested by the 2002 Kidney Disease Outcomes Quality Initiative guidelines, with values above 90% preferred [17]. In a study by Kakde et al. on kidney donors in South Asia, the CKD-EPI creatinine cystatin C 2012 formula showed the highest accuracy, achieving a P10 accuracy of 43% and a P20 accuracy of 72%. Overall, the CKD-EPI formulas demonstrated greater accuracy and less bias compared to those of the Cockcroft–Gault and MDRD formulas [19]. Mroz et al. also found that the accuracy (P10) of the CKD-EPI formulas was higher than that of the Cockcroft–Gault and MDRD formulas: the Cockcroft–Gault equation had an accuracy of 20%, the MDRD equation’s accuracy was 27%, the CKD-EPI creatinine 2009 equation’s accuracy was 33%, the CKD-EPI cystatin C 2012 equation’s accuracy was 40%, and the CKD-EPI creatinine cystatin C 2012 equation’s accuracy was 37% [20].
Pottel et al. analyzed data from 11 studies involving both a healthy population and a population with renal disease, finding that the accuracies (P30) of the CKD-EPI creatinine 2009, CKD-EPI cystatin C 2012, and CKD-EPI creatinine cystatin C 2012 formulas, when the mGFR was 80 mL/min/1.73 m2, were 88.1%, 80.4%, and 88.2%, respectively [21]. Furthermore, a Mexican study of 97 healthy individuals demonstrated that the CKD-EPI formula significantly outperformed the MDRD formula in all comparisons (bias, correlation, and accuracy) [22], with similar results reported in Asian populations [19,23].
Our data showed that the Cockcroft–Gault and MDRD equations exhibited lower accuracy and higher (negative) bias, underestimating the GFR in healthy kidney donors. The CKD-EPI creatinine cystatin C 2012 and 2021 equations showed higher accuracy, lower bias, and narrower limits of agreement in the Bland–Altman plots, confirming their strong consistency with the mGFR. The accuracy of the CKD-EPI equations based on creatinine and cystatin C was better in females, individuals with a BMI under 25, and those aged 40 and older. Conversely, in males, individuals with a BMI over 25, and those under 40 years of age, the CKD-EPI creatinine 2021 performed better. These findings suggest that gender, BMI, and age significantly influence the accuracy of eGFR in kidney donors.
Giron-Luque et al. [24] evaluated 799 potential living kidney donors, comparing the Cockcroft–Gault, MDRD, and CKD-EPI creatinine 2009 estimation formulas with the 24 h creatinine clearance value. Although all three formulas underestimated the GFR, the CKD-EPI equation was the least scattered and most precise, with a better accuracy in females and those under 40 years of age. In Pakistan, a study with 207 potential kidney donors found the accuracy of the MDRD, Cockroft–Gault, and CKD-EPI formulas to be 48.8%, 41.5%, and 78.2%, respectively. The donors’ body mass index and obesity did not impact the accuracy of the eGFR calculated with these formulas [25]. Lemoine et al. studied 209 obese individuals and also found the CKD-EPI formula to be valuable for assessing the renal function in this population [26].
Carla Burballa et al. analyzed the correlation between the measured GFR assessed using 99mTc-DTPA and the estimated GFR according to the MDRD and CKD-EPI formulas in living kidney donors. Both formulas also underestimated the eGFR compared to the mGFR, but the CKD-EPI formula was more suitable for screening kidney donors [27].
In 2021, Inker et al. developed two equations, namely CKD-EPI creatinine 2021 and CKD-EPI creatinine cystatin C 2021, which omit race and improve the accuracy of kidney function assessment [16]. Goodson et al. [28] evaluated the eGFR in 637 potential living kidney donors, comparing the accuracy of the MDRD formulas and CKD-EPI creatinine 2009 and CKD-EPI creatinine 2021 formulas with the mGFR assessed using iohexol. The results showed that the value calculated using the CKD-EPI creatinine 2021 formula was less biased and more accurate than those derived from previous creatinine-based estimated GFR equations, with a P30 value of 96.4% in Asian individuals.
One study assessed the effectiveness of various formulas, including the CKD-EPI creatinine 2009, CKD-EPI creatinine 2021, CKD-EPI cystatin C 2012, CKD-EPI creatinine cystatin C 2012, and CKD-EPI creatinine cystatin C 2021 formulas, in estimating the GFR before and three months after kidney donation in 486 living donors in the Netherlands. The results indicated that the eGFR values derived from the CKD-EPI creatinine 2021, CKD-EPI creatinine cystatin C 2012, and CKD-EPI creatinine cystatin C 2021 formulas had the closest correlation with the mGFR assessed both before and after kidney donation. The accuracy (P30) before kidney donation was 97.5%, 98.9%, and 97.9%, respectively, and after kidney donation, it was 96.6%, 96.6%, and 96.2% [18].
Overall, the estimated GFR (eGFR) obtained from the CKD-EPI formulas (CKD-EPI creatinine cystatin C 2012, CKD-EPI creatinine 2021, and CKD-EPI creatinine cystatin C 2021) demonstrated a better correlation, accuracy, and bias than the eGFR derived from the Cockcroft–Gault and MDRD formulas in living kidney donors. These formulas are effective for the screening and initial assessment of renal function in potential kidney donors.
Limitations
Our study has several limitations. Firstly, it was conducted at a single center, which may limit the generalizability to the findings to other populations with different demographic characteristics. Additionally, the retrospective nature of the study restricts our ability to control for potential confounders and may introduce selection bias. Furthermore, the cohort consisted of generally healthy potential kidney donors with normal kidney function, which limits the applicability of these findings to patients with renal impairment.
5. Conclusions
The CKD-EPI equations based on creatinine and cystatin C showed the highest accuracy and consistency with the measured GFR, making them valuable tools for assessing the kidney function in potential living kidney donors. However, since these equations may underestimate or overestimate GFR, their use in the initial evaluation of renal function among potential donors must be approached with caution, especially in clinical subgroups defined by gender, BMI, and age. Developing new GFR estimation formulas suitable for these subgroups is essential to improve the accuracy and reliability of donor selection processes.
Author Contributions
Conceptualization, T.D., T.T.T.T., C.K.H., and S.M.T.; methodology, T.D., T.T.T.T., C.K.H., and S.M.T.; investigation and analysis, T.D. and T.T.T.T.; writing—original draft preparation, T.D. and T.T.T.T.; writing—review and editing, T.D., T.T.T.T., C.K.H., and S.M.T.; supervision, T.D., T.T.T.T., and S.M.T. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
This study was conducted in accordance with the Declaration of Helsinki, and was approved by the Ethics Committee on Biological Research at Can Tho University of Medicine and Pharmacy in Vietnam (No. 536/PCT-HĐĐĐ; 5 November 2021).
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study.
Data Availability Statement
The data that support the findings of this study are available from the corresponding authors upon reasonable request.
Acknowledgments
We are grateful to Can Tho University of Medicine and Pharmacy in Can Tho City and Cho Ray Hospital in Ho Chi Minh City, Vietnam, for their time and effort in supporting this study.
Conflicts of Interest
The authors declare no conflicts of interest.
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Figure 1.
Bland–Altman plot (agreement between glomerular filtration rate estimated by various equations and mGFR by 99mTc-DTPA).
Figure 1.
Bland–Altman plot (agreement between glomerular filtration rate estimated by various equations and mGFR by 99mTc-DTPA).
Table 1.
Descriptive characteristics of the study participants.
| Characteristics | No. or Mean (SD) or Median (IQR) |
|---|---|
| No. of donors | 189 |
| Sex, n (%) | |
| Male | 83 (43.92) |
| Female | 106 (56.08) |
| Age, years, median (IQR) | 51 (42–56) |
| Age groups, n (%) | |
| Age 18–39 | 30 (15.87) |
| Age ≥ 40 | 159 (84.13) |
| BMI, kg/m2, median (IQR) | 22.67 (21.00–23.82) |
| BMI groups, n (%) | |
| <25 | 168 (88.89) |
| ≥25 | 21 (11.11) |
| mGFR by 99mTc-DTPA, mL/min/1.73 m2, median (IQR) | 94.20 (88.40–100.50) |
| eGFR by CG, mL/min/1.73 m2, median (IQR) | 77.52 (70.50–86.33) |
| eGFR by MDRD, mL/min/1.73 m2, median (IQR) | 76.14 (68.05–83.37) |
| eGFR by CKD-EPI cystatin C 2012, mL/min/1.73 m2, mean (SD) | 106.80 (15.24) |
| eGFR by CKD-EPI creatinine cystatin C 2012, mL/min/1.73 m2, mean (SD) | 96.44 (13.40) |
| eGFR by CKD-EPI creatinine 2021, mL/min/1.73 m2, mean (SD) | 88.74 (13.27) |
| eGFR by CKD-EPI creatinine cystatin C 2021, mL/min/1.73 m2, mean (SD) | 101.32 (12.82) |
SD: standard deviation; IQR: interquartile range; kg: kilograms; BMI: body mass index; mGFR: measured glomerular filtration rate; eGFR: estimated glomerular filtration rate; mL: milliliters; min: minute; CG: Cockcroft–Gault; MDRD: Modification of Diet in Renal Disease; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration.
Table 2.
Accuracy of estimated glomerular filtration rate equations compared to 99mTc-DTPA glomerular filtration rate.
Table 2.
Accuracy of estimated glomerular filtration rate equations compared to 99mTc-DTPA glomerular filtration rate.
| eGFR (mL/min/1.73 m2) | P10, n (%) | P20, n (%) | P30, n (%) |
|---|---|---|---|
| Cockcroft–Gault | 43 (22.40) | 112 (58.33) | 161 (83.85) |
| MDRD | 36 (18.75) | 96 (50.00) | 153 (79.69) |
| CKD-EPI cystatin C 2012 | 80 (41.67) | 138 (71.88) | 170 (88.54) |
| CKD-EPI creatinine cystatin C 2012 | 128 (66.67) | 177 (92.19) | 190 (98.96) |
| CKD-EPI creatinine 2021 | 129 (67.19) | 178 (92.71) | 190 (98.96) |
| CKD-EPI creatinine cystatin C 2021 | 116 (60.42) | 169 (88.02) | 188 (97.92) |
Table 3.
Agreement between glomerular filtration rate estimated according to various equations and mGFR assessed using 99mTc-DTPA.
Table 3.
Agreement between glomerular filtration rate estimated according to various equations and mGFR assessed using 99mTc-DTPA.
| eGFR (mL/min/1.73 m2) | Bias (SD Bias) | Limits of Agreement |
|---|---|---|
| Cockcroft–Gault | −16.14 (12.97) | −41.56, 9.28 |
| Male | −15.12 (13.32) | −41.23, 10.99 |
| Female | −16.93 (12.69) | −41.80, 7.94 |
| BMI < 25 | −17.43 (12.21) | −41.36, 6.50 |
| BMI ≥ 25 | −5.76 (14.42) | −34.02, 22.50 |
| Age < 40 | −8.94 (14.39) | −37.14, 19.26 |
| Age ≥ 40 | −16.79 (12.69) | −41.66, 8.08 |
| MDRD | −18.60 (12.28) | −42.67, 5.47 |
| Male | −13.27 (11.38) | −35.57, 9.03 |
| Female | −22.78 (11.34) | −45.01, −0.55 |
| BMI < 25 | −19.22 (12.03) | −42.80, 4.36 |
| BMI ≥ 25 | −14.38 (13.38) | −40.60, 11.84 |
| Age < 40 | −19.95 (13.05) | −45.53, 5.63 |
| Age ≥ 40 | −19.01 (12.28) | −43.08, 5.06 |
| CKD-EPI cystatin C 2012 | 10.92 (13.91) | −16.34, 38.18 |
| Male | 10.62 (15.95) | −20.64, 41.88 |
| Female | 11.15 (12.15) | −12.66, 34.96 |
| BMI < 25 | 11.03 (14.17) | −16.74, 38.80 |
| BMI ≥ 25 | 10.01 (11.87) | −13.26, 33.28 |
| Age < 40 | 11.03 (14.17) | −16.74, 38.80 |
| Age ≥ 40 | 10.02 (11.87) | −13.25, 33.29 |
| CKD-EPI creatinine cystatin C 2012 | 0.56 (10.54) | −20.10, 21.22 |
| Male | 2.85 (10.51) | −17.75, 23.45 |
| Female | −1.24 (10.25) | −21.33, 18.85 |
| BMI < 25 | 0.38 (10.70) | −20.59, 21.35 |
| BMI ≥ 25 | 1.98 (9.22) | −16.09, 20.05 |
| Age < 40 | 6.44 (11.46) | −16.02, 28.90 |
| Age ≥ 40 | −0.03 (9.86) | −19.36, 19.30 |
| CKD-EPI creatinine 2021 | −7.14 (11.72) | −30.11, 15.83 |
| Male | −2.64 (10.36) | −22.95, 17.67 |
| Female | −10.66 (11.55) | −33.30, 11.98 |
| BMI < 25 | −7.75 (11.52) | −30.33, 14.83 |
| BMI ≥ 25 | −2.21 (12.42) | −26.55, 22.13 |
| Age < 40 | −5.78 (12.79) | −30.85, 19.29 |
| Age ≥ 40 | −7.56 (11.80) | −30.69, 15.57 |
| CKD-EPI creatinine cystatin C 2021 | 5.44 (10.44) | −15.02, 25.90 |
| Male | 8.20 (10.53) | −12.44, 28.84 |
| Female | 3.27 (9.90) | −16.13, 22.67 |
| BMI < 25 | 5.23 (10.57) | −15.49, 25.95 |
| BMI ≥ 25 | 7.08 (9.46) | −11.46, 25.62 |
| Age < 40 | 9.54 (11.29) | −12.59, 31.67 |
| Age ≥ 40 | 5.05 (10.68) | −15.88, 25.98 |
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MDPI and ACS Style
Diep, T.; Tran, T.T.T.; Hoang, C.K.; Thai, S.M. Accuracy of Estimated Glomerular Filtration Rate Equations in Potential Vietnamese Living Kidney Donors. Transplantology 2024, 5, 312-320. https://doi.org/10.3390/transplantology5040031
AMA Style
Diep T, Tran TTT, Hoang CK, Thai SM. Accuracy of Estimated Glomerular Filtration Rate Equations in Potential Vietnamese Living Kidney Donors. Transplantology. 2024; 5(4):312-320. https://doi.org/10.3390/transplantology5040031
Chicago/Turabian StyleDiep, Thang, Tam Thai Thanh Tran, Chuan Khac Hoang, and Sam Minh Thai. 2024. "Accuracy of Estimated Glomerular Filtration Rate Equations in Potential Vietnamese Living Kidney Donors" Transplantology 5, no. 4: 312-320. https://doi.org/10.3390/transplantology5040031
APA StyleDiep, T., Tran, T. T. T., Hoang, C. K., & Thai, S. M. (2024). Accuracy of Estimated Glomerular Filtration Rate Equations in Potential Vietnamese Living Kidney Donors. Transplantology, 5(4), 312-320. https://doi.org/10.3390/transplantology5040031