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Evaluation of long‐term follow‐up of glomerular function in renal transplant recipients

Sir: Evaluation of the progression or stabilization of the glomerular filtration rate (GFR) of a renal graft is more complex than evaluation of changes in GFR function in individuals with chronic renal disease [4,5]. The decrease in GFR in patients with chronic renal disease can often be expressed using a simple linear relation to time [2,3]. By contrast, the time course of GFR of a renal graft is often irregular and cannot be expressed by a simple mathematical function. Figure 1 gives examples of irregular decreases in GFR in two renal transplant recipients. It is evident from the figure that, although starting GFR values (GFR,) and those found at the end of follow-up (GFR,) are almost identical, the time course of GFR is different. In patient A, GFR was at a relatively high level for most of the follow-up and did not decline until the end of the follow-up. In patient B, GFR decreased right at the very beginning of follow-up and remained low throughout the follow-up period. Considering the fact that, both pathophysiologically and clinically, the quality of kidney function is relevant there is a significant difference between patients A and B that is not apparent from the ratio between the initial and final GFR