eGFR and creatinine clearance in relation to metabolic changes in an unselected patient population
| Autor: | Henk J. G. Bilo, L. D. Dikkeschei, Hanneke Joosten, Klaas H. Groenier, I. Drion |
|---|---|
| Přispěvatelé: | University of Groningen, Lifestyle Medicine (LM) |
| Rok vydání: | 2009 |
| Předmět: |
CHRONIC KIDNEY-DISEASE
Male medicine.medical_specialty (estimated) glomerular filtration rate Urology Renal function urologic and male genital diseases Hospital population CHRONIC RENAL-INSUFFICIENCY Chronic kidney disease Internal medicine Prevalence Internal Medicine medicine Humans MDRD-4 Hypocalcaemia Biochemical disturbances Aged Retrospective Studies Uremia OUTCOMES business.industry 24-hour urine sampling Anemia Retrospective cohort study Middle Aged medicine.disease female genital diseases and pregnancy complications Hyperphosphatemia Patient population Endocrinology Quartile Creatinine Disease Progression Hyperkalemia Kidney Failure Chronic Female HEALTH Urine sample business Glomerular Filtration Rate Kidney disease |
| Zdroj: | European Journal of Internal Medicine, 20(7), 722-727. ELSEVIER SCIENCE BV |
| ISSN: | 0953-6205 |
| DOI: | 10.1016/j.ejim.2009.07.002 |
| Popis: | It is widely assumed that moderate to severe renal failure (creatinine clearance60 ml/min; or an MDRD-4 (Modification of Diet in Renal Disease equation)60 ml/min/1.73 m(2)) is associated with metabolic changes, often needing further assessment and treatment. We investigated whether such abnormalities are already present at earlier stages of kidney disease, as assessed by 24-hour urine sampling and MDRD-4 calculation.A select, retrospective cohort study was conducted. Creatinine clearance was measured by collecting 24-hour urines. The individual eGFRs were calculated with the MDRD-4 formula and patients were then divided by renal function category (15, 15-30, 30-45, 45-60, 60-90,90 ml/min(/1.73 m(2))). Per clearance category the number of people with anaemia, hypokalaemia, uraemia and hyperphosphataemia was evaluated.The median creatinine clearance rate was 67.3 ml/min (quartiles: 42.9-95.8) versus a median MDRD-4-eGFR of 51.6 ml/min/1.73 m(2) (35.8-67.7). Anaemia, hyperkalaemia, hypocalcaemia, and uraemia were found to be present at higher levels of creatinine clearance rate and eGFR than previously reported (p0.0005). This increased prevalence was more pronounced in elderly subjects, particularly with respect to anaemia (OR 2.71 and 2.02 for MDRD-4 and creatinine clearance respectively, p0.0005). The same holds for the proportion with uraemia (OR 1.85, p0.0005) and hypocalcaemia (OR 1.97, p=0.011) for MDRD-4.Metabolic changes in an in- and outpatient hospital population are present at earlier stages than was stated in recent guidelines, especially when creatinine clearance levels are used as indicators. This might have implications for testing and treatment of patients with suspected kidney disease and/or loss of renal function. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect