scholarly journals Proteinuria, 99mTc-DTPA Scintigraphy, Creatinine-, Cystatin- and Combined-Based Equations in the Assessment of Chronic Kidney Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-16 ◽  
Author(s):  
Hernán Trimarchi ◽  
Alexis Muryan ◽  
Agostina Toscano ◽  
Diana Martino ◽  
Mariano Forrester ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Observational Study ◽  
Creatinine Clearance ◽  
Global Assessment ◽  
Filtration Rate ◽  
Cross Sectional ◽  
Precise Estimation ◽  
Stage 4

Background. Precise estimation of the glomerular filtration rate (GFR) and the identification of markers of progression are important. We compared creatinine, cystatin, and combined CKD-EPI equations with Tc-DTPA99m scintigraphy to measure GFR and proteinuria as markers of progression. Methods. Cross-sectional, observational study including 300 subjects. CKD was classified by Tc-DTPA99m scintigraphy. Determinations. Creatinine, 24-hour creatinine clearance, cystatin, Hoek formula, and creatinine, cystatin, and combined CKD-EPI equations. Results. In the global assessment, creatinine CKD-EPI and combined CKD-EPI equations yielded the highest correlations with Tc-DTPA99m: ρ = 0.839, P<0.0001 and ρ = 0.831, P<0.0001. Intergroup analysis versus Tc-DTPA99m: control G, creatinine clearance ρ = 0.414, P = 0.013; G3, combined CKD-EPI ρ = 0.5317, P<0.0001; G4, Hoek ρ = 0.618, P<0.0001, combined CKD-EPI ρ = 0.4638, P<0.0001; and G5, creatinine clearance ρ = 0.5414, P<0.0001, combined CKD-EPI ρ = 0.5288, P<0.0001. In the global assessment, proteinuria displayed the highest significant correlations with cystatin (ρ = 0.5433, P<0.0001) and cystatin-based equations (Hoek: ρ=-0.5309, P<0.0001). When GFR < 60 mL/min: in stage 3, proteinuria-cystatin (ρ = 0.4341, P<0.0001); proteinuria-Hoek (ρ = −0.4105, P<0.0001); in stage 4, proteinuria-cystatin (ρ = 0.4877, P<0.0001); proteinuria-Hoek (ρ = −0.4877, P = 0.0026). Conclusions. At every stage of GFR < 60 mL/min, cystatin-based equations displayed better correlations with Tc-DTPA99m. Proteinuria and cystatin-based equations showed strong associations and high degrees of correlation.

P0656FULL AGE SPECTRUM EQUATION IN THE ESTIMATION OF GLOMERULAR FILTRATION RATE IN RUSSIAN ADULT PATIENTS WITH CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mokhamad Khasun ◽  
Ivan Kayukov, ◽  
Olga Beresneva ◽  
Marina Parastaeva ◽  
Anatoly Kucher ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Creatinine Clearance ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Reference Method ◽  
Compartment Model ◽  
Russian Population ◽  
Reference Methods

Abstract Background and Aims Glomerular filtration rate (GFR) is the most important and accurate parameter of kidney function in the course of chronic kidney disease (CKD). Renal or plasma inulin, diethylenetriaminepentaacetate (DTPA), ethylenediaminetetraacetate (EDTA), radiocontrast agents (iohexol, iothalamate) and some other substances clearances are the reference methods for determining GFR. However, these methods cannot be applied routinely because of the inconvenience. Several available methods have been developed to estimate GFR in a simpler manner and at low costs. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is widely used to evaluate the GFR in practice. However, this equation is not accurate for the full age spectrum. In 2016, the new equation, full age spectrum equation, based on the serum creatinine (FAScr), was developed and can be applicable to all ages. However, data on the benefits of using the FAScr-method in different populations are contradictory. In particular, it is unclear whether the FAScr provides any advantages over the CKD-EPI method in adults. In this regards, we attempted to compare data obtained FAScr method with results some non-reference and reference methods in adult Russian population. Method We examined 120 Caucasian patients (M:F - 52:68; age 18-76 year) with CKD 1 - 5 stages. Patients with nephrotic syndrome and congestive heart failure were excluded. GFR (reference method) measured by plasma clearance of 99mTc-DTPA (CDTPA). CDTPA determined by one- compartment model 2-4 h method using a Chantler-Barratt linear correction. Estimation GFRs (eGFR) were established by Cockcroft-Gault creatinine clearance (CG), CKD-EPI (creatinine), FAScr and Modification of Diet in Renal Disease (MDRD) methods. Also, renal creatinine clearance (Ccr; UV/P method) was measured. Only GFRs values corrected on 1.73 m2 body surface area had been use. Results The values of GFR (Mean(SEM)) are: CDTPA 67.0(2.46); FAS 69.7(2.50); CKD-EPI 64.3(2.54); MDRD 60.9(2.62); CG 77.6(3.31); Ccr 85.2(3.40), мл/мин/1.73 m2. MDRD was significantly lower (paired Student t-test with correction on multiply comparison by Benjamini-Hochberg method) than CDTPA (P=0.0024), CG (P=0.0001) or Ccr (P&lt;0.0001) were significantly higher. The bias (CDTPA minus non reference GFR) were: FAS -2.67(1.71); CKD-EPI 2.72(1.58); MDRD 6.12(1.78); CG -10.57(2.51); Ccr -18.22(2.26), ml/min. All biases are significantly differ between themselves (P from 0.00064 to &lt;0.000001). The percentage of P30 of the FAS 81.6(3.5) was not significant differ from P30 of CKD-EPI (78.3(3.8); P=0.524) or MDRD (71.7(4.1); P=0.071). However, P30 of CG (67.5(4.3),%; P=0.01) or Ccr (54.2(5.42),%; P&lt;0,001) were significant lower, than P30 of FAS. There were significant comparable direct correlations between CDTPA and FAS (r=0.764), CKD-EPI (r=0.801), MDRD (r=0.756), CG (r=0.656), Ccr (r=0.749); P&lt;0.00001 in all cases. Conclusion In adult Russian population FAScr-method of GFR estimation had not any advantage over CKD-EPIcr-method.

scholarly journals Prospects for improved glomerular filtration rate estimation based on creatinine—results from a transnational multicentre study

2020 ◽  
Vol 13 (4) ◽  
pp. 674-683 ◽  
Author(s):  
Jonas Björk ◽  
Ulf Nyman ◽  
Marie Courbebaisse ◽  
Lionel Couzi ◽  
R Neil Dalton ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Patient Characteristics ◽  
Cross Sectional ◽  
Disease Epidemiology ◽  
Gfr Estimation ◽  
Glomerular Filtration Rate Estimation

Abstract Background The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved. Methods In a cross-sectional analysis covering the years 2003–17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund–Malmö revised equation (LMR) and the Full Age Spectrum equation. Results 7In patients aged 18–39 years old, CKD-EPI overestimated GFR with 5.0–16 mL/min/1.73 m2 in median in both cohort types at mGFR levels &lt;120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%. Conclusions None of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.

scholarly journals Performance of CKD-EPI equation to estimate glomerular filtration rate as compared to MDRD equation in South Brazilian individuals in each stage of renal function

2014 ◽  
Vol 52 (12) ◽  
Author(s):  
Francisco Veríssimo Veronese ◽  
Eduardo C. Gomes ◽  
Joana Chanan ◽  
Maicon A. Carraro ◽  
Eduardo G. Camargo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Disease Epidemiology ◽  
Mdrd Equation ◽  
Estimate Glomerular Filtration Rate

AbstractThe Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation seems to correct the overdiagnosis of chronic kidney disease (CKD) provided by Modification of Diet in Renal Disease (MDRD) equation. However, this point has not been tested in some ethnic groups. This study investigated the performance of MDRD and CKD-EPI equations in South Brazilian individuals.This cross-sectional study included 354 individuals including healthy volunteers, diabetic and non-diabetic individuals with or without CKD. Glomerular filtration rate (GFR) was measured by theIn the group as a whole,CKD-EPI reduces GFR underestimation in individuals with GFRs >60, but still presents a quite low accuracy at this GFR range. Moreover, it tends to overestimate GFR in subjects with GFRs <60 mL/min/1.73 m

scholarly journals Leptin and adiponectin in patients with chronic kidney disease and secondary hyperparathyroidism

2021 ◽  
Vol 17 (8) ◽  
pp. 596-603
Author(s):  
N. Karlovich ◽  
Т. Mokhort ◽  
Е. Sazonоva
Keyword(s):  
Body Mass Index ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Glomerular Filtration ◽  
Body Mass ◽  
Filtration Rate ◽  
Cardiovascular Risks ◽  
Cross Sectional

Background. The results of studies evaluating the levels of adiponectin, leptin and their ratios in chronic kidney disease (CKD) are conflicting. It is assumed that hyperleptinemia and changes in adiponectin clearance are consequences of a decrease in the glomerular filtration rate, they exacerbate renal impairment and may affect the prognosis of survival due to cardiovascular events. It is known that secondary hyperaparathyroidism is the most frequent complication of CKD, which not only affects calcium-phosphorus metabolism and bone tissue, but also contributes to the development of pathological processes involving other hormonal and metabolic markers. Of greatest interest is the assessment of adipocytokine levels in the development of secondary hyperparathyroidism against the background of CKD as an independent factor of increasing cardiovascular risks. The purpose of the study was to assess adipocytokine levels (adiponectin, leptin) and their ratios in patients with different stages of chronic kidney disease and their relationship with manifestations of secondary hyperparathyroidism. Materials and methods. This cross-sectional study enrolled 160 people with CKD and 40 healthy individuals as a comparison group. Results. Leptin level reduction and an increase in the proportion of patients with hypoleptinemia with a decrease in the glomerular filtration rate were found, which may be an important factor determining nutritional status. Correlations were revealed between leptin level, body mass index (ρ = 0.411) and patients’ age (ρ = 0.189), as well as between leptin/adiponectin and adiponectin/leptin ratios (ρ = 0.395 and ρ = –0.395) and body mass index in patients with CKD persisting in subgroups by stage of renal failure. A relationship was found with sex for leptin and a decrease in its levels below normal values in both men and women. Conclusions. The proportion of patients with hyperadiponectinemia was significantly higher among those with end-stage CKD compared to patients with stages 1–2. There was no statistically significant relationship between adipocytokine and parathyroid hormone levels and the presence of secondary hyperparathyroidism in patients examined.

scholarly journals Approaches for the identification of chronic kidney disease in CPRD–HES-linked studies

2020 ◽  
Author(s):  
Sreeram Ramagopalan ◽  
Thomas P Leahy ◽  
Elaine Stamp ◽  
Cormac Sammon
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Nonvalvular Atrial Fibrillation ◽  
Diagnostic Codes ◽  
Stage 4

Aim: There are different methods to identify chronic kidney disease (CKD) in Clinical Practice Research Datalink (CPRD)-Hospital Episode Statistics (HES). Methods: Using CPRD-HES, nonvalvular atrial fibrillation patients were classified according to CKD category. Results: Using glomerular filtration rate/estimated glomerular filtration rate tests only to identify patients with CKD resulted in 3.5% stage 2, 2.7% stage 3, 0.3% stage 4 and 0.03% stage 5. Using data from diagnostic codes to identify patients with CKD resulted in 1.4% stage 3, 0.4% stage 4 and 0.3% stage 5. Using test records and codes resulted in 3.5% stage 2, 4.0% stage 3, 0.6% stage 4 and 0.4% stage 5. Conclusion: To identify CKD status in CPRD-HES, a combination of test records and codes should be used. Using diagnostic codes only significantly underestimates CKD prevalence.

HUBUNGAN LAJU FILTRASI GLOMERULUS DENGAN KADAR HEMOGLOBIN DAN KALSIUM PADA PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISIS

2021 ◽  
Vol 3 (2) ◽  
pp. 272-284
Author(s):  
Fiora Ladesvita ◽  
Lilis Mulyani
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Cross Sectional ◽  
Consecutive Sampling

Chronic Kidney Disease (CKD) didefinisikan sebagai kerusakan ginjal dengan penurunan Glomerular Filtration Rate (GFR) kurang dari 60 ml/menit/1,73 m2 yang terjadi selama lebih dari tiga bulan. Penurunan fungsi ginjal dapat menyebabkan produksi hormon eritropoietin yang berfungsi untuk memproduksi sel darah berkurang sehingga dapat menyebabkan penurunan kadar hemoglobin. Selain itu, kerusakan ginjal dapat menyebabkan penurunan aktivasi vitamin D yang dapat menyebabkan penyerapan kalsium di usus berkurang. Tujuan dari penelitian ini adalah untuk mengetahui hubungan GFR dengan kadar hemoglobin dan kadar kalsium pada pasien CKD yang menjalani hemodialisis. Penelitian ini menggunakan desain cross sectional dengan pendekatan retrospektif menggunakan rekam medis pasien CKD yang menjalani hemodialisis dari bulan Januari sampai Desember 2020. Penelitian ini dilakukan pada 95 sampel dengan metode consecutive sampling. Uji korelasi pearson menunjukkan nilai p 0,000 dan nilai r 0,974 untuk korelasi antara GFR dan kadar hemoglobin. Juga pengujian menunjukkan nilai p 0,000 dan nilai r 0,950 untuk korelasi antara GFR dan kadar kalsium. Kesimpulannya, ada hubungan yang signifikan antara GFR dengan kadar hemoglobin dan kadar kalsium.   Kata kunci: Penyakit Ginjal Kronis, Laju Filtrasi Glomerulus, Hemoglobin, Kalsium

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