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NDT Advance Access originally published online on October 28, 2007
Nephrology Dialysis Transplantation 2008 23(1):33-38; doi:10.1093/ndt/gfm708
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Estimated glomerular filtration rate as an end point in kidney transplant trial: where do we stand?

Christophe Mariat, Nicolas Maillard, Manolie Phayphet, Lise Thibaudin, Sylvi Laporte, Eric Alamartine and François Berthoux

Service de Néphrologie, Dialyse et Transplantation Rénale, Laboratoire d’Explorations Fonctionnelles Rénales, EA 3065, CHU de Saint-Etienne, Université Jean Monnet, Saint-Etienne, France

Correspondence and offprint requests to: Christophe Mariat, Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital NORD, C-H-U de Saint-Etienne, 42055 Saint-Etienne, France. Tel: +33-4-77-82-83-45; Fax: +33-4-77-82-83-57; E-mail: christophe.mariat@univ-st-etienne.fr

Keywords: clinical trial; cystatin; glomerular filtration rate; predicting equations; transplantation

The first 150 words of the full text of this article appear below.



   Introduction
 
Over the past two decades, substantial improvements in short-term kidney transplant outcome have greatly limited our ability to assess the efficacy of newer therapeutic strategies according to conventional short-term end points, namely the 1-year graft/patient survival and the 1-year acute rejection rate. For instance, with current figures, of less than 15% of patients experiencing an acute rejection episode over the first year post-transplant, it has become logistically challenging (if not clinically questionable) to test a new treatment on its ability to further prevent acute rejection (Table 1). Meanwhile, these traditional end points have failed to predict long-term survival, which is at present a major challenge in renal transplantation. Identification of new, short-term end points capable of correlating with long-term graft outcome is thus necessary. Among other candidates, post-transplant graft function seems to be an attractive alternative end point for clinical trials [1], even though its use . . . [Full Text of this Article]



   GFR predicting equations: potential candidates for assessing renal graft function
 


   How is predictive performance evaluated? How should it be?
 


   Performance of Cockcroft–Gault, Walser, Nankivell and MDRD equations in predicting renal graft function
 


   Are we doomed to exclusively use reference methods to assess renal graft function in clinical trials?
 


   Conclusion
 

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