Estimating Glomerular Filtration Rate Calculated by Serum Creatinine Lacks Precision and Accuracy in Adults with Type 2 Diabetes with Preserved Renal Function

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 537-P
Author(s):  
JULIE A. LOVSHIN ◽  
LEIF ERIK LOVBLOM ◽  
PETTER BJORNSTAD ◽  
YULIYA LYTVYN ◽  
HARINDRA RAJASEKERAN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Precision And Accuracy

STUDY OF RADIATION CHARACTERISTICS THE RENAL FUNCTION IN PATIENTS WITH TYPE 2 DIABETES

2014 ◽  
pp. 73-77
Author(s):  
Van Chuong Nguyen ◽  
Thi Kim Anh Nguyen
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Disease Duration ◽  
Left Kidney ◽  
Cross Sectional ◽  
The Right

Background: A Research glomerular filtration rate (GFR) of 61 patients with type 2 diabetes mellitus with renal scanning 99mTc-DTPA glomerular filtration rate at the hospital 175. Objective: (1) To study characteristics of imaging of renal function. (2) Understanding the relationship between GFR with blood sugar, HbA1c, blood pressure and albuminuria in patients with type 2 diabetes. Methods: Descriptive, prospective, cross-sectional study. Clinical examination, Clinical tests and 99mTc-DTPA GFR gamma - camera renography for patients. Result: GFR of the study group was 75,4 ± 22,3 ml/phut/1,73m2, the left kidney was 35,0 ± 13,0 is lower than the right kidney and 39,8 ± 11,9; p <0,01. There is no correlation between GFR with blood glucose and HbA1c, the risk of reduced GFR in hypertensive group associated is OR = 6,5 with p<0,01; albuminuria (+) is OR = 4,2 with p <0,01; and disease duration > 10 years is OR = 3,5 with p <0.01. Conclusion: GFR of the left kidneys is lower than the right kidney; correlation decreased GFR associated with hypertension, albuminuria and disease duration. Keywords: GFR, diabetes, albuminuria

scholarly journals Comparison of Glomerular Filtration Rate Estimation from Serum Creatinine and Cystatin C in HNF1A-MODY and Other Types of Diabetes

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Magdalena Szopa ◽  
Maria Kapusta ◽  
Bartlomiej Matejko ◽  
Tomasz Klupa ◽  
Teresa Koblik ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Glomerular Filtration Rate Estimation ◽  
Measured Gfr

Introduction. We previously showed that in HNF1A-MODY the cystatin C-based glomerular filtration rate (GFR) estimate is higher than the creatinine-based estimate. Currently, we aimed to replicate this finding and verify its clinical significance. Methods. The study included 72 patients with HNF1A-MODY, 72 with GCK-MODY, 53 with type 1 diabetes (T1DM), 70 with type 2 diabetes (T2DM), and 65 controls. Serum creatinine and cystatin C levels were measured. GFR was calculated from creatinine and cystatin C using the CKD-EPI creatinine equation (eGRF-cr) and CKD-EPI cystatin C equation (eGFR-cys), respectively. Results. Cystatin C levels were lower (p<0.001) in the control (0.70±0.13 mg/L), HNF1A (0.75±0.21), and GCK (0.72±0.16 mg/L) groups in comparison to those with either T1DM (0.87±0.15 mg/L) or T2DM (0.9±0.23 mg/L). Moreover, eGFR-cys was higher than eGRF-cr in HNF1A-MODY, GCK-MODY, and the controls (p=0.004; p=0.003; p<0.0001). This corresponded to 8.9 mL/min/1.73 m2, 9.7 mL/min/1.73 m2, and 16.9 mL/min/1.73 m2 of difference. Additionally, T1DM patients had higher eGFR-cr than eGFR-cys (11.6 mL/min/1.73 m2; p=0.0004); no difference occurred in T2DM (p=0.91). Conclusions. We confirmed that eGFR-cys values in HNF1A-MODY patients are higher compared to eGFR-cr. Some other differences were also described in diabetic groups. However, none of them appears to be clinically relevant.

scholarly journals The Error of Estimated GFR in Type 2 Diabetes Mellitus

2019 ◽  
Vol 8 (10) ◽  
pp. 1543 ◽  
Author(s):  
Sergio Luis-Lima ◽  
Tomás Higueras Linares ◽  
Laura Henríquez-Gómez ◽  
Raquel Alonso-Pescoso ◽  
Angeles Jimenez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate

Type 2 diabetes mellitus represents 30–50% of the cases of end stage renal disease worldwide. Thus, a correct evaluation of renal function in patients with diabetes is crucial to prevent or ameliorate diabetes-associated kidney disease. The reliability of formulas to estimate renal function is still unclear, in particular, those new equations based on cystatin-C or the combination of creatinine and cystatin-C. We aimed to assess the error of the available formulas to estimate glomerular filtration rate in diabetic patients. We evaluated the error of creatinine and/or cystatin-C based formulas in reflecting real renal function over a wide range of glomerular filtration rate (from advanced chronic kidney disease to hyperfiltration). The error of estimated glomerular filtration rate by any equation was common and wide averaging 30% of real renal function, and larger in patients with measured glomerular filtration rate below 60 mL/min. This led to chronic kidney disease stages misclassification in about 30% of the individuals and failed to detect 25% of the cases with hyperfiltration. Cystatin-C based formulas did not outperform creatinine based equations, and the reliability of more modern algorithms proved to be as poor as older equations. Formulas failed in reflecting renal function in type 2 diabetes mellitus. Caution is needed with the use of these formulas in patients with diabetes, a population at high risk for kidney disease. Whenever possible, the use of a gold standard method to measure renal function is recommended.

scholarly journals РARTICULAR QUALITIES OF THE RENAL OSMOREGULATORY FUNCTION IN PATIENTS WITH TYPE 2 DIABETES

2015 ◽  
pp. 21-26 ◽  
Author(s):  
E.S. Kuznetsova ◽  
A.S. Kuznetsova ◽  
V.V. Shuhtin ◽  
A.I. Gozhenko
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Freezing Point ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Osmoregulatory Function

The aim of the study was to examine the osmoregulatory state of renal function in patients with type 2 diabetes in a water - salt load with 0,5% NaCl in the amount of 0.5% of body weight. Materials and methods. The study involved 56patients with insulin - dependent diabetic nephropathy,24 men (42.9%) and 32 women (57.1%), aged from 38 to 81 years. The osmolality was measured by freezing point depression on osmomat 030 - D (USA). Glomerular filtration rate (GFR) was calculated by the formula GFR - EPI with subsequent determination of renal functional reserve. Results. It demonstrated that renal osmoregulatory function provides effective regulation of osmotic homeostasis even in a reduced amount of nephrons, but as the glomerular filtration rate decreses to 30 ml/min, the excretion of osmotically active substances gradually decrease too. Conclusion. Osmoregulatory disturbances in the renal function in patients with 2 types diabetes depend both on the reduction in GFR, - and on changes in the functional capacity of nephron's tubules.

scholarly journals The Relationship Between Simple Renal Cysts and Renal Function in Patients With Type 2 Diabetes

2020 ◽  
Vol 11 ◽  
Author(s):  
Ling Wei ◽  
Ying Xiao ◽  
Xiaofen Xiong ◽  
Li Li ◽  
Yuan Yang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Renal Cysts ◽  
The Relationship ◽  
Phosphorus Levels

Introduction: Simple renal cysts (SRCs) are the most common acquired cystic kidney disease, but the relationship between SRCs and renal function has not been clarified in patients with type 2 diabetes mellitus (T2DM).Methods: A retrospective study was conducted to analyze the clinical features of renal cysts and ultrasound data of the kidney in 4,304 patients with T2DM.Results: The prevalence of SRCs in patients with T2DM was 21.1%. Compared to patients with no SRCs, patients with SRCs had worse renal function (estimated glomerular filtration rate: 108.65 ± 40.93 vs. 92.38 ± 42.1 ml/min/1.73 m2, p &lt; 0.05). After adjusting the confounders, SRC was related to estimated glomerular filtration rate in patients with T2DM [odds ratio = 1.49, 95% confidence interval (1.24, 1.79), p &lt; 0.01]. Age, gout, proteinuria, cerebrovascular disease (CVD), and increased serum phosphorus levels were associated with SRCs in patients with T2DM.Conclusion: SRCs are associated with worse renal function in patients with T2DM. More attention should be paid to gout, proteinuria, CVD, serum phosphorus levels, and renal function in T2DM patients with SRCs.

scholarly journals The association of serum creatinine and estimated glomerular filtration rate variability with diabetic retinopathy in Asians with type 2 diabetes: A nested case–control study

2018 ◽  
Vol 15 (6) ◽  
pp. 548-558 ◽  
Author(s):  
Xiao Zhang ◽  
Neelam Kumari ◽  
Serena Low ◽  
Keven Ang ◽  
Darren Yeo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Glomerular Filtration Rate ◽  
Standard Deviation ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Proliferative Diabetic Retinopathy ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate

Background: Fluctuation of kidney function may signify intra-glomerular microvascular hemodynamic instability. We aim to examine the association of long-term serum creatinine and estimated glomerular filtration rate variability with diabetic retinopathy. Methods: We included type 2 diabetes mellitus patients who attended the Diabetes Centre in 2011–2014 and were followed up (median = 3.2 years). Digital colour fundus photographs were assessed for diabetic retinopathy at follow-up. Diabetic retinopathy severity was categorized into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. We conducted a nested case–control study involving 177 diabetic retinopathy (118 non-proliferative diabetic retinopathy, 50 proliferative diabetic retinopathy) and 327 age- and gender-matched non-diabetic retinopathy. Serum creatinine measured before follow-up visit was obtained (⩾3 readings/patient). Variability was calculated as intra-individual standard deviation/√ n/( n – 1). Results: Diabetic retinopathy have higher adjusted-serum creatinine-standard deviation than non-diabetic retinopathy [9.1 (4.9–21.6) vs 5.4 (3.4–10.1) µM, p < 0.001]. After multivariable adjustment, adjusted-serum creatinine-standard deviation was associated with diabetic retinopathy [odds ratio = 1.47, 95% confidence interval (1.02–2.10), p = 0.04]. The area under the curve increased significantly after adding adjusted-serum creatinine-standard deviation [0.70 (0.65–0.75) vs 0.72 (0.68–0.77), p < 0.03]. Proliferative diabetic retinopathy have higher adjusted-serum creatinine-standard deviation than non-proliferative diabetic retinopathy [15.5 (6.6–39.7) vs 7.47 (4.52–17.8) µM, p < 0.001]. After adjustment, adjusted-serum creatinine-standard deviation remained associated with non-proliferative diabetic retinopathy [1.48 (1.04–2.12), p = 0.03] and proliferative diabetic retinopathy [2.43 (1.34–4.39), p = 0.003; p-trend = 0.002]. Similar findings were observed for estimated glomerular filtration rate variability. Conclusion: Serum creatinine and estimated glomerular filtration rate variability is associated with the presence and severity of diabetic retinopathy independent of intra-individual means. This may inform novel therapeutic strategies aiming to achieve stable renal function in type 2 diabetes mellitus.

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