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leading to a higher proportion of marginal candidates with a growing number of comorbidities&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> This could lead to accelerated loss of kidney function post-donation&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Although the absolute risk of terminal kidney disease post-donation has historically been low &#40;0&#46;31&#37;&#8211;0&#46;47&#37;&#41;&#44; comorbidities in marginal donors such as albuminuria&#44; hypertension and obesity<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a> could shift this paradigm&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Therefore&#44; precise assessment of kidney function pre-donation and follow-up thereof post-nephrectomy are essential for identifying increased-risk donors in order to implement prevention and follow-up strategies&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Measured glomerular filtration rate &#40;mGFR&#41;&#44; determined using an exogenous marker&#44; is considered the best method for measuring kidney function&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> However&#44; the complexity and costs of this technique limit its availability at most transplant centres&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Estimated GFR &#40;eGFR&#41; equations&#44; including the modification of diet in renal disease &#40;MDRD&#41; equation<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> and the chronic kidney disease epidemiology collaboration &#40;CKD-EPI&#41; equation&#44;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> are considered reasonable alternatives&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">However&#44; these equations were designed and validated in populations with chronic kidney disease and therefore underestimate GFR in the highest range&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Creatinine clearance may also be useful&#44; but it generally shows a great deal of variability&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The limitations of the MDRD formula include poor correlation with mGFR with values exceeding 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; The CKD-EPI formula was validated based on a cohort that&#44; unlike the MDRD formula&#44; included not only patients with reduced kidney function but also individuals with normal kidney function&#46; Thus&#44; it offers better correlation to mGFR in healthy subjects&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In Latin America&#44; there is limited experience in assessment of kidney function by techniques for measuring GFR in kidney donors as an acceptance criterion&#44; or in follow-up of GFR post-nephrectomy&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The objective of this study was to assess the long-term performance of the MDRD and CKD-EPI equations in kidney donors in order to examine post-nephrectomy GFR dynamics&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study design</span><p id="par0060" class="elsevierStylePara elsevierViewall">A prospective cohort study was conducted with repeated GFR measurements and estimates in 189 kidney donors&#44; all over 18 years of age&#44; who underwent nephrectomy between 2007 and 2016 at Hospital Privado Universitario de C&#243;rdoba &#91;C&#243;rdoba University Private Hospital&#93; in C&#243;rdoba&#44; Argentina&#46; All donors with at least one GFR measurement pre-donation and who underwent another GFR measurement following nephrectomy &#40;both measurements performed using iothalamate clearance&#41; in 2017 and 2018 were enrolled&#46; All participants signed an informed consent form for this study&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The following kidney donors were excluded&#58; those allergic to iodine or to the contrast used &#40;iothalamate meglumine&#41;&#59; those with confirmed evidence of a urinary tract infection or systemic infection of any origin at the time when the study was being conducted&#59; those on treatment with diuretics&#44; non-steroidal anti-inflammatory drugs or trimethoprim&#47;sulfamethoxazole&#59; and those with any decompensated cardiovascular disease&#44; any of the above-mentioned infectious diseases or dehydration which affected their GFR at the time when the clearance was being determined&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">GFR measurement was performed with iothalamate determined by HPLC and the corresponding value was used as an acceptance criterion for donation&#46; Another post-donation measurement was done at different times in relation to the pre-donation measurement&#46; The study was approved by the institutional ethics committee &#40;IEC&#41;&#46; All procedures were performed in accordance with the Declaration of Helsinki and the Declaration of Istanbul&#46; Height&#44; weight and body mass index &#40;BMI&#41; data were collected at all visits&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Kidney function measurement</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Iothalamate clearance measurement</span><p id="par0075" class="elsevierStylePara elsevierViewall">An iothalamate clearance test was performed on donors who fulfilled the conditions set out in the protocol&#46; The determination was made under fasting conditions&#44; without taking any drugs&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">First&#44; the bladder was emptied and the urine was discarded&#46; Next&#44; 1<span class="elsevierStyleHsp" style=""></span>ml of iothalamate meglumine &#40;Conray&#174; &#91;Mallinckrodt Inc&#46; Blanchardstown&#44; Dublin&#44; Ireland&#93; 60&#37;&#41; was administered subcutaneously&#46; Following an equilibration period of 60<span class="elsevierStyleHsp" style=""></span>min&#44; the first blood sample was taken&#46; The donor remained at rest and maintained oral hydration with 150<span class="elsevierStyleHsp" style=""></span>ml of water every 15<span class="elsevierStyleHsp" style=""></span>min until they emptied their bladder again&#46; Two hours after administration of iothalamate&#44; the entire volume of urine was collected and the second blood sample was taken&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The glomerular filtration rate was determined using non-radiolabelled iothalamate renal clearance determined by high-performance liquid chromatography&#46; The instrument used was a Gilson&#174; HPLC system &#40;Middleton&#44; WI&#44; United States&#41; with a Model 189 UV&#47;visible detector&#46; The column used was a Phenomenex&#174; column &#40;Torrance&#44; CA&#44; United States&#41; &#40;C<span class="elsevierStyleInf">18</span>&#44; 20<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>4&#46;5<span class="elsevierStyleHsp" style=""></span>mm&#41;&#46; Plasma samples were taken with lithium heparin as an anticoagulant&#44; and urine samples were collected in sterile bottles&#46; Clearance was calculated as U<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>V&#47;P&#44; where U was the concentration of iothalamate determined in urine&#44; P was the concentration of iothalamate determined in plasma and V was the volume &#40;ml&#41; adjusted for time and BMI&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;21</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Calculation of the estimated glomerular filtration rate</span><p id="par0090" class="elsevierStylePara elsevierViewall">The abbreviated MDRD equation &#40;MDRD-4&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> with creatinine standardised by isotope dilution mass spectrometry &#40;ID-MS&#41;&#44; was used&#46; The CKD-EPI equation was used with differentiation by gender and stratification by creatinine level&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Creatinine concentration in serum was determined using a compensated kinetic Jaffe technique traceable to the ID-MS reference method in MODULAR P&#174; &#40;Roche&#44; Mannheim&#44; Germany&#41; and COBAS 6000&#174; autoanalysers &#40;Roche&#44; Mannheim&#44; Germany&#41;&#46; The reagents and calibrators used were from Roche&#44; the internal quality controls used were from RANDOX&#174; ACUSERA &#40;Randox Laboratories Ltd&#46; County Antrim&#44; United Kingdom&#41; and the external control used was from RIQAS &#40;United Kingdom&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0095" class="elsevierStylePara elsevierViewall">Continuous variables were expressed in terms of mean and 95&#37; confidence interval &#40;CI&#41; or in terms of median and interquartile range &#40;p25&#8211;p75&#41;&#44; depending on the type of distribution&#46; Qualitative variables were expressed in terms of percentage and 95&#37; CI&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The Kolmogorov&#8211;Smirnov test was used to determine the normality of the quantitative variables&#46; For intergroup comparisons of independent quantitative variables&#44; the following were used as non-parametric tests&#58; the Kruskal&#8211;Wallis test for more than two samples and the Wilcoxon test for analysis of two related samples&#46; To evaluate agreement between two systems of measurement&#44; a Bland&#8211;Altman analysis was performed&#46; Receiver operating characteristic &#40;ROC&#41; curves were constructed from which different diagnostic parameters were obtained&#44; such as the area under the curve &#40;AUC&#41; for each eGFR for the detection of an mGFR lower than 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; The CIs were computed at the 95&#37; level&#46; The level of significance was 95&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Kidney compensation was defined as the percentage GFR achieved by the remaining kidney compared to the baseline GFR determined prior to nephrectomy&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The percentage was calculated of donors whose post-nephrectomy GFR&#44; estimated using the MDRD and CKD-EPI equations&#44; underestimated the filtration rate when compared with the GFR measured by iothalamate clearance&#46; The values studied were 60 and 90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">To conduct the statistical analysis&#44; the statistical software package IBM SPSS&#174; Statistics version 19 &#40;Armonk&#44; New York&#44; United States&#41; was used&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0120" class="elsevierStylePara elsevierViewall">The cohort&#8217;s demographic characteristics&#44; anthropometric characteristics and kidney function pre-donation are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; GFR stabilisation dynamics post-nephrectomy were studied in a subgroup of donors&#46; GFR stabilisation was seen as of three months post-nephrectomy &#40;results not shown&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows demographic and kidney function values&#46; Two groups were established considering post-donation GFR evaluation time&#46; The evaluation time for group 1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>107&#41; was between three months &#40;period observed for post-donation GFR stabilisation&#41; and five years&#46; The evaluation time for group 2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41; was between five years and 10 years post-donation&#46; A statistically significant difference was seen in all pre- and post-donation parameters&#44; both in group 1 and in group 2&#44; except in height and weight&#46; The groups studied showed no differences in long-term versus short-term changes in creatinine &#40;group up to 5 years and more than 5 years&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;47&#41;&#46; Kidney compensation for the two groups was 61&#46;9&#37; &#40;52&#46;0&#37;&#8211;71&#46;1&#37;&#41; for group 1 and 75&#46;6&#37; &#40;64&#46;9&#37;&#8211;84&#46;4&#37;&#41; for group 2&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">The post-donation groups were compared to one another&#44; and a statistically significant difference was seen in mGFR alone &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the correlations between the GFRs estimated using the MDRD and CKD-EPI equations in relation to the GFRs measured by iothalamate clearance prior to nephrectomy&#46; A value of 90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> was established as a reference&#46; Both formulas were subjected to regression analysis&#46; The resulting equation for MDRD was y<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;6608 X<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>26&#46;52&#44; r&#58; 0&#46;53 p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#46; The same for CKD-EPI was y<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;4702 X<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>54&#46;69&#44; r&#58; 0&#46;58 p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the GFR estimated using the MDRD and CKD-EPI equations compared to the GFR measured by iothalamate clearance post-nephrectomy&#46; Two GFR values were established and considered references&#58; 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> and 90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">The percentage was determined of donors whose post-nephrectomy GFR determined using each equation underestimated its value when compared to the reference mGFRs of 60 and 90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; The MDRD equation underestimated GFRs for 3&#46;2&#37; and 38&#46;6&#37; of donors compared to mGFRs greater than 90 and 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; while the CKD-EPI equation showed that 2&#46;6&#37; and 13&#46;8&#37; of the eGFRs underestimated when evaluating mGFRs greater than 90 and 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; respectively&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Diagnostic performance was determined using the area under the ROC curve for each eGFR in the post-nephrectomy donor assessment&#58; MDRD &#40;AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;66&#44; CI&#58; 0&#46;59&#8211;0&#46;73&#41;&#44; sensitivity 98&#46;7&#37;&#44; specificity 63&#46;3&#37; and CKD-EPI &#40;AUC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;79&#44; CI&#58; 0&#46;73&#8211;0&#46;85&#41;&#44; sensitivity 96&#46;9&#37; and specificity 76&#46;4&#37;&#44; considering a GFR of 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> as a reference&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> shows the agreement of the eGFR pre-and post-donation using the Bland&#8211;Altman test&#46; The MDRD equation showed a pre-donation bias of &#8211;15&#46;0 &#40;CI&#58; &#8211;24&#46;0&#59; &#8211;0&#46;2&#41; ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> and a post-donation bias of &#8211;20&#46;5 &#40;&#8211;30&#46;4&#59; &#8211;08&#46;5&#41;<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; The CKD-EPI equation showed a bias of &#8211;6&#46;1 &#40;&#8211;14&#46;0&#59; 2&#46;4&#41;<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> and &#8211;3&#46;4 &#40;&#8211;12&#46;1&#59; 8&#46;6&#41;<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> in pre- and post-nephrectomy GFR&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a> shows the GFRs of the donors pre- and post-nephrectomy by age group &#40;I&#41;&#46; No statistically significant differences were found between intragroup GFRs &#40;before and after nephrectomy&#41; or between the different age groups comparing the pre-nephrectomy GFRs and the post-nephrectomy GFRs&#46; The cohort was divided into men &#40;II&#41; and women &#40;III&#41;&#44; and the structure for analysis used for the full cohort was applied to these divisions&#46; No statistically significant differences were found between the GFRs under the same conditions in which the complete sample was compared&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0165" class="elsevierStylePara elsevierViewall">Prior studies that have compared the MDRD equation and the CKD-EPI equation with GFR measurement methods for assessing kidney function in donor screening have yielded different results&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> The equations revealed underestimations with respect to mGFR and showed poor precision&#46; The performance of the equations involved high percentages of potential donors who would be rejected without measurement of glomerular filtration rate using direct techniques&#46; Similarly&#44; it was found that some donors might be erroneously accepted with the use of the equations&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;23</span></a> Therefore&#44; estimation of GFR with MDRD and CKD-EPI in candidates for kidney donation results in both the rejection of suitable candidates with a falsely low GFR and the acceptance of unsuitable candidates with a supposedly high GFR&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">It is considered advisable to use a measured method&#44; since approximation &#40;correlation and percentage of error&#41; of the eGFR by equations to the mGFR is limited&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> Despite its importance&#44; there is no consensus on the minimum GFR allowed for a prospective donor to undergo nephrectomy&#46; This exposes the need for more comprehensive evaluation of GFR in kidney donor screening&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">This study evaluated the behaviour of kidney function and the performance of different methods for measurement and estimation thereof in a cohort of kidney donors&#46; The compensation values seen post-nephrectomy ranged from 62&#37; to 76&#37; between three months and 10 years post-nephrectomy&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Several studies have analysed recovery of kidney function post-donation&#46; All of them have linked an increase in kidney volume to GFR compensation&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#8211;27</span></a> Different reports have given a detailed account of the process through which the remaining kidney increases its GFR following donation&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> In a live kidney donor&#44; kidney flow is increased immediately after nephrectomy such that&#44; despite the loss of half the donor&#8217;s functional kidney mass&#44; a GFR corresponding to 70&#37; of the donor&#8217;s prior kidney function is achieved&#46; Some studies have evaluated pre-existing factors associated with recovery of kidney function and have agreed that a higher baseline GFR is predictive of better kidney function a year after donation&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;28&#44;29</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">The performance of the equations for estimating GFR post-nephrectomy following the stabilisation thereof was evaluated&#46; Both the MDRD equation and the CKD-EPI equation underestimated GFR post-donation&#44; particularly for GFRs of 60&#8211;90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Several studies have assessed these equations as tools for donor screening&#44; but few studies have evaluated them in a post-donation context&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">This was the scenario in which we found the greatest underestimation effect&#44; particularly with MDRD&#44; which erroneously classified 38&#46;6&#37; of donors post-nephrectomy with GFRs exceeding 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; The area under the ROC curve for the MDRD equation&#44; for an mGFR &#60;60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#44; was a low value &#40;0&#46;66&#41; due to its poor diagnostic specificity&#44; which could cause incorrect evaluation of GFRs in kidney donors post-nephrectomy&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">This study reported biases on the part of the MDRD and the CKD-EPI&#44; in line with other published studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;22&#44;30</span></a> finding an increase in the bias of the MDRD equation when it was used post-nephrectomy &#40;&#8211;19&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">We evaluated the distribution of estimated and measured GFR values considering donor age group&#46; Both equations applied to different age groups showed a lack of agreement with measured values&#44; both in the evaluation before donation and in the evaluation after it&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">The CKD-EPI equation showed a distribution with greater agreement compared to the MDRD in relation to mGFR values&#46; However&#44; underestimation was seen across all age groups&#46; The underestimation and high variability of the equations&#44; where wide ranges of estimated values compared to measured values were seen for the same values&#44; call into question their applicability&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">This takes on great importance when precise determination of GFR is required in the care of kidney donors&#44; as well as in their screening&#44; particularly in those with expanded criteria&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">The possibility of detecting modest changes in GFR is essential for identifying donors at risk and thus for being able to promptly implement strategies for prevention and personalised monitoring&#46; Most transplant programmes assess serum creatinine levels or estimate GFR with the equations that we assessed in this study for long-term follow-up of their donors&#44; all for reasons of accessibility&#44; despite the limitations previously reported in the general population and confirmed by our study when applied to donors&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19&#44;31</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">The KDIGO guidelines affirm the need to determine GFR&#44; but do not establish the most suitable methodology to be used to do so&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> The results of our series suggest that&#44; in donors under 40 years of age with a family history of chronic kidney disease&#44; albuminuria or blood pressure at the upper limit of normal&#44; a strategy of measurement rather than estimation with traditional formulas would be recommended&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">In conclusion&#44; post-donation GFR and GFR stabilisation post-nephrectomy achieves an average level of compensation of 70&#37; of the initial GFR&#46; Equations for estimating GFR show poor performance for long-term follow-up of GFR post-nephrectomy&#46; It would be advisable to measure GFR in the screening and follow-up of certain donors under the current criteria for screening and acceptability for donation&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Funding</span><p id="par0235" class="elsevierStylePara elsevierViewall">This study received no specific funding from public&#44; private or non-profit organisations&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicts of interest</span><p id="par0240" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
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          "titulo" => "Abstract"
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            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Background"
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            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Materials and methods"
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              "identificador" => "abst0015"
              "titulo" => "Results"
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          "titulo" => "Keywords"
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        2 => array:2 [
          "identificador" => "xpalclavsec1386473"
          "titulo" => "Abbreviations"
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          "titulo" => "Resumen"
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              "titulo" => "Introducci&#243;n"
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              "titulo" => "Materiales y m&#233;todos"
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          "titulo" => "Palabras clave"
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          "titulo" => "Introduction"
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          "titulo" => "Materials and methods"
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              "titulo" => "Study design"
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              "titulo" => "Kidney function measurement"
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                  "titulo" => "Iothalamate clearance measurement"
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                  "titulo" => "Calculation of the estimated glomerular filtration rate"
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              "titulo" => "Statistical analysis"
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          "titulo" => "Results"
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          "titulo" => "Conflicts of interest"
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          "titulo" => "References"
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    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2019-09-25"
    "fechaAceptado" => "2020-07-10"
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          "clase" => "keyword"
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          "palabras" => array:3 [
            0 => "Iothalamate"
            1 => "Glomerular filtration rate"
            2 => "Living kidney donor"
          ]
        ]
        1 => array:4 [
          "clase" => "abr"
          "titulo" => "Abbreviations"
          "identificador" => "xpalclavsec1386473"
          "palabras" => array:6 [
            0 => "CKD-EPI"
            1 => "GFR"
            2 => "HPLC"
            3 => "MDRD"
            4 => "NSAIDs"
            5 => "ROC"
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    "resumen" => array:2 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Long-term consequences associated with kidney donation are controversial&#46; Pre- and post-donation glomerular filtration rates &#40;GFRs&#41; are determinants of renal and cardiovascular risk weighting&#46; In Latin America&#44; there is limited experience in evaluating kidney function using GFR measurement techniques in kidney donors&#46; The MDRD 4-variable and CKD-EPI equations are considered reasonable options&#46; The objective of this study was to evaluate the performance of the MDRD and CKD-EPI equations in post-nephrectomy GFR dynamics in kidney donors&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">A prospective cohort study with GFR measurement and estimation in 189 kidney donors who underwent nephrectomy between 2007 and 2016 at the Hospital Privado Universitario de C&#243;rdoba &#91;Private University Hospital of C&#243;rdoba&#93; in C&#243;rdoba&#44; Argentina&#46; GFRs were evaluated before and after nephrectomy by iothalamate clearance determined by HPLC and by the MDRD and CKD-EPI equations for estimating GFR&#46; Two groups were formed for this study&#58; Group 1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>107&#41;&#44; with an evaluation time subsequent to GFR stabilization &#40;3 months&#41; of up to 5 years&#44; and Group 2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41;&#44; with an evaluation time of 5&#8211;10 years following donation&#46; Measured GFR &#40;mGFR&#41; was assessed by iothalamate clearance determined by HPLC&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Renal compensation values were 61&#46;9&#37; &#40;52&#46;0&#37;&#8211;71&#46;1&#37;&#41; and 75&#46;6&#37; &#40;64&#46;9&#37;&#8211;84&#46;4&#37;&#41; for Group 1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>107&#41; and Group 2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41;&#44; respectively&#46; MDRD underestimated the GFR in 3&#46;2&#37; &#40;90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; and 38&#46;6&#37; &#40;60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; compared to the mGFR&#44; and CKD-EPI underestimated the GFR in 2&#46;6&#37; &#40;90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; and 13&#46;8&#37; &#40;60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&#46; Diagnostic performance was evaluated with a ROC curve &#40;mGFR<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; for MDRD &#40;ABC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;66&#59; CI&#58; 0&#46;59&#8211;0&#46;73&#59; sensitivity&#58; 98&#46;7&#37;&#59; specificity&#58; 63&#46;3&#37;&#41; and for CKD-EPI &#40;ABC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;79 CI&#58; 0&#46;73&#8211;0&#46;85&#59; sensitivity&#58; 96&#46;9&#37;&#59; specificity&#58; 76&#46;4&#37;&#46; Estimated GFR &#40;eGFR&#41; showed poor performance for estimating the glomerular filtration rate in the post-nephrectomy follow-up of donors over 50 years of age&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Equations for estimating GFRs showed poor performance for long-term follow-up of post-nephrectomy GFRs&#46; Measuring GFRs to determine kidney function is recommended in the screening and follow-up of some donors under the current selection criteria&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Las consecuencias a largo plazo asociadas con la donaci&#243;n renal resultan controvertidas&#46; La tasa de filtraci&#243;n glomerular &#40;TFG&#41; pre y posdonaci&#243;n resulta determinante en la ponderaci&#243;n del riesgo renal y cardiovascular&#46; En Latinoam&#233;rica&#44; existe escasa experiencia sobre la evaluaci&#243;n de la funci&#243;n renal por t&#233;cnicas de medici&#243;n del filtrado glomerular en donantes renales&#46; Las ecuaciones MDRD y la CKD-EPI son consideradas alternativas razonables&#46; El objetivo del trabajo fue evaluar el rendimiento de las ecuaciones MDRD y CKD-EPI en la din&#225;mica del filtrado glomerular posnefrectom&#237;a en donantes renales&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y m&#233;todos</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de cohorte con medici&#243;n &#40;mTFG&#41; y estimaci&#243;n de la tasa de filtrado glomerular &#40;eTFG&#41; en 189 donantes renales con nefrectom&#237;a entre 2007 y 2016 en el Hospital Privado Universitario de C&#243;rdoba&#44; Argentina&#46; Las TFG se evaluaron&#44; previo y posterior a la nefrectom&#237;a&#44; mediante el aclaramiento de iotalamato determinado por cromatograf&#237;a l&#237;quida de alta eficacia y por las ecuaciones para estimaci&#243;n de TFG&#58; MDRD y CKD-EPI&#46; Se constituyeron 2 grupos de estudio&#58; grupo 1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>107&#41; con un tiempo de evaluaci&#243;n posterior a la estabilizaci&#243;n de la TFG posdonaci&#243;n &#40;3 meses&#41; hasta los 5 a&#241;os y grupo 2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41; con un tiempo entre 5 y 10 a&#241;os posdonaci&#243;n&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">El valor de compensaci&#243;n renal fue del 61&#44;9&#37; &#40;52&#44;0-71&#44;1&#37;&#41; y 75&#44;6&#37; &#40;64&#44;9-84&#44;4&#37;&#41; para los grupos 1 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>107&#41; y 2 &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>82&#41;&#44; respectivamente&#46; La ecuaci&#243;n MDRD subestim&#243; la TFG en el 3&#44;2&#37; &#40;90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; y el 38&#44;6&#37; &#40;60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; respecto a la mTFG y la CKD-EPI subestim&#243; en un 2&#44;6&#37; &#40;90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; y un 13&#44;8&#37; &#40;60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&#46; Se evalu&#243; el rendimiento diagn&#243;stico con curva ROC &#40;mTFG<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#44;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41; para MDRD &#40;ABC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;66&#44; IC&#58; 0&#44;59-0&#44;73&#41;&#44; sensibilidad&#58; 98&#44;7&#37; y especificidad&#58; 63&#44;3&#37;&#44; y para CKD-EPI &#40;ABC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;79&#44; IC&#58; 0&#44;73-0&#44;85&#41;&#44; sensibilidad&#58; 96&#44;9&#37; y especificidad&#58; 76&#44;4&#37;&#46; Las eTFG mostraron un bajo desempe&#241;o para estimar el filtrado en el seguimiento posnefrectom&#237;a de los donantes mayores de 50 a&#241;os&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Las ecuaciones de estimaci&#243;n de la TFG muestran un bajo desempe&#241;o para el seguimiento a largo plazo del filtrado posnefrectom&#237;a y la medici&#243;n del filtrado ser&#237;a recomendable en la selecci&#243;n como en el seguimiento de ciertos donantes bajo los criterios actuales de selecci&#243;n&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Luj&#225;n P&#44; Chiurchiu C&#44; Capra R&#44; de Arteaga J&#44; de la Fuente J&#44; Douthat W&#46; Medici&#243;n y estimaci&#243;n del filtrado glomerular posdonaci&#243;n renal&#46; Nefrologia&#46; 2021&#59;41&#58;191&#8211;199&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Correlation of equations for estimating GFR &#40;MDRD and CKD-EPI&#41; before uninephrectomy&#46; GFR estimates compared to iothalamate clearance&#46; A GFR value of 90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> is indicated with a dashed line &#40;<span class="elsevierStyleBold">---</span>&#41;&#46;</p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Correlation of equations for estimating GFR &#40;MDRD and CKD-EPI&#41; after uninephrectomy&#46; The questions are compared to iothalamate clearance&#46; A GFR value of 90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> is indicated with a dashed line &#40;----&#41;&#46; A GFR value of 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span> is indicated with a dotted line &#40;&#8230;&#46;&#41;&#46; The horizontal lines mark the area where underestimated GFRs are found in relation to 60<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46; The vertical lines mark the underestimated GFRs in relation to 90<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Bland&#8211;Altman analysis using both GFR equations&#46; MDRD pre-donation &#40;A&#41; and MDRD post-donation &#40;B&#41; are shown&#46; CKD-EPI pre-donation &#40;C&#41; and CKD-EPI post-donation &#40;D&#41; are also shown&#46; mGFR was determined using iothalamate clearance&#46; Spaced dashed lines &#40;<span class="elsevierStyleBold">- - -</span>&#41; indicate median&#44; and dotted lines &#40;<span class="elsevierStyleBold">&#8230;&#46;</span>&#41; correspond to 25th and 75th percentiles of bias&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">mGFR determined by iothalamate clearance by age group&#46; The cohort was divided into five subgroups&#46; Each one shows GFRs before &#40;A&#41; and after &#40;B&#41; nephrectomy&#46; The entire cohort of kidney donors is seen in I&#46; The subgroup of men is shown in II and the subgroup of women is shown in III&#46;</p>"
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          "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Quantitative variables were expressed in terms of median p&#40;25&#44;75&#41;&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CKD-EPI&#58; chronic kidney disease epidemiology collaboration&#59; MDRD&#58; modification of diet in renal disease&#59; mGFR&#58; measured glomerular filtration rate&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Number of donors&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">189&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;33&#8211;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female sex&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115 &#40;60&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Height &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">167 &#40;158&#8211;172&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weight &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;0 &#40;63&#8211;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;4 &#40;24&#46;1&#8211;30&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine &#40;mg&#47;dl&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;74 &#40;0&#46;72&#8211;0&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">mGFR &#40;ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114&#46;9 &#40;112&#46;2&#8211;117&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CKD-EPI &#40;ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">109&#46;0 &#40;106&#46;8&#8211;111&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MDRD &#40;ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#46;4 &#40;86&#46;6&#8211;114&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Quantitative variables were expressed in terms of mean &#40;95&#37; confidence interval &#91;CI&#93;&#41;&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">BMI&#58; body mass index&#59; CKD-EPI&#58; chronic kidney disease epidemiology collaboration&#59; MDRD&#58; modification of diet in renal disease&#59; mGFR&#58; measured glomerular filtration rate&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group 1 pre-donation</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group 2 pre-donation</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group 1 post-donation &#40;&#60;5 years&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group 1 p value</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group 2 post-donation &#40;&#62;5 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group 2 p value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group 1 versus Group 2 p value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Number of donors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;41&#8211;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;39&#8211;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;45&#8211;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;47&#8211;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female sex&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Height &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;163&#8211;166&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">167&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;165&#8211;169&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">164&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;163&#8211;165&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">166&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;164&#8211;168&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weight &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;71&#8211;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;70&#8211;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;75&#8211;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;73&#8211;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;26&#46;7&#8211;28&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;25&#46;4&#8211;27&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;27&#46;8&#8211;29&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;28&#46;3&#8211;30&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinine &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;73&#8211;0&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;0&#46;68&#8211;0&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;1&#46;12&#8211;1&#46;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;1&#46;11&#8211;1&#46;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">mGFR &#40;ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">111&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;108&#46;1&#8211;114&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;116&#46;0&#8211;124&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;69&#46;3&#8211;71&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;75&#46;9&#8211;79&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">GFR difference &#40;ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;39&#46;7&#8211;41&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;36&#46;7&#8211;39&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                      "titulo" => "The risks of living kidney donation"
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                            0 => "R&#46;W&#46; Steiner"
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                    0 => array:2 [
                      "doi" => "10.1056/NEJMe1513891"
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