Accuracy of creatinine clearance in measuring glomerular filtration rate in patients with systemic lupus erythematosus without clinical evidence of renal disease

Purpose: Cystatin C has a higher correlation with glomerular filtration rate and a more significant clinical prognosis than creatinine. We sought to determine whether it is a marker of renal function different from creatinine (cystatin C potentially superior to creatinine), in patients with systemic lupus erythematosus. Material and Methods: 37 patients with systemic lupus erythematosus were evaluated. Serum cystatin C was determined by nephelometry and creatinine by modified Jaffe method. We compared five formulas: Chronic Kidney Disease – Epidemiology Collaboration cystiatin; Chronic Kidney Disease – Epidemiology Collaboration creatinine-cystatin; Cockcroft-Gault; Modification of Diet in Renal Disease and Chronic Kidney Disease – Epidemiology Collaboration creatinine, using the latter as a reference. We analyzed the influence of clinical and laboratory factors in cystatin C variation, using multivariate linear regression. Results: Cystatin C was singly elevated in ten participants, versus none isolated creatinine elevation, and this difference was significant (p = 0.002). There was a difference between the estimated glomerular filtration rate by Chronic Kidney Disease – Epidemiology Collaboration cystatin and by Chronic Kidney Disease – Epidemiology Collaboration creatinine (-6.0541 mL/min/1.73 m2, p = 0.07), more pronounced for lower glomerular filtration rate. Consequently, Chronic Kidney Disease – Epidemiology Collaboration cystatin reclassified 4 patients as having chronic kidney disease de novo and 1 patient as not having chronic kidney disease (p = 0.375). Cystatin C was only significantly influenced by age (p < 0.001). Discussion: Several reports showed cystatin C as a better marker to define chronic kidney disease, allowing more accurate classification and risk stratification, compared with creatinine. In this study, Cystatin C revealed as a promisor marker of renal function in patient with lupus, mainly in patients with lower glomerular filtration rates. The correlation between age and cystatin C seems to be a confounding factor, as glomerular filtration rate physiologically declines with ageing. Conclusion: Cystatin C was potentially superior to creatinine and in this study and cystatin C seems to detect changes in glomerular filtration rate earlier than creatinine and may be a better screening method for chronic kidney disease in systemic lupus erythematosus.

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Chromium‐51 ethylenediamine tetraacetic acid glomerular filtration rate: a better predictor than glomerular filtration rate calculated by the Cockcroft–Gault formula for renal involvement in systemic lupus erythematosus patients

Rheumatology ◽

10.1093/rheumatology/40.3.324 ◽

2001 ◽

Vol 40 (3) ◽

pp. 324-328 ◽

Cited By ~ 5

Author(s):

T. Godfrey ◽

M. J. Cuadrado ◽

C. Fofi ◽

I. Abbs ◽

M. A. Khamashta ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Lupus Erythematosus ◽

Filtration Rate ◽

Renal Involvement ◽

Tetraacetic Acid ◽

Systemic Lupus ◽

Ethylenediamine Tetraacetic Acid ◽

Gault Formula

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Correlation between serum interleukin-6 with glomerular filtration rate in systemic lupus erythematosus

Jurnal Penyakit Dalam Udayana ◽

10.36216/jpd.v3i1.65 ◽

2019 ◽

Vol 3 (1) ◽

pp. 22-25

Author(s):

Gede Kambayana ◽

Meryl Pulcheria ◽

I Gde Raka Widiana

Keyword(s):

Systemic Lupus Erythematosus ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Lupus Erythematosus ◽

Interleukin 6 ◽

Filtration Rate ◽

Pearson Correlation ◽

Clinical Manifestations ◽

Systemic Lupus ◽

Pearson Correlation Test

Background: Systemic lupus erythematosus (SLE) is characterized by remarkable heterogeneity in clinical manifestations with underlying autoimmune mechanisms. The pleiotropic cytokine interleukin-6 (IL-6) is known to be involved in SLE immunopathogenesis and significantly related to disease activity as well as its complications. Additionally, IL-6 has been demonstrated to underlie important roles in lupus nephritis. Objective: To determine the correlation between Interleukin 6 (IL-6) Serum and Glomelular Filtration Rate (GFR) in SLE. Methods: In this study we investigated the correlation of serum IL-6 with glomerular filtration rate (GFR) to assess kidney damage in 67 premenopausal patients aged between 17-50 years with inactive SLE. The study variables including age, duration of illness, cumulative corticosteroid dose, MEX-SLEDAI score, serum creatinine, and GFR were obtained through interview and medical record review; whilst serum level of IL-6 was measured using ELISA. Results: Median level of IL-6 was found to be 2.71 (0.332-10.000) pg/ml. Pearson correlation test showed significant correlation between serum IL-6 and GFR (r = 0.288, P = 0.018). Conclusion: This study result shows that there was positive correlation observed between serum IL-6 and GFR in inactive SLE.

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Temporal hemodynamic changes in a female mouse model of systemic lupus erythematosus

AJP Renal Physiology ◽

10.1152/ajprenal.00598.2019 ◽

2020 ◽

Vol 318 (5) ◽

pp. F1074-F1085 ◽

Cited By ~ 2

Author(s):

Elena L. Dent ◽

Erin B. Taylor ◽

Jennifer M. Sasser ◽

Michael J. Ryan

Keyword(s):

Systemic Lupus Erythematosus ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Lupus Erythematosus ◽

Filtration Rate ◽

Systemic Lupus ◽

Renal Hemodynamic ◽

Kidney Involvement ◽

Hemodynamic Function ◽

Circulating Autoantibodies

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease characterized by circulating autoantibodies, prevalent hypertension, renal injury, and cardiovascular disease. Onset of the disease often occurs in young women of childbearing age. Although kidney involvement is common to patients with SLE, little is known about temporal changes in renal hemodynamic function and its relationship to the pathogenesis of hypertension during autoimmune diseases. We hypothesized that the loss of immunological tolerance and subsequent production of autoantibodies in SLE leads to impaired renal hemodynamic function that precedes the development hypertension. Female NZBWF1 (SLE) mice and female NZW/LacJ (control) mice were instrumented with carotid artery and jugular vein catheters to determine mean arterial pressure (MAP) and glomerular filtration rate, respectively, at ages of 15, 20, 24, 28, 31, and 34 wk. In addition, urinary albumin excretion, blood urea nitrogen, circulating autoantibodies, and glomerulosclerosis were assessed at each age. Levels of circulating autoantibodies are increased between 24 and 28 wk of age in NZBWF1 mice and were significantly greater than in control mice. Glomerular filtration rate was significantly increased at 28 wk of age in NZBWF1 mice followed by a sharp decline at 34 wk of age. NZBWF1 mice had an increase in MAP that occurred by 34 wk of age. These data show that changes in circulating autoantibodies, renal hemodynamic function, and glomerular injury occur in NZBWF1 mice before changes in MAP, suggesting an important mechanistic role for autoimmunity to directly impair renal hemodynamic function and promote the development of hypertension.

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“Renal Raynauds phenomenon” in systemic lupus erythematosus: Measurement of the glomerular filtration rate with 99mtechnetium-DTPA

Arthritis & Rheumatism ◽

10.1002/anr.1780321124 ◽

1989 ◽

Vol 32 (11) ◽

pp. 1487-1489 ◽

Cited By ~ 3

Author(s):

Kunihiko Yamauchi ◽

Yutaka Suzuki ◽

Shigeru Arimori

Keyword(s):

Systemic Lupus Erythematosus ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Lupus Erythematosus ◽

Filtration Rate ◽

Systemic Lupus ◽

Raynauds Phenomenon

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The impact of tabalumab on the kidney in systemic lupus erythematosus: results from two phase 3 randomized, clinical trials

Lupus ◽

10.1177/0961203316650734 ◽

2016 ◽

Vol 25 (14) ◽

pp. 1597-1601 ◽

Cited By ~ 14

Author(s):

B H Rovin ◽

M A Dooley ◽

J Radhakrishnan ◽

E M Ginzler ◽

T D Forrester ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Glomerular Filtration Rate ◽

Serum Creatinine ◽

Lupus Erythematosus ◽

Filtration Rate ◽

Creatinine Ratio ◽

Systemic Lupus ◽

Urine Protein ◽

Creatinine Concentration ◽

Intent To Treat

Introduction Tabalumab is a monoclonal antibody that neutralizes membrane and soluble B-cell activating factor. Two 52-week, randomized, double-blind, placebo controlled phase 3 trials evaluated the safety and efficacy of tabalumab in systemic lupus erythematosus. Methods Patients with moderate to severe active systemic lupus erythematosus (without severe active lupus nephritis) were randomly assigned 1:1:1 to receive tabalumab (120 mg subcutaneously every 2 or 4 weeks) or placebo for 52 weeks. Serum creatinine concentration, estimated glomerular filtration rate, urine protein/creatinine ratio, renal flares and renal adverse events were determined monthly. Data were analyzed for the intent-to-treat population and for intent-to-treat patients with baseline urine protein/creatinine ratio >20 mg/mmol (intent-to-treat plus urine protein/creatinine ratio). Results The trials enrolled 2262 patients. At baseline, demographics, systemic lupus erythematosus disease activity, serum creatinine concentration, estimated glomerular filtration rate and urine protein/creatinine ratio were similar among the treatment arms (with the exception of disease duration). In the intent-to-treat and intent-to-treat plus urine protein/creatinine ratio populations, there were no differences between the arms in the baseline-to-endpoint change in serum creatinine concentration, glomerular filtration rate, urine protein/creatinine ratio, or renal flare rates. Tabalumab resulted in a significant B-cell reduction and decreased immunoglobulin G levels at both doses. Conclusions Compared to placebo, tabalumab did not significantly affect the serum creatinine concentration, glomerular filtration rate, urine protein/creatinine ratio, or renal flare rates over 1 year in intent-to-treat or intent-to-treat plus urine protein/creatinine ratio patients. There were no significant renal safety signals. ClinicalTrials.gov identifiers: NCT01205438 and NCT01196091 Lupus (2016) 25, 1597–1601.

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Comparison of Measured Creatinine Clearance and Clearances Estimated by Cockcroft-Gault and MDRD Formulas in Patients with a Single Kidney

International Journal of Nephrology ◽

10.4061/2011/626178 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Sebastião Rodrigues Ferreira-Filho ◽

Camila Caetano Cardoso ◽

Luiz Augusto Vieira de Castro ◽

Ricardo Mendes Oliveira ◽

Renata Rodrigues Sá

Keyword(s):

Glomerular Filtration Rate ◽

Renal Disease ◽

Creatinine Clearance ◽

Glomerular Filtration ◽

Filtration Rate ◽

Urine Collection ◽

Strongly Correlated ◽

Rate Estimation ◽

Glomerular Filtration Rate Estimation ◽

Single Kidney

There are doubts about whether the values obtained from the Cockroft-Gault (ClCG) and Modification of Diet in Renal Disease (GFRMDRD) formulas are comparable to the more traditional formula used to obtain the creatinine clearance from a 24-hour urine collection (ClCrm), particularly in patients with only one kidney. The present study aimed to compare these formulas in individuals with one remaining kidney after previous nephrectomy (Nx) and to verify which estimated formula correlates more closely with ClCrm. Thirty-six patients who had undergone Nx had their renal filtration analyzed with ClCG, GFRMDRDand by ClCrm. The average time after Nx was years, and the average age at the time of the study was years old (X ± SD). The results of three clearances were mL·min·m2for ClCrm, mL·min·m2for ClCrCG, and mL·min·m2for GFRMDRD(with ClCrm> ClCrCGand GFRMDRD; ). No difference was found between the ClCrCGand GFRMDRDvalues (). The data demonstrated that both estimate formulas were strongly correlated with ClCrm, although ClCrCGwas more closely associated with ClCrmthan GFRMDRD(ClCrCGwith and GFRMDRDwith ; ). In conclusion, for people with only one kidney remaining after NX, our data showed that glomerular filtration rate estimation by ClCrCGis more related to the values obtained with the traditional clearance measurement based on a 24-hour urine collection test.

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