medigraphic.com
ISSN 2221-2434 (Electronic)

2013, Number 4

Next >>

Finlay 2013; 3 (4)

Need for estimating the glomerular filtration rate to assess renal function

Chipi CJA, Almaguer LM, Herrera VR, Silveira EJA, Abreu CMC, Fariñas MO

Language: Spanish
References: 15
Page: 209-218
PDF size: 210.15 Kb.


ABSTRACT

Background: plasma creatinine alone is not useful for assessing renal function; patients with normal creatinine values can experience a significant decline in the glomerular filtration rate, hindering early detection of renal function impairment.
Objective: to assess renal function by determining the plasma creatinine compared to the glomerular filtration rate estimated through the Cockcroft -Gault, MDRD -4 and CKD- Epi formulas.
Methods: the database of a population-based epidemiological study conducted in the Isle of Youth since November 2004 was used. It involved 897 patients, 342 women and 555 men. Plasma creatinine and glomerular filtration rate were estimated by means of 3 formulas. Renal function was considered normal when serum creatinine values were ‹123 µmol/l for women and ‹132 µmol/l for men and glomerular filtration rate › 60 ml/min.
Results: plasma creatinine was stable in the four age groups, with a mean of 100.68 ± 38.01, glomerular filtration rate decreased with increasing age in the three formulas. Correlation coefficient between plasma creatinine values and glomerular filtration rate for each formula expressed a linear relationship with r [CG formula 0.639 (p = 0.000)], [0.672 MDRD -4 (p = 0.000)] and [0.939 CKD – Epi formula (p = 0.000)].
Conclusions: the utility of the methods for estimating the glomerular filtration rate was demonstrated, leading to the detection of the renal function impairment before the serum creatinine level increases.


REFERENCES

  1. Maddox DA, Brenner BM. Glomerular ultrafiltration. In: Taal MW, Brenner BM, Rector FC. Brenner and Rector’s the kidney. Philadelphia, PA: Elsevier/Saunders; 2004. p. 353-412.

  2. Gowans EM, Fraser CG. Biological variation of serum and urine creatinine and creatinine clearance: ramifications for interpretation of results and patient care. Ann Clin Biochem. 1988 ; 25 (3): 259-63.

  3. Levey AS, Perrone RD, Madias NE. Serum creatinine and renal function. Annu Rev Med. 1988 ; 39: 465-90.

  4. Gracia S, Montañés R, Bover J, Cases A, Deulofeu R, Martín Al, et al. Documento de consenso: Recomendaciones sobre la utilización de ecuaciones para la estimación del filtrado glomerular en adultos. Nefrología. 2006 ; 26 (6): 1-8.

  5. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis. 2002 ; 39 Suppl 2: S1-266.

  6. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009 ; 150 (9): 604-12.

  7. Hallan S, Asberg A, Lindberg M, Johnsen H. Validation of the Modification of Diet in Renal Disease formula for estimating GFR with special emphasis on calibration of the serum creatinina assay. Am J Kidney Dis. 2004 ; 44 (1): 84-93.

  8. Lewis J, Agodoa L, Cheek D, Greene T, Middleton J, O’Connor D, et al. Comparison of cross-sectional renal function measurements in African Americans with hypertensive nephrosclerosis and of primary formulas to estimate glomerular filtration rate. Am J Kidney Dis. 2001 ; 38 (4): 744-53.

  9. Centro de Estudios de Población y Desarrollo. Cálculos de peso y talla promedio de la población por provincias y Cuba. II Encuesta de Factores de Riesgo para la Salud y Enfermedades no Trasmisibles, 2001 [Internet]. La Habana: Oficina Nacional de Estadísticas; 2008. [ cited 24 Oct 2 0 1 2 ] A v a i l a b l e f r o m : http://www.one.cu/publicaciones/cepde/peso%20 y%20talla.rar.

  10. Coresh J, Toto RD, Kirk KA, Whelton PK, Massry S, Jones C, et al. Creatinine clearance as a measure of GFR in screenees for the African-American Study of Kidney Disease and Hypertension pilot study. Am J Kidney Dis. 1998 ; 32 (1): 32-42.

  11. Shemesh O, Golbez H, Kriss JP, Meyers BD. Limitations of creatinine as a filtration marker in glomerulophatic patients. Kidney Int. 1985 ; 28 (5): 830-8.

  12. Jungers P. Screening for renal insufficiency: is it worth while? is it feasible?. Nephrol Dial Transplant. 1999 ; 14 (9): 2082-4.

  13. Fernández G, De Francisco AM, Rodrigo E, Piñera C, Herráez I, Ruíz JC, et al. Insuficiencia renal oculta por valoración de la función renal mediante la creatinina sérica. Nefrología. 2002 ; 22 (2): 144-51.

  14. Duncan L, Heathcote J, Djurdjev O, Levin A. Screening for renal disease using serum creatinine: who are we missing?. Nephrol Dial Transplant. 2001 ; 16 (5): 1042-6.

  15. Murphree DD, Thelen SM. Chronic kidney disease in primary care. J Am Board Fam Med. 2010 ; 23 (4): 542-50.




2020     |     www.medigraphic.com