Measured glomerular filtration rate predicts liver related deaths better than estimated glomerular filtration rate in advanced chronic liver disease.

Autor: González-Alayón C; Liver Unit, Hospital Universitario de Canarias, Tenerife, Spain; Laboratory of Renal Function, Faculty of Medicine, University of La Laguna, Tenerife, Spain., Hernández-Guerra M; Liver Unit, Hospital Universitario de Canarias, Tenerife, Spain; Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, Tenerife, Spain., Luis-Lima S; Laboratory of Renal Function, Faculty of Medicine, University of La Laguna, Tenerife, Spain; Department of Laboratory Medicine, Hospital Universitario de Canarias, Tenerife, Spain., Cruz Perera Lima C; Laboratory of Renal Function, Faculty of Medicine, University of La Laguna, Tenerife, Spain., Santana-Delgado A; Liver Unit, Hospital Universitario de Canarias, Tenerife, Spain., Díaz-Mesa C; Liver Unit, Hospital Universitario de Canarias, Tenerife, Spain., Morant-Domínguez A; Liver Unit, Hospital Universitario de Canarias, Tenerife, Spain., Martín LD; Laboratory of Renal Function, Faculty of Medicine, University of La Laguna, Tenerife, Spain., González-Rinne F; Laboratory of Renal Function, Faculty of Medicine, University of La Laguna, Tenerife, Spain., Hernández-Bustabad A; Liver Unit, Hospital Universitario de Canarias, Tenerife, Spain., Moreno M; Liver Unit, Hospital Universitario de Canarias, Tenerife, Spain., Gaspari F; Laboratory of Renal Function, Faculty of Medicine, University of La Laguna, Tenerife, Spain., Porrini E; Laboratory of Renal Function, Faculty of Medicine, University of La Laguna, Tenerife, Spain; Instituto de Tecnologías Biomédicas (ITB), Faculty of Medicine, University of La Laguna, Tenerife, Spain; Department of Internal Medicine, Dermatology and Psychiatry, University of La Laguna, Tenerife, Spain; Nephrology Unit, Hospital Universitario de Canarias, Spain. Electronic address: esteban.l.porrini@gmail.com.
Jazyk: angličtina
Zdroj: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2024 Oct 18. Date of Electronic Publication: 2024 Oct 18.
DOI: 10.1016/j.dld.2024.09.016
Abstrakt: Background & Aims: Renal dysfunction is prevalent in advanced chronic liver disease (aCLD) and is associated to liver-related death (LRD). This makes a reliable evaluation of renal function (RF) a crucial aspect. RF can be estimated by formulas or measured by gold standard method. Estimated RF is not reliable in aCLD. However, there is a lack of information on the reliability of formulas in the prediction of LRD.
Methods: We analysed a cohort of patients with aCLD in whom RF was measured by the plasma clearance of iohexol (mGFR) and estimated (eGFR) by formulas: MDRD, CKD-EPI, Royal Free Hospital (RFHC), GRAIL and Mindikoglu-eGFR. LRD was defined as death from hepatic causes. Multivariable analysis was used to evaluate association of mGFR or eGFR with LRD.
Results: 161 patients were evaluated, with median follow-up of 28 months, 58 died from LRD. In overall group mGFR (OR 0.99; p = 0.022) and formulas: CKD-EPI (OR 0.98; p = 0.044), GRAIL (OR 0.98; p = 0.038) was associated with LRD. In patients with normal creatinine levels (≤ 1.1 mg/dL), mGFR (OR 0.99; p = 0.031) was whereas any formula was not associated with LRD.
Conclusions: eGFR appears as an unreliable method for predicting LRDs in aCLD, especially in those with lower creatinine levels. By contrast, mGFR seems to be a superior predictor.
Competing Interests: Declaration of competing interest None of the authors have conflicts of interest for the reported study.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE