scholarly journals Evaluation of patient renal function following endovascular aneurysm repair with suprarenal fixation

2011 ◽  
Vol 1 (1) ◽  
pp. 10 ◽  
Author(s):  
YingBin Jia ◽  
Yun Shi ◽  
XiaoDong Guan ◽  
Jian Li ◽  
BaiMeng Zhang ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic ◽  
Aneurysm Repair

This study aimed to assess the mid-term renal function of abdominal aortic aneurysm patients following suprarenal endovascular repair. From March 2005 to December 2009, 290 abdominal aortic aneurysm patients were included in the study and grouped according to whether they had received infrarenal or suprarenal endovascular aneurysm repair. Suprarenal endovascular aneurysm repair was performed in 173 patients, with a mean age of 72(±8) years (85.0% male). Infrarenal endovascular aneurysm repair was performed in 117 patients, with a mean age of 71(±9) years (90.6% male). Preoperative and one week, 1-, 3-, 6- and 12-month postoperative serum creatinine and cystatin C values were recorded. Estimated glomerular filtration rate was calculated by cystatin-based formula and Cr-based Cockcroft formula. The t-test was used to determine statistical differences between or within groups. All patients received Talent or Zenith endograft. Patients’ characteristics and operative files in the two groups were well matched. Preoperative serum creatinine and cystatin C were 82 (±8) mmol/L and 0.89 (±0.11) mg/L for suprarenal endovascular aneurysm repair, respectively, and 81 (±11) mmol/L and 0.87 (±0.15) mg/L, respectively, for infrarenal endovascular aneurysm repair; no differences were observed between the two groups. Compared to preoperative renal markers within each group, a deterioration in serum creatinine, cystatin C and estimated glomerular filtration rate values was found at one week and 12 months after surgery（P<0.05). A deterioration in cystatin C [SR:(0.93±0.17) mg/L, IR: (0.92±0.31) mg/L] and estimated glomerular filtration rate by cystatin C was also found at six months after surgery（P<0.05). However, no differences in patient serum creatinine, cystatin C and estimated glomerular filtration rate values were observed between groups at each follow-up time interval. There was no greater significant difference in the association of the use of suprarenal fixation with midterm postoperative renal injury than with infrarenal fixation.

scholarly journals Cystatin C-based estimated glomerular filtration rate after percutaneous coronary intervention in the prediction of inhospital mortality in acute myocardial infarction

2021 ◽  
Vol 26 (12) ◽  
pp. 4642
Author(s):  
K. V. Protasov ◽  
O. S. Donirova ◽  
E. V. Batunova
Keyword(s):  
Myocardial Infarction ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Coronary Intervention ◽  
Inhospital Mortality ◽  
Percutaneous Coronary

Aim. To assess the significance of changes cystatin C-based estimated glomerular filtration rate (eGFRcys) in predicting inhospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).Material and methods. In 133 patients with STEMI, serum creatinine and cystatin C were determined. Creatinine clearance (CrCl) was estimated according to Cockcroft-Gault equation. Creatinine-based estimated glomerular filtration rate (eGFRcr) was assessed using the MDRD (eGFRcr_MDRD) and CKD-EPI 2009 (eGFRcr_CKD-EPI). In addition, eGFRcys and a combination of serum creatinine and cystatin C (eGFRcr-cys) was assessed using the CKD-EPI 2012 equation at admission and 24-48 hours after PCI. In the groups of deceased patients and survivors, the studied parameters were compared. Their relationship with imhospital mortality was assessed by logistic regression adjusted for acute kidney injury (AKI) and GRACE risk. To assess the informativeness of identified independent predictors, an ROC analysis was performed.Results. After PCI, serum creatinine level increased by 9,8%, cystatin C — by 38,2%. CrCl decreased by 9,0%, eGFRcr_MDRD — by 10,2%, eGFRcr_CKD-EPI — by 5,2%, eGFRcys — by 29,5%, eGFRcr-cys — by 19,3%. AKI was diagnosed in 21 people (15,8%). Among the deceased patients (n=12), compared with the survivors, serum creatinine level was higher at baseline and after PCI, cystatin C — after PCI, eGFR of any calculation method was lower, while AKI developed more often. According to multivariate regression analysis, the eGFRcr-cys after PCI and the GRACE risk score were independent predictors of the endpoint. The area under the ROC curve for eGFRcr-cys after PCI was 0,835 [0,712-0,958], while the cut-off point was 38 ml/min/1,73 m2, below which the odds ratio of developing a fatal outcome was 22,2 with a 95% confidence interval of 5,7- 86,8.Conclusion. Estimated GFR determined 24-48 h after PCI based on the combination of serum creatinine and cystatin C using the CKD-EPI 2012 equation was an independent predictor of inhospital mortality in STEMI. The cut-off point of this parameter was 38 ml/min/1,73 m2, below which the death risk increases significantly. The results indicate the viability of introducing novel methods for assessing renal function based on cystatin C to improve the quality of prediction in STEMI. 

EXPRESS: Drug dosing using estimated Glomerular Filtration Rate: Misclassification due to metamizole interference in a creatinine assay

2021 ◽  
pp. 000456322110200
Author(s):  
Luana Bojko ◽  
Gustavo de Paula Ripka ◽  
Laura Mattana Dionísio ◽  
Celso Luiz Borges ◽  
Danielle Cristyane Kalva Borato ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Drug Dosing ◽  
Significant Difference ◽  
The Impact ◽  
Creatinine Measurement

The estimated glomerular filtration rate is a rather important measurement for patients under intensive care, since they often receive several drugs, and impaired renal function may result in misleading dosing. The estimated glomerular filtration is derived from mathematical models using serum creatinine, a measurement that suffers interference of some drugs, such as metamizole. The study intented to evaluate the impact on patient stratification for dose adjustment of two antimicrobials (meropenem and vancomycin) caused by metamizole interference in creatinine measurement by dry chemistry. A cross-sectional study was conducted with a group of 108 hospitalized patients under metamizole prescriptions at fixed intervals. Serum creatinine levels were determined by enzymatic dry chemistry and Jaffé assays and the estimated glomerular filtration rate was calculated through the CKD-EPI equation. Patients were stratified in groups according to their estimated glomerular filtration rate for drug dosing of vancomycin and meropenem. As expected, creatinine values were significantly lower in measurements performed by the dry chemistry method in comparison to Jaffé assay (p<0.0001) when patients are under metamizole treatment. A significant bias (-40.3%) was observed between those two methods, leading to a significant difference (p<0.0001) in patient classification according to renal function using the CKD-EPI equation for dosing adjustment. Thus, during the validity of metamizole treatment, the stratification for drug dosing by the estimated glomerular filtration rate is not reliable if the creatinine measurement is done through dry chemistry. Clinical and laboratory staff must be aware of these limitations and cooperate to optimize pharmacotherapy.

No Correlation Between Lipoprotein(a) and Biochemical Markers of Renal Function in the General Population

2008 ◽  
Vol 132 (9) ◽  
pp. 1436-1438
Author(s):  
Giuseppe Lippi ◽  
Gian Luca Salvagno ◽  
Martina Montagnana ◽  
Giovanni Targher ◽  
Massimo Franchini ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Biochemical Markers ◽  
Impaired Renal Function ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Linear Regression Analysis ◽  
Lipoprotein A

Abstract Context.—Lipoprotein(a) (Lp(a)) is receiving major emphasis as an independent risk factor for cardiovascular disease. Results of studies on Lp(a) in patients with impaired renal function are contradictory, and no information is available on the association between Lp(a) and estimated glomerular filtration rate and cystatin C. Objective.—To evaluate the potential relationships among the biochemical markers creatinine, estimated glomerular filtration rate, and cystatin C and their association with Lp(a) in patients with impaired renal function. Design.—We performed a retrospective analysis using the database of our laboratory to retrieve results of Lp(a), creatinine, and cystatin C tests performed on consecutive outpatients referred by general practitioners for routine blood testing during the last year. Results.—Cumulative results for all of the above-mentioned variables were retrieved for 150 adults older than 35 years. After stratifying Lp(a) values according to thresholds of creatinine, estimated glomerular filtration rate, and cystatin C, no significant differences in Lp(a) concentration were observed in subjects with abnormal values of these biochemical markers. The prevalence of Lp(a) values greater than or equal to 300 mg/L was not significantly different in subjects with biochemical markers suggestive of impaired renal function, as compared with those without such markers. In multivariable linear regression analysis, none of the parameters tested was significantly associated with Lp(a). Conclusions.—We suggest that unless renal function is completely compromised, measurement of biochemical markers of renal function might be relatively unimportant to improve clinical usefulness of Lp(a) testing.

Renal function – estimation of glomerular filtration rate

2006 ◽  
Vol 44 (11) ◽  
Author(s):  
Lothar Thomas ◽  
Andreas R. Huber
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Routine Laboratory ◽  
Prediction Equations

AbstractAssessment and follow-up of renal dysfunction is important in the early detection and management of chronic kidney disease. The glomerular filtration rate (GFR) is the most accurate measurement of kidney disease and is reduced before the onset of clinical symptoms. Drawbacks to the measurement of GFR include the high cost and incompatibility with routine laboratory monitoring. Serum creatinine determination is a mainstay in the routine laboratory profile of renal function. The measurement of serum cystatin C has been proposed as a more sensitive marker for GFR. According to National Kidney Foundation-K/DOQ1 clinical guidelines for chronic kidney disease, serum markers should not be used alone to assess GFR. Based on prediction equations, clinical laboratories should report an estimate of GFR, in addition to reporting the serum value. In this article, information is presented on how best to estimate GFR using prediction equations for adults and for children. Using serum creatinine concentration with the Modification of Diet in Renal Disease (MDRD) study equation offers a suitable estimation of GFR in adults. The cystatin C prediction equation with the use of a prepubertal factor seems superior to creatinine-based prediction equations in children of <14years.Clin Chem Lab Med 2006;44:1295–302.

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