Impact and consequences of the error of estimated GFR in patients with heart failure.

Autor: Jorge-Pérez P; Acute Cardiovascular Care Unit, Cardiology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., García-González MJ; Acute Cardiovascular Care Unit, Cardiology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Martín-Cabeza MM; Acute Cardiovascular Care Unit, Cardiology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Negrín-Mena N; Research Unit Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Luis-Lima S; Department of Laboratory Medicine, Complejo Hospitalario Universitario de Canarias, Santa Cruz de Tenerife, Spain., González-Rinne F; Research Unit Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Bosa-Ojeda F; Acute Cardiovascular Care Unit, Cardiology Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Gaspari F; Internal Medicine Department, ITB: Instituto de Tecnologías Biomédicas, Universidad de La Laguna, La Laguna, 38320, Santa Cruz de Tenerife, Spain., Díaz Martín L; Research Unit Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Porrini E; Internal Medicine Department, ITB: Instituto de Tecnologías Biomédicas, Universidad de La Laguna, La Laguna, 38320, Santa Cruz de Tenerife, Spain. estebanporrini72@hotmail.com.; Research Unit Department, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. estebanporrini72@hotmail.com.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Oct 28; Vol. 14 (1), pp. 25840. Date of Electronic Publication: 2024 Oct 28.
DOI: 10.1038/s41598-024-71425-z
Abstrakt: Heart failure is a highly prevalent disease, which courses with frequent readmissions, mainly by Acute Heart Failure (AHF). Reduced renal function is associated with increased mortality in patients with HF. Therefore, an accurate and precise evaluation of renal function in patients with HF is crucial. The error of estimated GFR (eGFR) is wide and common, showing a ± 30% variability compared to measured GFR (mGFR). However, there is no evidence on the error of formulas in reflecting real renal function and particularly the consequences of this error in patients with AHF. This is a prospective study comparing the impact of mGFR versus eGFR in the onset of cardiovascular (CV) outcomes in patients with AHF. This was tested with cox survival analysis. Measured GFR was determined by the plasma clearance of iohexol-dbs and eGFR by Cockroft-Gould, MDRD, CKD-EPI creatinine, CKD-EPI cystatin-C and CKD-EPI creatinine + cystatin-C equations formulas. Also the agreement between mGFR and eGFR was analyzed. A total of 90 patients were included. Average age was 66 (± 12 years) and 52 (58%) were male. Of them 53 patients (59%) had a cardiovascular event during follow-up, 22 fatal (41%). The agreement between mGFR and eGFR indicated moderate precision and accuracy (concordance correlation coefficient of 0.77; CI = 0.73-0.82). In multiple cox survival analysis, mGFR was significantly associated with cardiovascular events together with NTproBNP, BMI, LVEF and previous coronary artery disease (p = 0.037; HR = 0.98, 95% CI = 0.95-0.99). Estimated GFR by formulas was not significant. In patients with AHF the error of formulas is large, frequent and random, also, mGFR and not eGFR predicted future CV events. The error of eGFR may have clinical consequences in specific subpopulations.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: