Estimation of renal function in subjects with normal serum creatinine levels: influence of age and body mass index.
BACKGROUND: The Cockcroft-Gault (CG) and simplified Modification of Diet in Renal Disease (MDRD) formulas are the most widely used estimates of renal function. The influence of age and body mass index (BMI) on the performance of these equations was analyzed in 850 subjects with serum creatinine leve...
| Publicado en: | American Journal of Kidney Diseases Vol. 46; no. 2; pp. 233 - 242 |
|---|---|
| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
W B Saunders
8/1/2005
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106363425&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106363425 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02726386 1WY jtl: American Journal of Kidney Diseases issn: 02726386 maglogo: N pubinfo: dt: 8/1/2005 vid: 46 iid: 2 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 106363425 106363425 2009318055 NLM16112041 106363425 ppf: 233 ppct: 9 formats: tig: atl: Estimation of renal function in subjects with normal serum creatinine levels: influence of age and body mass index. aug: au: Verhave JC Fesler P Ribstein J du Cailar G Mimran A affil: Department of Internal Medicine, CHU Montpellier, France. sug: subj: Creatinine Blood Glomerular Filtration Rate Kidney Physiology Adolescence Adult Age Factors Aged Aged, 80 and Over Aging Body Mass Index Comparative Studies Data Analysis, Statistical Descriptive Statistics Diet Female France Male Middle Age Technetium Human Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: BACKGROUND: The Cockcroft-Gault (CG) and simplified Modification of Diet in Renal Disease (MDRD) formulas are the most widely used estimates of renal function. The influence of age and body mass index (BMI) on the performance of these equations was analyzed in 850 subjects with serum creatinine levels less than 1.5 mg/dL (<133 micromol/L). METHODS: Glomerular filtration rate (GFR) was measured as urinary clearance of continuously infused technetium Tc 99m-labeled diethylene triaminopentaacetic acid. Performance was assessed as bias, precision, and accuracy. RESULTS: In the total population, the CG and MDRD calculations based on enzymatic measurement of serum creatinine (which is constantly less than that obtained by using the alkaline picrate [Jaffé] method) significantly underestimated GFR by 4.9 and 12.4 mL/min/1.73 m2 (0.08 and 0.21 mL/s/1.73 m2), respectively. In patients 65 years and older, underestimation by means of the CG formula was enhanced, whereas that by means of the MDRD formula was blunted, compared with the group younger than 65 years (-11.3 versus -3.7 mL/min/1.73 m2 [-0.19 versus -0.06 mL/s/1.73 m2] for CG and -3.7 versus -14.0 mL/min/1.73 m2 [-0.06 versus -0.23 mL/s/1.73 m2] for MDRD). GFR was underestimated to a large extent by means of the MDRD equation irrespective of BMI. Conversely, the underestimation by means of the CG formula found in lean people (-13.0 mL/min/1.73 m2 [-0.22 mL/s/1.73 m2]) was blunted in overweight people (BMI, 25 to 30 kg/m2) and reversed to overestimation (+10.1 mL/min/1.73 m2 [+0.17 mL/s/1.73 m2]) in obese subjects (BMI > 30 kg/m2). CONCLUSION: As suggested by estimations obtained using enzymatic serum creatinine measurement, the MDRD equation may be the estimation of choice in elderly patients, whereas the CG estimate is preferable in subjects younger than 65 years. Nevertheless, when obesity is present, no reliable estimation can be obtained by using the CG or MDRD formula. Copyright © 2005 National Kidney Foundation, Inc. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|